• 대한골관절종양학회지
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• 제4권2호
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• pp.81-87
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• 1998

Although autoclaved autogenous bone reconstruction is one of the established procedures, it may have some problems in bone regeneration and mechanical property. The purpose of this study is to evaluate the efficacy of more biologic and anatomical reconstruction where allograft is not readily available. From Aug.1991 to Feb. 1996 the authors analyzed 32 cases of reconstruction with autogenous low heat treated bone. Autogenous graft sites were humerus 4, tibia 4, pelvis 9, and 15 femur. Average follow-up period was 23(range;12-51) months. There were 49 graft-host junctional sites. Diaphysis was 22, metaphysis 10, and flat bone 17. Average duration of healing for the 38 united sites was 7 months. Average union time for each anatomical area 8 months in 19 diaphysis, 12 months in 7 metaphysis, and 12.7 months in 12 flat bone(pelvis). Eleven nonunion sites consisted of 3 diaphysis(3/22), 3 metaphysis(3/10), and 5 flat bone(5/17). Complications other than nonunion were local recurrence(4), bone resorption(3), graft fracture(2), osteomyelitis(1), metal failure(2), and wound infection(1). Initial bone quality and stable fixation technique was important for union rate. Plate and screw is a good method for diaphyseal lesion. Metaphyseal and flat bone are weak area for rigid fixation and one stage augmentation with iliac bone graft can be a salvage procedure.

• 대한치과의사협회지
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• 제55권11호
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• pp.778-788
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• 2017

Ultrasound sonography(US) is used to evaluate various diseases of oral and maxillofacial region including salivary glands, soft tissue and jaw lesions because of easy accessibility and no hazard of ionizing radiation. Also, US can offer dynamic study showing real-time images during diagnostic or surgical procedure. US images provide accurate information about the internal features of lesions on the jaw prior to surgical treatment. Doppler images are used to visualize the vascular distribution of the lesions and to provide additional information to enhance diagnostic value. It is necessary to evaluate the diagnostic value of US and evaluate its usefulness by looking at clinical cases using US images. Therefore, US imaging may be recommended as an assistant image in evaluating jaw lesions. US images provided accurate information about the internal structure of lesions on the jaw prior to surgical treatment, and diagnostic value was enhanced by visualizing the vascular distribution of the lesion using doppler imaging. We report the protocol and suggest the effectiveness of US for various lesions and US-guided sialography.

• 대한골관절종양학회지
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• 제8권2호
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• pp.58-62
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• 2002

골의 거대세포종은 원발성 골 종양의 5-10%를 차지한다. 주로 20-40세 사이의 연령에서 많으며 90% 이상이 장골에 발생하지만 아주 드물게 수부나 족부 같은 편평골이나 단골에도 발생한다. 주요 증상은 동통이며 종종 병적 골절이나 심지어 연부 조직의 침범이 동반될 수있다. 방사선학적으로 골간단에 음영이 감소된 균질의 골 용해 소견이 보이며 주위에 반응성골 형성은 없다. 치료는 골 종양의 병기에 따라 차이가 있으며 재발율을 줄이고 침범 부위의 기능을 보존할 수 있는 수술적 치료가 필요하다. 비진행성 병기는 소파술후 골이식이나 골시멘트 충전을 할 수 있고 진행성 병기는 광범위 절제술후 관절 고정술이나 종양 대치물로 사지 구제술을 시행한다. 전이, 국소재발을 주기적으로 관찰해야 한다. 저자들은 족부의 외측 설상골에 발생한 거대 세포종을 경험하였기에 보고하고자 한다.

• 대한핵의학회지
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• 제24권1호
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• pp.119-123
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• 1990

Unexpected renal abnormality can be detected on bone scan using Tc-99m-MDP. The purpose of the study is to evaluate the diagnostic significance of diffusely increased bliateral renal uptake on bone scarf. 1,500 boor scan were reviewed and 43 scans which showed diffusely increased bliateral renal uptake were selected for analysis. Laboratory findings for renal and liver function tests including routine urinalysis were reviewed in 43 patients. 26 of 43 case showed abnormality in urinalysis and renal function stud 20 of 43 cases showed abnormal liver function study and 3 of these cases were diagnosed as hepatorenal syndrome later. 13 of those 20 cases had liver cirrhosis with or without hepatoma. 12 of 43 cases showed abnormality both in renal and liver function studies. 2 of 43 cases showed diffusely increased bilateral renal uptake after chemotherapy for cancer but not on previous scans before chemotherapy. 2 of 43 cases showed hypercalcemia and 8 of 43 cases had multifocal bone uptake due to metastasis or benign bone lesion. but the latter showed no hypercalcemia at all. There was no significant correlatrion between increased renal uptake and MDP uptake in soft tissue other than kidneys. This study raised the possibility that the impaired liver and/or renal function may result in diffuse increase of bliateral renal uptake of MDP of unknown mechaninsm. It seems to need further study on this correlation.

• Archives of Reconstructive Microsurgery
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• 제7권1호
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• pp.1-9
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• 1998

From January 1985 to February 1997, 96 patients had undergone the free vascularized groin flap on the upper and lower extremities with microsurgical technique at the department of orthopaedic surgery, Yonsei University College of Medicine. The results were as follows: 1. Average age at the time of operation was 24.9 years. and there were 71 men and 25 women and mean follow up was 62.4 months. 2. The lesion site was 82 cases on the lower extremity: foot(40), leg(20), ankle(13), and 14 cases on the upper extremity: forearm(6), elbow(3), hand(3), wrist(2). 3. The anatomical classification of the superficial circumflex iliac artery was as follows: 1) 39.8% of common origin with superficial inferior epigastric artery, 2) 30.1% of isolated origin and absent superficial inferior epigastric artery, 3) 13.3% of separate origin, 4) 16.9% of origin from the deep femoral artery. 4. There was no statistical significance on arterial anastomosis between end to end and end to side, and on venous anastomosis(end to end) between one vein and two veins. 5. The success rate was average 84.4% in 81 of 96 cases. 6. In the 15 failed cases, the additional procedures were performed: 5 cases of free vascularized scapular flap, 6 cases of full thickness skin graft, 2 cases of cross leg flap, 1 case of latissimus dorsi flap, 1 case of split thickness skin graft. In conclusion, the free vascularized groin flap can be considered as the treatment of choice for the reconstruction of the extensive soft tissue injury on the extremities, and show the higher success rate with the experienced surgeon.

• 한국임상수의학회지
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• 제39권5호
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• pp.258-263
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• 2022

An eight-year-old, intact female, Shih-Tzu, weighing 4.5 kg presented with complaints of anorexia, pale mucous membrane, and vomiting for the past 5 days. On physical examination, nausea, abdominal pain, and melena were noted. On hematologic examination, severe anemia and thrombocytosis were identified. On radiographs examination, soft tissue opacity with small faint mineral opacity mass in the mid-abdomen and two mineral opacity regions in the cranial aspect of mass were identified. Ultrasonographic findings showed thickening of descending duodenal wall with loss of layering and mineralization within the duodenal wall and mesentery adjacent to the duodenal lesion. Computerized tomography showed circumferential wall thickening of descending duodenum with mineralization. Mineralization of the mesentery and mesenteric lymph nodes was identified. Based on the diagnostic imaging, the tentative diagnosis was descending duodenal tumor with dystrophic mineralization. Endoscopy revealed mucosal hemorrhage and erythema within the descending duodenum and stomach. Surgery was performed, and mineralization in the pancreatic tail to duodenum and mesentery was found. Resection of the duodenum, regional lymph node, and mineralized pancreatic region and the duodenal anastomosis were performed. The histologic examination revealed a high-grade undifferentiated duodenal carcinoma with metastases to the regional lymph node and mesentery. The patient was managed with supportive therapy for 8 days and discharged. The patient was followed up for 5 months and there were no complications.

• 한국임상수의학회지
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• 제40권4호
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• pp.283-287
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• 2023

A 10-year-old spayed female beagle dog presented with a 2-month history of third-eyelid elevation in the left eye (OS). Ophthalmic examination revealed slightly diminished corneal and palpebral reflexes along with exophthalmos in the OS. Schirmer's tear test and intraocular pressure values were within the normal range for the OS. Slit-lamp biomicroscopy revealed protrusion of the third eyelid and corneal opacity in the OS. Fundoscopy revealed a prominent black mass in the OS covering the optic nerve. Tapetal hyper-reflectivity was also observed around the mass. Ocular ultrasonography showed a 0.74 × 0.67 cm echogenic posterior segment mass around the optic nerve protruding into the retrobulbar space. Computed tomography revealed a contrast-enhanced soft tissue lesion in the posteromedial aspect of the left eyeball protruding into the retrobulbar region, and the optic nerve was suspected to be involved. No evidence of osteolytic changes in the adjacent bone or distant metastasis was observed. Enucleation was performed to prevent potential metastasis or local invasion of the mass and to relieve discomfort due to exposure to keratopathy resulting from lagophthalmos. Histopathological examination revealed a central choroidal melanocytoma extending into the optic nerve. No local recurrence was detected until 16 months postoperatively.

• 구강회복응용과학지
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• 제39권4호
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• pp.222-228
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• 2023

교모는 치아 간의 접촉으로 인하여 치아 경조직이 소실되는 것으로, 심한 경우 상아질이 노출되어 선택적인 부식과 치아의 과도한 마모가 동반되는데, 이를 cupping이라고 부른다. 이러한 병소를 치료하지 않고 방치할 경우 병소의 크기가 점차 커지게 되어 지지되지 않는 법랑질이 파절되고, 결과적으로 심미성과 저작 기능이 저하된다. 본 증례보고에서는 심한 교모로 인해 cupping과 법랑질 파절이 동반된 환자에서 유기필러가 함유되어 부드러운 성질을 지닌 레진을 이용하여 직접수복을 실시하였다. 6년 후의 경과관찰에서 교합면의 충전은 대부분 탈락하였으나 협측의 충전은 비교적 온전하게 남아 있음을 관찰할 수 있었고, 이런 형태의 레진이 교합력이 크게 가해지는 부위보다는 교합력이 비교적 약하게 가해지는 부위에 적합한 재료임을 확인할 수 있었다.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제50권4호
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• pp.235-240
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• 2024

Lipomas, the most common soft-tissue mesenchymal neoplasms in adults, are characterized by the proliferation of mature white adipocytes without cytologic atypia. Lipomas are rarely observed in the head and neck region. We present a case of resection and orthognathic surgical removal of an intramuscular lipoma of the mandible with involvement of the mandibular ramus and condylar head and neck. An 18-year-old female patient was referred to our hospital for orthognathic surgery for the management of facial asymmetry and mandibular prognathism. The patient did not present with facial swelling, pain, or temporomandibular dysfunction; however, on radiographic examination, including cone-beam computed tomography and magnetic resonance imaging, an infiltrative fatty lesion was observed in the masticator space inside the right mandible, and the adjacent mandible exhibited bone thinning and deformity. Resection of the lipoma was performed along with orthognathic surgery, including a Le Fort I osteotomy for the maxilla and bilateral sagittal split ramus osteotomy (BSSRO). In this case, because the ramus was split using BSSRO, accessing the lipoma intraorally was easy. Consequently, aesthetic scarring was avoided, and no complications, such as unfavorable splitting or pathologic fracture, occurred. Although recurrence has not been observed about 1 year, long-term follow-up should be performed.

• 치위생과학회지
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• 제5권4호
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• pp.199-204
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• 2005

51예의 구강 백반증과 149예의 편평태선의 임상적 발현 양상을 비교 분석하고 병리조직 소견에 따른 환자 예후를 추적하여 임상적 병리조직학적 차이점을 고찰하였다. 분석 결과, 연령 분포와 성별, 임상적 특징, 환자의 임상 증상, 상피 이형성 빈도, 임상 추적 관찰 결과 재발 여부 등에 있어 차이를 나타냈다. 구강 백반증과 편평태선의 임상적인 감별점은 구강백반증의 경우 각화증을 유발한 원인, 즉 협점막과 혀의 측면부위에 가해질 수 있는 만성적 자극, 흡연 등의 원인을 제거했을 때 소실되는지의 여부, 편평태선의 경우 전형적으로 양측성 발생과 다발성 병소, 통증이나 압통, 불쾌감과 작열감 등의 증상, 동반되는 피부 병소 등을 들 수 있다. 임상 진단에서 확진을 하지 못하는 경우는 조직 생검을 통하여 최종 진단을 내릴 수 있다.