• Journal of Yeungnam Medical Science
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• v.14 no.1
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• pp.245-261
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• 1997

Slipped capital femoral epiphysis(SCFE) is a disorder in which there is a gradual or acute disruption through the capital physeal plate. The physiolysis is through a widened zone of hypertrophy, which is weakened due to altered chondrocytic maturation and endochondral ossification. The cause or causes of SCFE remain uncertain. The association of obesity and adolescent age with growth rate are predisposing factors. The possibility that most patients with subclinical hormonal abnormality were proved. The goal of treatment of slipped capital femoral epiphysis is to restore the function of the hip and delay the development of degenerative osteoarthrosis by prevention of additional displacement of the epiphysis. We report 10 patients(12hips) with SCFE who were treated by surgical means and followed along for more than one year, at Yeungnam University Hospital, from 1989 to 1996. There were six boys and four girls. The average age at operation was 11.8 years. Seven cases occurred in the left hip, one case in the right and 2 cases had bilateral involvement, five cases had a history of minor trauma on affected hip. Among hormonally studied six patients, panhypopituitarism patient was one case; decreased testosterone, two; decreased growth hormone, two; and decreased thyroid hormone, one. According to clinical stage, two cases were the acute type; five cases, acute on chronic type; and three cases, chronic type. On the radiological grades of slipping, mild slippage were nine hips; moderate, one; and severe, two. The eleven hips were treated by pin fixation in situ, and one, by cuneiform osteotomy. On the average follow-up of 2.6 years, ten hips were excellent or good functional results, two hips were failure.

• Clinics in Shoulder and Elbow
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• v.16 no.1
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• pp.33-39
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• 2013

Purpose: The aim of this study is to evaluate the clinical result of intra-articular fractures of the distal humerus (AO type C) in elderly osteoporotic patients treated with double tension band osteosynthesis. Materials and Methods: From January 2006 to December 2010, 10 elderly osteoporotic patients(1 male, 9 females) with intra-articular fractures of the distal humerus (AO type C) were treated with double tension band osteosynthesis. The mean age of patients at the time of surgery was 74.6(66~84) years and the mean follow-up period was 39.2(20~74) months. The fracture union and complications were assessed and the functional result was evaluated by the rating system of Jupiter et al. and the Mayo elbow performance index. Results: Bone union was achieved in all patients with no secondary displacement. The mean time for union was 16.6(13~22) weeks. The average postoperative arc of elbow flexion was 119(100~140) degrees with a mean flexion contracture of 8.5(0~15) degrees. The recovery in two patients was rated as excellent, in 7 as good, and in 1 as fair in terms of the Mayo elbow performance index with average value of 82(70~90) points. Seven patients were rated as excellent, 1 as good, and 2 as fair in terms of the rating system of Jupiter et al. Changing tension band wiring was performed in one patient as skin irritation was noticed due to tension band knots. Heterotopic ossification developed in one patient but had no symptom. Conclusion: Double tension band osteosynthesis in intra-articular fractures of distal humerus (AO type C) in elderly osteoporotic patients can provide sufficient and secure stability to allow early rehabilitation.

• The korean journal of orthodontics
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• v.29 no.2 s.73
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• pp.183-195
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• 1999

Growth and development evaluation of patients with growth potential is of great importance for orthodontic treatment planning. Timing of orthodontic intervention greatly depends on one's developmental status, thus if there is a difference in skeletal maturation among malocclusion types different treatment timing should be applied. The objective of this study was to evaluate and compare skeletal maturation among different malocclusion types. The samples used in this study was 38 Class I, 36 Class II and 33 ClassIII females aging from 8 to 10 years. Handwrist X-rays were taken with 6 month interval till 12-13 years of age. The results were as follows. 1. There was no skeletal maturity difference among different malocclusion types. 2. The hamular process of hamate was observed at $9.16{\pm}0.72$ years, pisiform bone at $9.13{\pm}0.71$ years and the ulnar sesamoid at $10.34{\pm}0.84$ years. 3. The timing of epiphyseal capping on the third finger was $10.96{\pm}0.80$ years for distal phalanx and $11.27{\pm}0.87$ years for middle phalanx, $11.12{\pm}0.85$ years for proximal phalanx of the first finger, $11.21{\pm}0.82$ years for radius and $11.62{\pm}0.85$ years for middle phalanx of the fifth finger. 4. The appearance of pisiform bone showed high correlation with appearance of hamular process of hamate(r=0.91) and ulnar sesamoid bone appearance showed high correlation with advanced ossification of hamular process(r=0.86). Timing of epiphyseal capping among different parts showed high correlation(r=0.80-0.90). 5. The shape of middle phalanx of the fifth finger showed the highest variability ($20.6\%$).

• Journal of Acupuncture Research
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• v.26 no.2
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• pp.159-170
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• 2009

Backgrounds and Objectives: A fracture means a loss of continuity in the substance of bone. Bone differs from other musculoskeletal tissue due to its ability to repair and heal itself without leaving a scar. The cutter head has multinucleated osteoclast cells to resorb the dead bone. The tail, with its conical surface, is lined with osteoblast cells laying down new bone. The conjugation of fracture is a unique biological process regulated by a complex array of signaling molecules and proinflammatory cytokines. Pyritum, one of the important prescriptions in the oriental medicine, has been used for conjugation fracture. The purpose of this study is to evaluate the effects of administration of Pyritum on activation of osteoblast cells in human body & on tibia bone fracture in mice. Materials and Methods : Four weeks aged 30 female DBA mice were used for this study. They were divided three groups, normal group, control group(fracture elicitate mice: FE group) and experimental group(Pyritum administered mice group after fracture elicitation : PA group). Left tibia bones of mice in FE and PA groups were fractured by bone cutters. MG-63 cells in human body th Pyritum in the ratio of 1 mg/m${\ell}$, and the cells were further incubated for 24 hours. Activation of osteoblast was identified using osteopontin, FGF in vitro test. In vivo test, regeneration of fractured tibia through the morphological changes was observed, and also activation of inflammation through NF-${\kappa}$B p65, iNOS, COX-2, osteoblast through osteopontin, FGF and osteoblast's proliferation in each group was measured. Results and Conclusions : 1. In vitro test for activation of osteoblast cells in human body by Pyritum, osteopontin and FGF production were remarkably increased in Pyritum treated MG-63 cells. 2. In regeneration of fractured tibia by Pyritum, fractured area in external tibia morphology was decreased more in the PA group than that of the FE group. Osteogenesis in fractured area was increased more in the PA group than that of the FE group. Also, endochodrial ossification in central area of fracture and osteoid in lateral area of fracture were increased more in the PA group than those of the FE group. 3. In activation of inflammation by Pyritum administered, activation of NF-${\kappa}$B p65, increase of iNOS and COX-2 production were higher in the PA and the FE groups than those of the control group. Especially, the PA group showed higher activation and increase than those of the FE group. 4. In activation of osteoblast by Pyritum, increase of osteopontin, FGF and osteoblast's proliferation were higher in the PA and the FE groups than those of the control group. Especially, the PA group showed higher increase and proliferation than those of the FE group.

• Toxicological Research
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• v.4 no.1
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• pp.55-84
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• 1988

This study was carried out to investigate the teratological potential of azinphos-methyl in the rat fetuses and to establish the nature of the effects on organogenesis and intrauterine development. The Sprague-Dawley female rats (180-210g) without previous litter were used in this study. Azinphos-methyl dosages of 0.094mg/kg, 0.4mg/kg, 1.5mg/kg were selected based on the acute intragastric $LD_{50}$ of 15mg/kg in the rat. Azinphos-methyl in water (Treatment Group), non-treatment control (Negative Control), water control (Sham Control), were administered by oral route and aqueous solution of acetyl salicylic acid (Positive Control) was administered by gavage at rate of 10 ml/kg of body weight from day 6 through 15. The results obtained were summarized as follows. 1. Decreased body weight of dams was observed in animals treated with aspirin and azinphos-methyl 1.5 mg/kg from day 7 through 14. (P<0.01) 2. There was an apparent decrement in the absolute liver weight in the azinphos-methyl 1.5 mg/kg treated group (P<0.05). However, the absolute and relative kidney weight in aspirin group (P<0.05, P<0.01) and the absolute and relative ovary weight in aspirin, azinphos-methyl treatment groups (P<0.01, P<0.05) were increased. 3. Decreased protein contents of dam's liver was observed in the aspirin and high dose azinphos-methyl treated group of animals (P<0.01). 4. The number of male-female ratio per dam increased in azinphos-methyl 1.5 mg/kg group but there was an apparent decrement in the body weight of fetuses in aspirin and high dose azinphos-methyl group (P<0.01, P<0.05). Total immature and resorbed fetuses were increased in aspirin group and the number of dead fetuses were also increased in azinphos-methyl 1.5mg/kg treated group of animals. (P<0.01, P<0.05). 5. In soft tissue defects, diaphragmatic hernia in diaphragm, anophthalmia, enlarged olfactory bulb, hydrocephalus, absence of third and lateral ventricle in skull, hydronephrosis in kidney, atrophy of left ventricle wall, enlarged apex in heart were observed. Especially, defects of diaphragm, heart and eye ball showed peak incidences in the high dose azinphosmethyl and aspirin group. (P<0.01). 6. Variations in the ossification patterns of skull, sternebrae, tail, forelimbs and hindlimbs showed peak incidences in the aspirin and high dose azinphos-methyl group. (P<0.01). 7. In the developmental indices of offspring, the mortality of aspirin and azinphos-methyl 1.5mg/kg treated group was higher than that of negative control. And, there was an apparent decrement in the body weight of fetuses (P<0.01) and considerable differences were obtained in pivoting, development of fur, auditory function, vision, quadrupled muscle development and testes descent in aspirin and azinphos-methyl 1.5mg/kg group. (P<0.01).

• Journal of the korean academy of Pediatric Dentistry
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• v.30 no.3
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• pp.391-405
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• 2003

Craniosynostosis, known as a premature fusion of cranial sutures, is a developmental disorder characterized by precocious differentiation and mineralization of osteoblasts in the calvarial sutures. Recent genetic studies have demonstrated that mutation in the homeobox gene Msx2 causes Boston-type human craniosynostosis. Additionally, the phenotype of Dlx5 homozygote mutant mouse presents craniofacial abnormalities including a delayed ossification of calvarial bone. Furthermore transcription of osteocalcin, a mature osteoblast marker, is reciprocally regulated by the homeodomain proteins Msx2 and Dlx5. These facts suggest important roles of osteocalcin, Msx2 and Dlx5 genes in the calvarial bone growth and suture morphogenesis. To elucidate the function of these molecules in the early morphogenesis of mouse cranial sutures, we have first analyzed by in situ hybridization the expression of osteocalcin, Msx2 and Dlx5 genes in the developing parietal bone and sagittal suture of mouse calvaria during the embryonic (E15-E18) stage. Osteocalcin mRNA was found in the periosteum of parietal bones from E15, and gradually more highly expressed with aging. Msx2 mRNA was intensely expressed in the sutural mesenchyme, osteogenic fronts and mildly expressed in the dura mater during the embryonic stage. Dlx5 mRNA was intensely expressed osteogenic fronts and the periostem of parietal bones. To further examine the upstream signaling molecules of transcription factor Msx2 and Dlx5, we have done in vitro experiments in E15.5 mouse calvarial explants. Interestingly, implantation of BMP2-, BMP4-soaked beads onto the osteogenic fronts after 48 hours organ culture induced etopic expressions of Msx2 and Dlx5 genes. On the other hand, overexpression of $TGF{\beta}1$, GDF-6, -7, FGF-2, -4 and Shh did not induce the expression of Msx2 and Dlx5. Taken together. these data indicate that transcription factor Msx2 and Dlx5 play critical roles in the calvarial bone and suture development, and that BMP siganling is involved in the osteogenesis of calvarial bones and the maintenance of cranial sutures through regulating these two transcriotpn factors. Furthermore, different expression patterns between Msx2 and Dlx5 suggest their specific functions in the osteoblast differentiation.

• Proceedings of the KOR-BRONCHOESO Conference
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• 1982.05a
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• pp.16.2-16
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• 1982

The palatine tonsils which are located in entrance of digestive and upper respiratory tracts are the most important organ in anatomical and functional structures of the pharyngeal lymphatic tissues. As for function of the tonsil, there have been many suspected theories that were included hematopoietic, hormonal, digestive function and production of vitamin, entry of bacteria with other antigenous materials and defence mechanism of which has taken charge by Virchow in 1860 in past. But among these theories, in recently, defence mechanism of the tonsil was strongly accepted immunologically. For the purpose of elucidating immune response of the tonsil, the author observed serum immunoglobulin levels, peripheral total lymphocyte counts and populations of T, B and Null lymphocytes before and after tonsillectomy in 30 cases of patients with chronic tonsillitis and 29 cases of healthy controls. The results obtained were as follows; 1) Serum Ig M level was significantly higher in patient group than in control group but was not significantly different preoperative from postoperative patient group. 2) Population of T-lymphocyte more significantly decreased in patient group than in control group but it was not significantly different preoperative from postoperative patient group. 3) Population of B-lymphocyte more significiantly increased in patient group than in control group but it was not significantly different preoperative from postoperative patient group. On the basis of these results, it may be suggested that tonsil play partially a role in the immune response of human.

• Journal of the korean academy of Pediatric Dentistry
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• v.30 no.2
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• pp.308-319
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• 2003

Mechanical forces are known to have an effect on bone formation, maintenance and remodeling, and there is evidence that the development of the mandibular condyle in the rat or mouse is influenced by altered functional force. However, studies are lacking in molecular-biologic mechanism such as the identification of differentiation factor induced from functional force. Here a mouse model was used to investigate the functional stress-responsive gene or factors which is related to the altered force by comparing the expression genes of functional state and hypo-functional state of the mouse mandible. ICR mice were provisioned with either a soft, mushy diet (soft-diet group) or hard rat pellets (hard-diet group) beginning at weaning for the alteration of functional force and subsequently sacrificed at 89 days of age. Incisor of mice in group 1 were trimmed twice a week to reduce occlusal forces. After killing the animals, mandibular bone including condyle were collected for RNA extraction, subtractive hybridization, northern blot analysis and mRNA in-situ hybridization. The results as follows; 1. A total of 39 clones were sequenced, and 11 individual sequence types were subsequently identified by subtractive hybridization, as 28 clones were represented twice in the analyzed sets. 2. Consequently four candidate clones, FS-s (functional stress-specific)2, -5, -18, and -22 were identified and characterized by homolgy search and northern analysis. Four of these clones, FS-s2, -5, -18, and -22, were shown to be expressed differentially in the hard-diet group. 3. Histologic sections showed that osteoblastic activity along the bone trabeculae and active bone remodeling were significantly lower in soft than in hard diet animals. A soft diet seems to enable a longer period of endochondral ossification in the mandibular condyle. 4. Although the mRNAs of FS-s2, -5, -18, and -22 were expressed rarely by cells of the soft-diet group, highest expression was detected in the cells of the hard-diet group. Together with the above results, it is suggested that FS-s2, -5, -18, and -22 could act as an important factors controlling the tissue changes in response to functional stress. The exact functional significance of these findings remains to be established.

• Journal of the korean academy of Pediatric Dentistry
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• v.30 no.2
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• pp.217-228
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• 2003

Co-ordinate growth of the brain and skull is achieved through a series of tissue interactions between the developing brain, the growing bones of the skull and the sutures that unite the bones. Craniosynostosis, the premature fusion of cranial sutures, presumably involves disturbance of these interactions. Bmp2, one of bone morphogenetic proteins (Bmps), is involved in the regulation of the shapes of individual bones and the relative proportions of the skeleton. Mutations in the homeobox gene Msx2, known as a downstream gene of Bmp, cause Boston-type human craniosynostosis. The phenotype of Dlx5 homozygote mutant mouse presents craniofacial abnormalities including a delayed ossification of calvarial bone. These facts suggest important roles of Bmp2, Msx2 and Dlx5 genes in the cranial bone growth and suture morphogenesis. To elucidate the function of these molecules in the early morphogenesis of mouse cranial sutures, we first analyzed by in situ hybridization the expression of Bmp2(E15-18), Msx2 and Dlx5 genes in the developing sagittal suture of calvaria during the embryonic stage. Bmp2 mRNA was intensely expressed in the osteogenic fronts and also at the low level in the periosteum of parietal bones during embryonic stage, Msx2 mRNA was intensely expressed in the sutural mesenchyme and mildly expressed in the dura mater during the embryonic stage. Dlx5 mRNA was intensely expressed osteogenic fronts and parietal bones. To further examine the role of Bmp signaling in cranial suture, we did in vitro experiments in E15.5 mouse calvarial explants. Interestingly, implantation of Bmp2-soaked beads onto the osteogenic fronts after 48 hours organ culture resulted in the increase of the tissue thickness and cell number around Bmp2 beads, compared to BSA control beads. In addition Bmp2 induced etopic expressions of Msx2 and Dlx5 genes. On the other hand, overexpression of FGF2 did not induce the expression of Msx2 and Dlx5. Taken together, these data indicate that Bmp2 signaling molecule has a important role in regulating the cranial bone growth and early morphogenesis of cranial suture. We also suggest that Bmp signaling is involved in all the stages of osteogenesis of cranial bones and the maintenance of cranial suture by regulating Msx2 and Dlx5 genes, and that Msx2 and Dlx5 genes are specific transcription factors of Bmp signaling pathway.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.27 no.5
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• pp.385-396
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• 2001

The purpose of this experiment was to examine the histological changes and the pattern of expression of proliferating cell nuclear antigen(PCNA) and type I collagen in the elongated bone affected by osteodistraction of the mandibular body in an adult canine model. Seven adult male mongrel dogs weighing over 20kg were used for this experiment. The author excluded 3 animals because they died before the planned time of sacrifice. The custom-made linear extraoral device and 4 bicortical fixation screws 2.3mm in diameter, 50mm in total length, 15mm in screw length were used in each animal. The distal part of the distractor produced a 0.75mm gap between proximal and distal bony segments every $360^{\circ}$ turn of the rotation rod of the device. The mandibular body of the right side from each animal was experimental side and the left side was left intact and served as control. At the experimental side, the mandibular body was osteotomized. After 5-day latency period, the segments were distracted with a rate of 1.1mm/day and a rhythm of two/day for ensuing 7 days. The animals were sacrificed at the 4th. 17th, and 32th day after the end of the distraction. The bony specimens were decalcified, embedded in paraffin, sectioned $5{\mu}m$ thick and stained with Masson trichrome and examined under the light microscope. The immunohistochemical examinations using anti-PCNA antibody and anti-type-I collagen antibody were performed to examine the pattern of the expression of PCNA and type I collagen, respectively. Results : 1. The mean increment of the distance between the proximal and distal screw-holding parts of the distractor was 6.8mm. The average elongation of the mandible in the experimental side was 5.3mm. The loss of elongation was 1.5mm in average. 2. New bone was already observed at the 4th. day after the end of distraction. But, bony union was not completed in the distraction gap at the 32th. day after the end of distraction by radiographic and microscopic examinations. 3. The expression rate of PCNA positive cells in the distraction gap had a tendency of decrease from 35.1-68.8% initially, to 49.1%, and finally to 17.6-27.2%. But at the final period, the tissue of the elongated gap still had the ability of cell proliferation. On the other hand, the expression of PCNA positive cells in the control side were negligible through the experimental period. 4. PCNA positive cells were observed primarily both at the central fibrous zone and at the region of just adjacent to CFZ which initiated new bone formation. 5. The expression pattern of the type I collagen was not zone-specific. They were observed diffusely throughout the elongation gap. 6. The predominant mechanism of new bone formation in the distraction gap was intramembranous. But, some of the regenerated bone was formed by endochondral ossification.