• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.29 no.6
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• pp.379-391
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• 2003

The present study was undertaken to evaluate bone regenerative capacity around titanium screw implants placed in irradiated rat's tibiae. At one week after single 15-Gy dose irradiation, miniaturized titanium screw implants were inserted into anterior aspect of the upper tibia of rats weighing 200-250g. Seventy rats were involved: 35 rats were control and 35 rats radiation group. The rats were killed at different intervals as 1, 2, 3, 4, 6, 8, 12 weeks after implantation for histologic observation, histomorphometric analysis and immunohistochemical study with fibronectin and CD34 antibody. 1. Histologically, various stages of bone maturation and ossification can be seen at 4 weeks and regenerated bone close to edges demonstrates more advanced calcification, and network of new bone are well formed at 12 weeks in non-irradiated group. In contrast, active bone formation with increased contact of newly formed bone to implant surface was noted at 4 weeks and a significant amount of new bone formation and bone-implant contact is oberved at 12 weeks in irradiated group. 2. Histomorphometrical analysis confirmed these histologic findings. A significant difference in implant-bone contact and bone density was measured between the control and radiation group. Mean MBD was 62.2% in control group and 27.5% in radiation group, mean MBIC was 86.6% in control group and 47.7% in radiation group, and mean TBIC was 87.3% in control group and 45.6% in radiation group at 12 weeks after implantation. 3. In immunohistochemical study with fibronectin and CD34, radiation reduced hematopoietic progenitor cells severely and disturbed differentiation of osteoblast in bone marrow. The results of this study revealed bone healing capacity around implant after radiation therapy was severely impaired and irradiation reduces the capacity for osseointegration of titanium implants. Many factors including radiation dose, period between radiation and implantation, bone quality, time elapse between first and second surgery, type of prosthetics and hyperbaric oxygen therapy must be considered carefully in postradiation implantation.

• Journal of the korean academy of Pediatric Dentistry
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• v.38 no.1
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• pp.95-100
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• 2011

Fibrodysplasia ossificans progressiva(FOP) is characterized by episodes of permanent heterotopic ossifications of soft tissues throughout the body. FOP is inherited in an autosomal dominant pattern, but most cases result from new mutations in the ACVR1 gene. Even minimal trauma can cause permanent ossifications of soft tissues and give rise to complications following routine dental care. Dental block anesthesia, severe stretching of the jaw and biopsies are all contraindicated in children with FOP. There is no effective treatment. Since the prevalence of FOP is very low and most patients with FOP are misdiagnosed during childhood, they undergo dangerous and unnecessary treatment that can lead to permanent harm. For patients with FOP, early diagnosis and prevention of complications are most important. This study aims at contemplating the characteristic features and consideration factors for the dental treatment of FOP patients in relation to the case of an eight years-and-one month old boy who was referred to Pediatric Dentistry due to prolonged retention of mandibular right and left deciduous central incisors after being diagnosed with sporadic FOP at Pediatric Orthopaedics, Seoul National University Hospital, and received dental treatment without the exacerbation of the FOP symptoms.

• Journal of Ginseng Research
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• v.36 no.2
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• pp.161-168
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• 2012

The abnormal maturation and ossification of articular chondrocytes play a central role in the pathogenesis of osteoarthritis (OA). Inhibiting the enzymatic degradation of the extracellular matrix and maintaining the cellular phenotype are two of the major goals of interest in managing OA. Ginseng is frequently taken orally, as a crude substance, as a traditional medicine in Asian countries. Ginsenoside $Rb_1$, a major component of ginseng that contains an aglycone with a dammarane skeleton, has been reported to exhibit various biological activities, including anti-inflammatory and anti-tumor effects. However, a chondroprotective effect of ginsenoside $Rb_1$ related to OA has not yet been reported. The purpose of this study was to demonstrate the chondroprotective effect of ginsenoside $Rb_1$ on the regulation of pro-inflammatory factors and chondrogenic genes. Cultured rat articular chondrocytes were treated with 100 ${\mu}M$ ginsenoside $Rb_1$ and/or 500 ${\mu}M$ hydrogen peroxide ($H_2O_2$) and assessed for viability, reactive oxygen species production, nitric oxide (NO) release, and chondrogenic gene expression. Ginsenoside $Rb_1$ treatment resulted in reductions in the levels of pro-inflammatory cytokine and NO in $H_2O_2$-treated chondrocytes. The expression levels of chondrogenic genes, such as type II collagen and SOX9, were increased in the presence of ginsenoside $Rb_1$, whereas the expression levels of inflammatory genes related to chondrocytes, such as MMP1 and MMP13, were reduced by approximately 50%. These results suggest that ginsenoside $Rb_1$ has potential for use as a therapeutic agent in OA patients.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.19 no.3
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• pp.265-286
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• 1997

Bone morphogenetic proteins(BMPs) are a group of transforming growth factor beta(TGF-${\beta}$)-related factors and multifunctional proteins, especially the only known biologic factors capable of inducing endochondral bone formation at an extraskeletal site. This study was performed to investigate the effect of the partially purified porcine BMP(pBMP) at an ectopic site. PBMP was partially purified from porcine bone matrix and its activity was monitored by an in vivo bioassay. The purification method utilized extraction of the bone-inducing activity with 4M guanidine, followed by chromatography on heparin-Sepharose. Active fractions were assayed by sodium dodecyl sulfate-polyacrylamide gel electrophoresis. And the fractions were reconstituted with inactive insoluble collagenous bone matrix from rats, acid soluble type I collagen from rat tail and chondroitin-6-sulfate sodium salt and implanted into the pectroralis muscle pouches of Sprague-Dawley rats. And the carrier complex was implanted on the opposite side as control. The rats were sacrificed at the day of 1st, 3rd, 5th, 7th, 11th, 14th and 21st after implantation and examined histologically, radiologically and biochemically. And alkaline phosphatase activity and calcium content were used as indices of bone formation. The results were as follows ; 1. Active fractions were localized in a zone between 31 and 40 KDa on SDS-PAGE. 2. The implanted 3.0mg of the partially purified pBMP induced cartilage and bone in the muscle tissue of rats through an endochondral ossification process. 3. Inactive insoluble bone matrix, type I collagen and chondroitin-6-sulfate have functioned as carriers for pBMP, but revealed some foreign body reactions. 4. Soft X-ray didn't reveal significant change between the experimental and the control group. 5. The alkaline phosphatase activities in the experimental group of 5th, 7th, 11th, 14th and 21st were increased significantly compared with control (p<0.01) with the peak in the group of 11th day. 6. With time, the calcium content of the experimental group increased. And the calcium contents in the experimental group of 11th, 14th and 21st were increased significantly compared with control (p<0.01).

• The Journal of the Korean bone and joint tumor society
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• v.12 no.2
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• pp.126-130
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• 2006

Liposclerosing myxofibrous tumor (LSMFT) is a fibro-osseous lesion of the bone with a marked predilection for the intertrochanteric region of the proximal femur. It is characterized by a complex mixture of histological elements including fibrous dysplasia-like features, myxofibrous tissue, lipomatous area, ischemic ossification, xanthoma cells and pseudo-Paget's bone. Though some consider LSMFT as a variant of the fibrous dysplasia, intraosseous lipoma, or other benign osseous lesions, recently LSMFT is emerged as a genuine clinicopathologic entity. We experienced a 48-year female patient with typical histologic and radiologic findings of LSMFT. It was located at the intertrochanteric area of the femur. Radiologically, the lesion was radiolucent and ground-glass appearance with sclerotic rim in the plain film and magnetic resonance imaging. Histologically, myxofibrous tissue, lipomatous area and fibrous dysplasia-like features were predominant findings.

• The Journal of the Korean bone and joint tumor society
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• v.12 no.2
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• pp.103-111
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• 2006

Purpose: Sternocostoclavicular hyperostosis (SCCH) is a disease of unknown etiology, which is characterized by periosteal reaction and endosteal hyperossification of the sternum, clavicles and upper ribs as well as ossification of the surrounding soft tissue. SCCH is a well recognized but uncommon condition which is important differential diagnosis to consider to avoid misdiagnosis and to differentiate the condition from malignant process. But few studies have reported long-term clinical result of SCCH. We report long-term clinical result of SCCH. Materials and Methods: From 1986 to 2000, 17 cases of SCCH were followed up over two to 14 years. We evaluated the radiologic, pathologic and clinical results. Results: Four men and thirteen women were studied. The age when first symptom appeared were raged from17 to 60(average-48.7) There are no specific bacteriological, serological or histological finding. Usually a permanent increase in the erythrocyte sedimentation rate is found. The radiological examination showed the signs of proliferate destructive arthritis in most case. The majority of patients respond to NSAIDs and antibiotics. Conclusion: Sternocostoclavicular hyperostosis is uncommon benign condition, but important condition in the differential diagnosis of inflammatory or malignant process of this joint.

• Archives of Craniofacial Surgery
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• v.19 no.3
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• pp.181-189
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• 2018

Background: Autogenous bone grafts have several limitations including donor-site problems and insufficient bone volume. To address these limitations, research on bone regeneration is being conducted actively. In this study, we investigate the effects of a three-dimensionally (3D) printed polycaprolactone (PCL)/tricalcium phosphate (TCP) scaffold on the osteogenic differentiation potential of adipose tissue-derived stem cells (ADSCs) and bone marrow-derived stem cells (BMSCs). Methods: We investigated the extent of osteogenic differentiation on the first and tenth day and fourth week after cell culture. Cytotoxicity of the 3D printed $PCL/{\beta}-TCP$ scaffold was evaluated by 3-(4,5-dimethylthiazol-2-yl)-5-(3-carboxymethoxyphenyl)-2-(4-sulfophenyl)-2H-tetrazolium assay, prior to osteogenic differentiation analysis. ADSCs and BMSCs were divided into three groups: C, only cultured cells; M, cells cultured in the 3D printed $PCL/{\beta}-TCP$ scaffold; D, cells cultured in the 3D printed $PCL/{\beta}-TCP$ scaffold with a bone differentiation medium. Alkaline phosphatase (ALP) activity assay, von Kossa staining, reverse transcription-polymerase chain reaction (RT-PCR), and Western blotting were performed for comparative analysis. Results: ALP assay and von Kossa staining revealed that group M had higher levels of osteogenic differentiation compared to group C. RT-PCR showed that gene expression was higher in group M than in group C, indicating that, compared to group C, osteogenic differentiation was more extensive in group M. Expression levels of proteins involved in ossification were higher in group M, as per the Western blotting results. Conclusion: Osteogenic differentiation was increased in mesenchymal stromal cells (MSCs) cultured in the 3D printed PCL/TCP scaffold compared to the control group. Osteogenic differentiation activity of MSCs cultured in the 3D printed PCL/TCP scaffold was lower than that of cells cultured on the scaffold in bone differentiation medium. Collectively, these results indicate that the 3D printed PCL/TCP scaffold promoted osteogenic differentiation of MSCs and may be widely used for bone tissue engineering.

• Clinics in Shoulder and Elbow
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• v.17 no.2
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• pp.68-76
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• 2014

Background: Recently, reverse total shoulder arthroplasty (RTSA) has been accepted as a main treatment option in irreparable massive rotator cuff tear with cuff arthropathy. The purpose of this study was to evaluate the early complication incidence and the preliminary clinical results of RTSAs performed in single institute. Methods: Fifty-seven RTSAs (56 patients) were performed between April 2011 and March 2013. The indications for RTSA were cuff tear arthropathy and irreparable massive rotator cuff tear with or without pseudoparalysis. Exclusion criteria were revision, preoperative infections and fractures. At final follow-up, 45 shoulders were enrolled. Mean follow-up duration was 12.5 months (range, 6-27 months). The mean age at the time of surgery was 73.6 years (range, 58-87 years). All the patients were functionally accessed via Constant score, American Shoulder and Elbow Surgeons (ASES) score, pain and functional visual analogue scale (VAS) scores and active range of motion. Complications were documented as major and minor. Major complications include fractures, infections, dislocations, nerve palsies, aseptic loosening of humeral or glenoid components, or glenoid screw problems. Minor complications include radiographic scapular notching, hematomas, heterotopic ossification, algodystrophy, intraoperative dislocations, intraoperative cement extravasation, or radiographic lucent lines of the glenoid. Results: The mean Constant score increased from 31.4 to 53.8 (p < 0.001). The pain and functional VAS scores improved (5.2 to 2.7, p < 0.001, 4.0 to 6.7, p < 0.001) and active forward flexion improved from $96.9^{\circ}$ to $125.6^{\circ}$ (p = 0.011). One or more complications occurred in 16 (35.6%) of 45 shoulders, with one failure (2.2%) resulting in the removal of implants by late infection. The single most common complication was scapular notching (9 [20%]). There were 4 (8.9%) axillary nerve palsies postoperatively (n=3: transient n. palsy, n=1: Symptom existed at 11 months postoperatively but improving). Conclusions: In a sort term follow-up, RTSA provided substantial gain in overall function. Most common early complications were scapular notching and postoperative neuropathy. Although overall early complication rate was as high as reported by several authors, most of the complications can be observable without compromise to patients' clinical outcome. Long term follow-up is required to clarify the clinical result and overall complication rate.

• Journal of Korean Neurosurgical Society
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• v.60 no.5
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• pp.577-583
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• 2017

Objective : Laminoplasty is an effective surgical method for treating cervical degenerative disease. However, postoperative complications such as kyphosis, restriction of neck motion, and instability are often reported. Despite sufficient preoperative lordosis, this procedure often aggravates the lordotic curve of the cervical spine and straightens cervical alignment. Hence, it is important to examine preoperative risk factors associated with postoperative kyphotic alignment changes. Our study aimed to investigate preoperative radiologic parameters associated with kyphotic deformity post laminoplasty. Methods : We retrospectively reviewed the medical records of 49 patients who underwent open door laminoplasty for cervical spondylotic myelopathy (CSM) or ossification of the posterior longitudinal ligament (OPLL) at Pusan National University Yangsan Hospital between January 2011 and December 2015. Inclusion criteria were as follows : 1) preoperative diagnosis of OPLL or CSM, 2) no previous history of cervical spinal surgery, cervical trauma, tumor, or infection, 3) minimum of one-year follow-up post laminoplasty with proper radiologic examinations performed in outpatient clinics, and 4) cases showing C7 and T1 vertebral body in the preoperative cervical sagittal plane. The radiologic parameters examined included C2-C7 Cobb angles, T1 slope, C2-C7 sagittal vertical axis (SVA), range of motion (ROM) from C2-C7, segmental instability, and T2 signal change observed on magnetic resonance imaging (MRI). Clinical factors examined included preoperative modified Japanese Orthopedic Association scores, disease classification, duration of symptoms, and the range of operation levels. Results : Mean preoperative sagittal alignment was $13.01^{\circ}$ lordotic; $6.94^{\circ}$ lordotic postoperatively. Percentage of postoperative kyphosis was 80%. Patients were subdivided into two groups according to postoperative Cobb angle change; a control group (n=22) and kyphotic group (n=27). The kyphotic group consisted of patients with more than $5^{\circ}$ kyphotic angle change postoperatively. There were no differences in age, sex, C2-C7 Cobb angle, T1 slope, C2-C7 SVA, ROM from C2-C7, segmental instability, or T2 signal change. Multiple regression analysis revealed T1 slope had a strong relationship with postoperative cervical kyphosis. Likewise, correlation analysis revealed there was a statistical significance between T1 slope and postoperative Cobb angle change (p=0.035), and that there was a statistically significant relationship between T1 slope and C2-C7 SVA (p=0.001). Patients with higher preoperative T1 slope demonstrated loss of lordotic curvature postoperatively. Conclusion : Laminoplasty has a high probability of aggravating sagittal balance of the cervical spine. T1 slope is a good predictor of postoperative kyphotic changes of the cervical spine. Similarly, T1 slope is strongly correlated with C2-C7 SVA.

• Journal of Trauma and Injury
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• v.32 no.2
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• pp.80-85
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• 2019

Purpose: To compare the time intervals to magnetic resonance imaging (MRI) and surgical treatment in patients having traumatic cervical spinal cord injury (SCI) with and without bony lesions. Methods: Retrospectively analyzed adult patients visited Kyungpook National University Hospital and underwent surgical treatment for cervical SCI within 24 hours. The patients who were suspected of having cervical SCI underwent plain radiography and computed tomography (CT) upon arrival. After the initial evaluation, we evaluated the MRI findings to determine surgical treatment. Waiting times for MRI and surgery were evaluated. Results: Thirty-four patients were included. Patients' mean age was 57 (range, 23-80) years. Patients with definite bony lesions were classified into group A, and 10 cases were identified (fracture-dislocation, seven; fracture alone, three). Patients without bony lesions were classified into group B, and 24 cases were identified (ossification of the posterior longitudinal ligament, 16; cervical spondylotic myelopathy, eight). Mean intervals between emergency room arrival and start of MRI were 93.60 (${\pm}60.08$) minutes in group A and 313.75 (${\pm}264.89$) minutes in group B, and the interval was significantly shorter in group A than in group B (p=0.01). The mean times to surgery were 248.4 (${\pm}76.03$) minutes in group A and 560.5 (${\pm}372.56$) minutes in group B, and the difference was statistically significant (p=0.001). The American Spinal Injury Association scale at the time of arrival showed that group A had a relatively severe neurologic deficit compared with group B (p=0.046). There was no statistical significance, but it seems to be good neurological recovery, if we start treatment sooner among patients treated within 24 hours (p=0.198). Conclusions: If fracture or dislocation is detected by CT, cervical SCI can be easily predicted resulting in MRI and surgical treatment being performed more rapidly. Additionally, fracture or dislocation tends to cause more severe neurological damage, so it is assumed that rapid diagnosis and treatment are possible.