• Journal of Periodontal and Implant Science
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• 제32권3호
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• pp.475-488
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• 2002

The purpose of this study is to evaluate histologically the resorption and tissue response of various resorbable collagen membranes used for guided tissue regeneration and guided bone regeneration, using a subcutaneous model on the dorsal surface of the rat. In this study, 10 Sprague-Dawley male rats (mean BW 150gm) were used and the commercially available materials included acellular dermal matrix allograft, porcine collagen membrane, freeze-dried bovine dura mater. Animals were sacrificed at 2,6 and 8 weeks after implantation of various resorbable collagen membranes. Specimens were prepared with Hematoxylin-Eosin stain for light microscopic evaluation. The results of this study were as follows: 1. Resorption : Inner portion of porcine collagen membrane was resorbed a lot at 6 weeks, but its function was being kept for infiltration of another tissues were not observed. Freeze-dried bovine dura mater and acellular dermal allograft were rarely resorbed and kept their structure of outer portion for 8 weeks. 2. Inflammatory reactions : Inflammatory reaction was so mild and foreign body reaction didn't happen in all of resorbable collagen membranes, which showed their biocompatibility. 3. In all of resorbable collagen membranes, multinuclcated giant cells by foreign body reactions were not observed. Barrier membranes have to maintain their function for 4-6 weeks in guided tissue regeneration and at least 8 weeks in guided bone regeneration. According to present study, we can find all of the resorbable collagen membranes kept their function and structure for 8 weeks and were rarely resorbed. Foreign body reaction didn't happen and inflammatory reaction was so mild histologically. Therefore, all of collagen membranes used in this experiment were considered proper resorbable membranes for guided tissue regeneration and guided bone regeneration.

• 대한두개안면성형외과학회지
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• 제14권1호
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• pp.69-72
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• 2013

Lateral eyebrow mass with primary skull lesion are rare in pediatric population. Although epidermoid cyst and dermoid cyst are the most commonly encountered skull lesions in pediatric population, Langerhans cell histiocytosis (LCH) is rarely reported. We report a case of LCH arising from the lateral eyebrow with osteolytic lesion involving the frontal bone. A 5-year-old boy was presented with a hard, fixed mass in his lateral eyebrow. Contrast magnetic resonance imaging revealed inhomogeneous enhancement of the mass with direct invasion of the frontal bone and adjacent dura mater. Under general anesthesia, linear incision at the lateral eyebrow region was made. Intraoperative evaluation revealed hard, fixed and well-defined soft tissue mass. The final extirpated mass was $2.5{\times}2.4cm$ in size, and was accompanied by a $1{\times}1cm$ sized defect on the frontal bone with intact dura mater. The surgical wound was closed primarily by a layer-by-layer fashion. Histologic examination was later performed for definite diagnosis. The histologic examination revealed abnormal proliferation of Langerhans cell with granuloma formation. Radionuclide bone scan and positron emission tomography was taken and revealed free of multi-organ involvement. At 3 months after surgery, natural looking contour at the lateral eyebrow region was observed with no tumor recurrence. Differential diagnosis of the hard and fixed mass at the lateral eyebrow region affecting the primary skull lesion from pediatric population includes epidermoid cyst, dermoid cyst and LCH. Generally, brief physical examination with plain X-ray view can be performed for clinical evaluation, but for a definite diagnosis, contrast MRI may be helpful.

• 대한소아치과학회지
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• 제30권1호
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• pp.171-180
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• 2003

두개골의 성장은 뇌의 발달과 밀접하게 연관되어 있으며, 두개봉합부 주위 여러 조직들사이의 조화로운 상호작용을 필요로 한다. 두개골의 조기융합으로 알려진 craniosynostosis는 이러한 상호작용의 불균형으로 인해 야기될 수 있으며, craniosynostosis의 원인 유전자의 하나로 Msx2가 알려져 있다. Msx1, Msx2, Msx3로 구성되어 있는 Msx 유전자는 homeobox를 포함하고 있는 전사조절인자로, 초파리의 muscle segment homeobox 유전자의 homologue이다. Msx1과 Msx2 유전자들은 척추동물의 발생과정에서 조직 상호작용하는 여러 부위에 서로 겹치는 양상으로 발현되며 기관형성동안 상피-간엽조직 상호작용과 연관되어 나타나고, BMP와 FGF signaling의 표적 유전자들이다. Mouse 두개골의 시상봉합부와 관상봉합부의 초기 형태발생과정에서의 Msx 유전자들의 기능을 알아보기위해, 태생 15일에서 태생 18일까지의 mouse의 두개골을 이용하여 in vivo 실험을, 태생 15.5일 mouse 두개골을 이용하여 in vitro 실험을 시행하였다. 시상두개봉합부에서는, Msx1은 봉합부의 간엽조직과 dura mater에 발현하였으며 Msx2는 두개봉합부와 dura mater에 강하게 발현되었다. 관상두개봉합부에서는 Msx1, Msx2 유전자 모두 강하게 발현되었으며, 골막에서도 관찰할 수 있었고, Msx1이 Msx2보다 좀더 광범위하게 발현되었다. In vitro 실험결과, BMP2 bead 주위로 Msx1 mRNA와 Msx2 mRNA 모두 발현되었으나, FGF2 bead 주위로는 Msx1만 발현되고 Msx2는 관찰되지 않았다. 이 결과들을 종합해 볼 때, Msx1, Msx2 유전자들은 태생기 두개봉합부의 형태발생 및 유지를 조절하는데 중요하며, Msx 유전자들은 거의 유사한 발현양상을 나타내고 있으나 이들 유전자들을 조절하는 상위 siganling에 의해 서로 보완적으로 혹은 독립적으로 기능을 나타내고 있음을 시사해 주고 있다.

• Journal of Korean Neurosurgical Society
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• 제61권4호
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• pp.503-508
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• 2018

Objective : Anterior odontoid screw fixation is a safe and effective method for the treatment of odontoid fractures. The surgical technique is recommended for perforation of the apical cortex of the dens by the lag screw. However, overpenetration of the apical cortex may lead to potentially serious complications such as damages of adjacent vascular and neural structures. The purpose of this study was to assess the role of three-dimensional computed tomography (CT) scan to evaluate the safe margin beyond dens tip to ventral dura for anterior odontoid screw fixation. Methods : We retrospectively analyzed the three-dimensional CT scans of the cervical spines in 55 consecutive patients at our trauma center. The patients included 38 males and 17 females aged between 22 and 73 years (mean age${\pm}$standard deviation, $45.8{\pm}14.2years$). Using sagittal images of 3-dimensional CT scan, the safe margins beyond dens tip to ventral dura as well as the appropriate screw length were measured. Results : The mean width of the apical dens tip was $9.6{\pm}1.1mm$. The mean lengths from the screw entry point to the apical dens tip and posterior end of dens tip were $39.2{\pm}2.6mm$ and $36.6{\pm}2.4mm$. The safe margin beyond apical dens tip to ventral dura was $7.7{\pm}1.7mm$. However, the safe margin beyond the posterior end of dens tip to ventral dura was decreased to $2.1{\pm}3.2mm$, which was statistically significant (p<0.01). There were no significant differences of safe margins beyond dens tip to ventral dura with patient gender and age. Conclusion : Extension by several millimeters beyond the dens tip is safe, if the trajectory of anterior odontoid screw is targeted at the apical dens tip. However, if the trajectory of the screw is targeted to the posterior end of dens tip, extension beyond dens tip may lead to damage immediately adjacent to the vental dura mater.

• Journal of Korean Neurosurgical Society
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• 제59권2호
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• pp.165-167
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• 2016

Langerhans cell histiocytosis (LCH) is a rare disorder histologically characterized by the proliferation of Langerhans cells. Here we present the case of a 13-year-old girl with LCH wherein CT and MRI results led us to an initially incorrect diagnosis of meningioma. The diagnosis was corrected to LCH based on pathology findings. An intracranial mass was found mainly in the dura mater, with thickening of the surrounding dura. It appeared to be growing downward from the calvaria, pressing on underlying brain tissue, and had infiltrated the inner skull, causing a bone defect. The lesion was calcified with the typical dural tail sign. The dural origin of the lesion was verified upon surgical dissection. There are no previous reports in the literature describing LCH of dural origin presenting in young patients with typical dural tail signs and meningioma-like imaging findings. The current case report underscores the need for thorough histological and immunocytochemical examinations in LCH differential diagnosis.

• 대한두개안면성형외과학회지
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• 제16권2호
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• pp.80-83
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• 2015

We present reconstruction of a complicated scalp-dura defect using acellular human dermis and latissimus dorsi myocutaneous free flap. A 62-year-old female had previously undergone decompressive craniectomy for intracranial hemorrhage. The cranial bone flap was cryopreserved and restored to the original location subsequently, but necessitated removal for a methicillin-resistant Staphylococcal infection. However, the infectious nidus remained in a dermal substitute that was left over the cerebrum. Upon re-exploration, this material was removed, and frank pus was observed in the deep space just over the arachnoid layer. This was carefully irrigated, and the dural defect was closed with acellular dermal matrix in a watertight manner. The remaining scalp defect was covered using a free latissimus dorsi flap with anastomosis between the thoracodorsal and deep temporal arteries. The wound healed well without complications, and the scalp remained intact without any evidence of cerebrospinal fluid leak or continued infection.

• Journal of Korean Neurosurgical Society
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• 제48권6호
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• pp.534-537
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• 2010

Spinal extradural meningeal cyst has been rarely reported, whose etiologies are assumed to be the communication of cerebrospinal fluid (CSF) between intradural subarchnoid space and cyst due to the congenital defect in dura mater. Although the CSF communication due to this defect can be found, in most case, few cases in which there is a lack of the communication have also been reported. We report a case of the huge extradural meningeal cyst occurring in the thoracolumbar spine (from T10 to L2) where there was a lack of the communication between the intradural subarachnoid space and cyst in a 46-year-old man who presented with symptoms that were indicative of progressive paraparesis and leg pain. The patient underwent laminectomy and cyst excision. On intraoperative findings, the dura was intact and there was a lack of the communication with intradural subarachnoid space. Immediately after the surgery, weakness and leg pain disappeared shortly.

• 한국CDE학회논문집
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• 제17권6호
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• pp.436-442
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• 2012

Traumatic loading during car accidents or sports activities can lead to cervical spinal cord injury. Experiments in spinal cord injury research are mainly carried out on rabbit or rat. Finite element models that include the rat cervical spinal cord and adjacent soft tissues should be developed for efficient studies of mechanisms of spinal cord injury. Images of a rat were obtained from high resolution MRI scanner. Polygonal surfaces were extracted structure by structure from the MRI data using the ITK-SNAP volume segmentation software. These surfaces were converted to Non-uniform Rational B-spline surfaces by the INUS Rapidform rapid prototyping software. Rapidform was also used to generate a thin shell surface model for the dura mater which sheathes the spinal cord. Altair's Hypermesh pre-processor was used to generate finite element meshes for each structure. These processes in this study can be utilized in modeling of other biomedical tissues and can be one of examples for reverse engineering on biomechanics.

• Investigative Magnetic Resonance Imaging
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• 제21권3호
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• pp.183-186
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• 2017

A 7-year-old boy, diagnosed with an arachnoid cyst and subdural effusion on initial MRI, was admitted with left limb weakness and no history of head trauma. A subsequent follow-up MRI showed different stages of hematoma within multilayered enhancing membranes and in the arachnoid cyst, which was separated by the cerebrospinal fluid cleft. Craniotomy and fenestration of the cyst wall and hematoma removal were performed. The patient was diagnosed as a having a hemorrhagic rupture of an arachnoid cyst into the intradural space, probably via some one-way valve-like defect, based on the MRI and surgical findings. The MRI features and possible mechanism of this rare disease are discussed within the literature review.

• Journal of Korean Neurosurgical Society
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• 제37권3호
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• pp.238-240
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• 2005

Meningioma is usually known to occur stuck to the dura mater, but extradural meningioma occurs rarely. Most of the extradural meningiomas are located in the head and neck and we report a case of the primary intraosseous meningioma in the orbit. A 50-year old woman presented with the left eye hyperemia and exophthalmos. Neuroimaging modalities showed hyperostosis at the left sphenoid and orbital wall. On microscopic view, spindle cells and psammoma bodies between the woven bones were observed. The origin of the intraosseous meningioma is explained with various potent possibilities and differential diagnosis thoroughly explored.