• 제목/요약/키워드: soft margin

검색결과 174건 처리시간 0.026초

악성 연부조직 종양의 광범위 절제 후 전외측 대퇴부 유리 피판을 이용한 재건술 (Anterolateral Thigh Free Flap for Reconstruction after Wide Resection of Soft Tissue Sarcoma)

  • 박종혁;이형석;김정렬
    • 대한골관절종양학회지
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    • 제14권2호
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    • pp.119-124
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    • 2008
  • 서론: 악성 연부 조직의 광범위 절제술 후 발생한 연부 조직 결손에 대해 전외측 대퇴부 유리 피판 이식술로 재건술을 시행한 7예에 대해서 치료 결과 및 그 유용성에 대해 알아 보고자 한다. 대상 및 방법: 2003년 1월부터 2007년 6월까지 연부조직 악성 종양으로 광범위 절제술 후 전외측 대퇴부 유리 피판을 이용한 재건술을 시행 받은 7예를 대상으로 하였다. 연구 방법은 임상 기록의 검토를 통해 후향적으로 시행하였으며, 종양의 종류, 크기, 종양의 절제연, 종양 절제 후 연부 조직 결손의 크기, 피판의 성공여부, 수술 시간, 합병증 등을 조사하였다. 결과: 악성 연부 조직 종양은 활막 육종이 3예, 악성 섬유성 조직구종이 2예, 평활근 육종이 1예, 섬유육종이 1예였다. 종양의 크기는 $3{\times}5\;cm$부터 $7{\times}8\;cm$로 다양하였고, 모든 예에서 광범위 절제연을 얻을 수 있었다. 종양 절제 후 피부 연부 조직 결손의 크기는 $6{\times}8\;cm$부터 $15{\times}10\;cm$였고, 평균 수술 시간은 3.6시간이었다. 모든 예에서 이식된 피판은 생존하였다. 결론: 악성 연부 조직의 수술적 치료에 있어 전외측 대퇴부 유리 피판술은 종양의 광범위한 절제술 후에도 적절한 크기와 길이의 혈관경을 확보할 수 있으며, 공여부의 합병증을 최소화하며, 미용적으로 우수하여 종양 절제 후 연부조직의 재건에 유용한 술식으로 사료된다.

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가변 광도에 따른 복합레진의 기계적 물성 및 변연누출도 변화 (MECHANICAL PROPERTIES AND MICROLEAKAGE OF COMPOSITE RESIN MATERIALS CURED BY VARIABLE LIGHT INTENSITIES)

  • 한승렬;민경산;신동훈
    • Restorative Dentistry and Endodontics
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    • 제28권2호
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    • pp.134-145
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    • 2003
  • Mechanical properties and microleakage of two composites [conventional hybrid type DenFil (VERICOM Co., Anyang, Korea) / micro matrix hybrid type Esthet X (Dentsply Caulk, Milford, DE, U.S.A.)] were evaluated to assess whether variable light intensity curing is better than conventional curing technique. Curing was done for 40 seconds in two ways of 2 step soft-start technique and 5 step ramping technique. Three kinds of light intensities of 50, 100, $200{\;}mW/\textrm{cm}^2$ were initially used for 10, 20, 30 seconds each and the maximum intensity of $600 {\;}mW/\textrm{cm}^2$ was used for the rest of curing time in a soft-start curing tech nique. In a ramping technique, curing was done with the same initial intensities and the light intensity was increased 5 times with the same rate to the maximum intensity of $600{\;}mW/\textrm{cm}^2$. After determining conditions that showed no different mechanical properties with conventional technique, Esthet X composite was filled in a class V cavity, which dimension was $4{\times}3{\times}1.5{\;}mm$ and cured under those conditions. Microleakage was evaluated in two ways of dye penetration and maximum gap estimation through SEM observation. ANOVA and Spearman's rho test were used to confirm any statistical significance among groups. The results were as follows : 1 Several curing conditions of variable light intensities resulted in the similar mechanical properties with a conventional continuous curing technique, except conditions that start curing with an initial light intensity of $50{\;}mW/\textrm{cm}^2$. 2. Conventional and ramping techniques were better than soft-start technique in mechanical properties of microhardness and compressive strength. 3. Soft-start group that started curing with an initial light intensity of $100{\;}mW/\textrm{cm}^2$ for 10 seconds showed the least dye penetration. Soft-start group that started curing with an initial light intensity of $200{\;}mW/\textrm{cm}^2$ for 10 seconds showed the smallest marginal gap, if there was no difference among groups. 4. Soft-start technique resulted in better dye-proof margin than conventional technique(p=0.014) and ramping technique(p = 0.002). 5. There was a very low relationship(p=0.157) between the methods of dye penetration and marginal gap determination through SEM evaluation. From the results of this study, it was revealed that ramping technique would be better than conventional technique in mechanical properties, however, soft-start technique might be better than conventional one in microleakage. It was concluded that much endeavor should be made to find out the curing conditions, which have advantages of both aspects or to solve these kinds of problems through a novel idea of polymerization.

Tissue integration of zirconia and titanium implants with and without buccal dehiscence defects

  • Lim, Hyun-Chang;Jung, Ronald Ernst;Hammerle, Christoph Hans Franz;Kim, Myong Ji;Paeng, Kyeong-Won;Jung, Ui-Won;Thoma, Daniel Stefan
    • Journal of Periodontal and Implant Science
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    • 제48권3호
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    • pp.182-192
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    • 2018
  • Purpose: The purpose of the present study was to validate an experimental model for assessing tissue integration of titanium and zirconia implants with and without buccal dehiscence defects. Methods: In 3 dogs, 5 implants were randomly placed on both sides of the mandibles: 1) Z1: a zirconia implant (modified surface) within the bony housing, 2) Z2: a zirconia implant (standard surface) within the bony housing, 3) T: a titanium implant within the bony housing, 4) Z1_D: a Z1 implant placed with a buccal bone dehiscence defect (3 mm), and 5) T_D: a titanium implant placed with a buccal bone dehiscence defect (3 mm). The healing times were 2 weeks (one side of the mandible) and 6 weeks (the opposite side). Results: The dimensions of the peri-implant soft tissue varied depending on the implant and the healing time. The level of the mucosal margin was located more apically at 6 weeks than at 2 weeks in all groups, except group T. The presence of a buccal dehiscence defect did not result in a decrease in the overall soft tissue dimensions between 2 and 6 weeks ($4.80{\pm}1.31$ and 4.3 mm in group Z1_D, and $4.47{\pm}1.06$ and $4.5{\pm}1.37mm$ in group T_D, respectively). The bone-to-implant contact (BIC) values were highest in group Z1 at both time points ($34.15%{\pm}21.23%$ at 2 weeks, $84.08%{\pm}1.33%$ at 6 weeks). The buccal dehiscence defects in groups Z1_D and T_D showed no further bone loss at 6 weeks compared to 2 weeks. Conclusions: The modified surface of Z1 demonstrated higher BIC values than the surface of Z2. There were minimal differences in the mucosal margin between 2 and 6 weeks in the presence of a dehiscence defect. The present model can serve as a useful tool for studying peri-implant dehiscence defects at the hard and soft tissue levels.

흉골에 발생한 연골육종: 수술 치험 1례 (Chondrosarcoma of the Sternum - One Case Report -)

  • 정진용
    • Journal of Chest Surgery
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    • 제24권8호
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    • pp.802-806
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    • 1991
  • Primary neoplasms of the ribs and sternum are rare. Most primary bony chest wall neoplasms are malignant, and chondrosarcoma is the most common malignancy in this location The etiology of chondrosarcoma is unknown. Definitive diagnosis of chondrosarcoma can only be made pathologically. The natural history of chest wall chondrosarcoma is one of slow growth and local recurrence. Most tumors of the sternum require wide resection and reconstruction procedures, with potentially serious postoperative problems. Advances in chest wall reconstruction primarily through refinement in muscle transposition and clarification of the functional anatomy and blood supply of trunk muscles, has resulted in a more aggressive resection of the these tumors . Recently we experienced a case with chondrosarcoma of the sternum. A 56 year-old man was admitted to our hospital due to painless, slowly enlarging mass at the left sternoclavicular junctional area. The chest radiograph strongly suggested an underlying cartilaginous neoplasm owing to the appearance of typical flocculent and curvilinear calcifications within the lesion. On CT of the chest, the tumor exhibited a scalloped or lobulated contour, hypodensity of the nonmineralized component in comparison to adjacent muscle, and characteristic stippled cartilaginous matrix mineralization, also typical for cartilaginous neoplasm. The patient underwent wide resection of the chest wall tumor include with a 2-3cm margin of normal tissue on all sides and the thoracic skeletal defect was reconstructed with polytetrafluoroethylene [Gore-Tex] soft-tissue patch. Soft tissue reconstructive procedure was done with the pectoralis major muscle transposition. The patient had an uneventful postoperative course and discharged without adjuvant treatment such as radiation and chemotherapy.

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A better facial contour accomplished by parotid duct preserving superficial parotidectomy

  • Park, Jun Ho;Choi, Chang Yong;Wee, Syeo Young;Lee, Young Man
    • 대한두개안면성형외과학회지
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    • 제19권1호
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    • pp.75-78
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    • 2018
  • Depression of facial contour after parotidectomy is still challenging to many of surgeons. A 68-year-old man presented with a 4-month history of a painless swelling in both parotid area. The mass was multiple and fixed at the parotid region. We conducted a parotid duct preserving bilateral superficial parotidectomy by one-stage operation to remove the multiple tumors. A lazy S incision was made in both preauricular area and the peripheral branches of the facial nerve were identified using surgical landmark. After dissecting the branches of the facial nerve and parotid duct, main parotid duct was preserved but only small fine ductules from the superficial lobe were ligated. Parotid gland was excised from its anterior aspect with about 1 cm of normal parotid tissue margin. The patient was followed up for 6 years to evaluate postoperative parotid gland function and the computed tomography (CT) was taken. Patient was satisfied with no significant complication such as sunken changes in facial contour, facial nerve function. As far as we know, it is the first study to compare long-term soft tissue contours of soft tissue of duct preserving superficial parotidectomy with duct sacrificing superficial parotidectomy by means of CT findings.

구개부에 발생한 다형성 저등급 선암종: 증례보고 (Polymorphous Low-grade Adenocarcinoma of the Palate: Case Report)

  • 류혜인;지유진;이덕원;김태희;홍성옥;류동목
    • Maxillofacial Plastic and Reconstructive Surgery
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    • 제34권1호
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    • pp.65-70
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    • 2012
  • Polymorphous low-grade adenocarcinoma (PLGA) is a neoplasm that is regarded as the second most common malignant salivary gland tumor after mucoepidermoid carcinoma. After the diagnosis of PLGA it is important to make a treatment decision and consider the prognosis. A histopathologic examination is necessary for diagnosis. Treatment is primarily surgical excision and long-term follow up is essential to evaluate local recurrences. This report describes 2 cases of PLGA located in the soft palate without any evidence of metastasis. The first case was PLGA with bony infiltration and an irregular margin lesion. The second case was PLGA localized in palatal soft tissue. We present diagnoses, histopathologic features, treatments and prognosis of PLGA.

한국산 전갱이과(Carangidae) 어류 1미기록종, Scomberoides tol (First Reliable Record of the Needle-scaled Queenfish, Scomberoides tol (Perciformes: Carangidae), from Korea)

  • 김경무;최승호;김진구
    • 한국수산과학회지
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    • 제51권4호
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    • pp.444-449
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    • 2018
  • Two specimens of Scomberoides tol (99.0 mm and 124.5 mm in total length), belonging to the family Carangidae, order Perciformes were collected from Korean waters using a gape net with wings and a hand net between 2014 and 2017. These specimens are characterized by having the origin of the soft-rayed portion of the dorsal fin just above the origin of the soft-rayed portion of the anal fin, dorsal spines not connected by fin membranes and posterior end of the maxilla and upper jaw not extending beyond the posterior margin of the eye. A comparison of mitochondrial DNA cytochrome c oxidase subunit I sequences indicated that these specimens matched Scomberoides tol (K2P distance, d = 0.002), but differed from other Scomberoides species (6.9-9.1%). This is the first reliable report of Scomberoides tol from Korea.

경골과 접한 슬와부 활막육종의 치료 - 증례 보고 - (Treatment of Synovial Sarcoma in Popliteal Fossa Adjacent to Tibia - A Case Report -)

  • 신덕섭;곽병훈;안종철
    • 대한골관절종양학회지
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    • 제13권2호
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    • pp.201-206
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    • 2007
  • 연부조직 육종의 치료에서 광범위 절제술은 필수적이며, 국소 재발율은 수술시 절제연과 매우 밀접한 관계를 가지는 것으로 알려져 있다. 연부조직 육종이 뼈와 바로 접하여 있는 경우 치료의 방향을 정하는데 어려움이 있다. 인접 골을 같이 절제하지 않으면 충분한 절제연을 얻을 수가 없고, 뼈를 같이 절제하면 수술이 어려워지면서 많은 합병증을 가져 올 수 있는 재건술이 필요해진다. 저자들은 슬와부 신경 및 혈관 과 근위 경골 사이에 발생하여 경골을 침투한 활막육종을 치료한 경험을 증례 보고한다.

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Evaluation of calcium sulphate barrier to collagen membrane in intrabony defects

  • Budhiraja, Shilpa;Bhavsar, Neeta;Kumar, Santosh;Desai, Khushboo;Duseja, Sareen
    • Journal of Periodontal and Implant Science
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    • 제42권6호
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    • pp.237-242
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    • 2012
  • Purpose: The aim of this study was to clinically and radiographically evaluate and compare treatment of intrabony defects with the use of decalcified freeze-dried bone allograft in combination with a calcium sulphate barrier to collagen membrane. Methods: Twelve patients having chronic periodontal disease aged 20 to 50 years and with a probing depth >6 mm were selected. Classification of patient defects into experimental and control groups was made randomly. In the test group, a calcium sulphate barrier membrane, and in control group, a collagen membrane, was used in conjunction with decalcified freeze-dried bone graft in both sides. Ancillary parameters as well as soft tissue parameters along with radiographs were taken at baseline and after 6 months of surgery. Parameters assessed were plaque index, modified gingival index, probing depth, relative attachment level, and location of the gingival margin. A Student's t-test was done for intragroup and a paired t-test for intergroup analysis. Results: Intragroup analysis revealed statistically significant improvement in all the ancillary parameters and soft tissue parameters with no statistically significant difference in intergroup analysis. Conclusions: The study concluded that a calcium sulphate barrier was comparable to collagen membrane in achieving clinical benefits and hence it can be used as an economical alternative to collagen membrane.

Chondrocutaneous posterior auricular artery perforator free flap for single-stage reconstruction of the nasal tip: a case report

  • Lee, Jun Yong;Seo, Jeong Hwa;Jung, Sung-No;Seo, Bommie Florence
    • 대한두개안면성형외과학회지
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    • 제22권6호
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    • pp.337-340
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    • 2021
  • Full-thickness nasal tip reconstruction is a challenging process that requires provision of ample skin and soft tissue, and intricate cartilage structure that maintains its architecture in the long term. In this report, we describe reconstruction of a full-thickness nasal tip and ala defect using a posterior auricular artery perforator based chondrocutaneous free flap. The flap consisted of two lay ers of skin covering conchal cartilage, and was based on a perforating branch of the posterior auricular artery. A superficial vein was secured at the posterior margin. The donor perforator was anastomosed to a perforating branch of the lateral nasal artery. The superficial vein was connected to a superficial vein of the surrounding soft tissue. The donor healed well after primary closure. The flap survived without complications, and the contour of the nasal rim was sustained at follow-up 6 months later. As opposed to combined composite reconstructions using a free cartilage graft together with a small free flap or pedicled nasolabial flap, the posterior auricular artery perforator free flap encompasses all required tissue types, and is similar in contour to the alar area. This flap is a useful option in single-stage reconstruction of nasal composite defects.