1.Limb Salvage Surgery with Tumor Prosthesis for the Malignant Bone Tumors Involving the Proximal Femur.
Young Soo CHUN ; Jong Hun BAEK ; Seung Hyuk LEE ; Chung Hwan LEE ; Chung Soo HAN
The Journal of the Korean Bone and Joint Tumor Society 2014;20(1):7-13
PURPOSE: As well as patient survival, the restoration of postoperative function such as ambulation is important in limb salvage operations for treatment of malignant bone tumors involving the proximal femur. The authors analyzed clinical outcomes of limb salvage operations using tumor prostheses for metastatic or primary malignant bone tumors in the proximal femur. MATERIALS AND METHODS: From February 2005 to January 2014, 20 cases (19 patients) with malignant bone tumor involving the proximal femur with pain or complicated pathologic fracture were treated with segmental resection and limb salvage operations with tumor prostheses. Mean age was 63.1 years (range 35-86). Fourteen patients were male and six ones were female. The mean follow-up period was 20 months (1-94 months). There were 15 cases of metastatic bone tumor, 4 cases of osteosarcoma, and 1 case of multiple myeloma. The primary tumors of the metastatic bone tumors included 4 lung cancers, 3 hepatocellular carcinomas, and 3 renal cell carcinomas. Other primary tumors were breast cancer, thyroid cancer, colon cancer, prostate cancer, and malignant spindle cell tumor, each in 1 case. Modular tumor prostheses were used in all cases; (Kotz's(R) Modular Tumor prosthesis (Howmedica, Rutherford, New Jersey) in 3 cases, MUTARS(R) proximal femur system (Implantcast, Munster, Germany) in 17 cases). Perioperative pain was assessed with Visual Analogue Scales (VAS). Postoperative functional outcome was assessed with Musculoskeletal Tumor Society (MSTS) grading system. RESULTS: Out of 20 cases (19 patients), 11 cases (10 patients) survived at the last follow-up. Average postoperative survival of the 9 deceased patients was 10.1 months (1-38 months). VAS score improved from pre-operative average of 8.40 (5-10) to 1.35 (0-3) after operation. Average postoperative MSTS function score was 19.65 (65.50%, 7-28). The associated complications were 2 local recurrences, 3 hematomas, 3 infections, 2 scrotal swellings, and 1 dislocation. There was no case of periprosthetic fracture or loosening. CONCLUSION: Limb salvage operation with tumor prosthesis is an appropriate treatment for early pain reduction and functional restoration in malignant bone tumors in the proximal femur with pain an/or complicated pathologic fractures.
Breast Neoplasms
;
Carcinoma, Hepatocellular
;
Carcinoma, Renal Cell
;
Colonic Neoplasms
;
Dislocations
;
Female
;
Femur*
;
Follow-Up Studies
;
Fractures, Spontaneous
;
Hematoma
;
Humans
;
Limb Salvage*
;
Lung Neoplasms
;
Male
;
Multiple Myeloma
;
Osteosarcoma
;
Periprosthetic Fractures
;
Prostatic Neoplasms
;
Prostheses and Implants*
;
Recurrence
;
Thyroid Neoplasms
;
Walking
;
Weights and Measures
2.The effect of Er:YAG laser irradiation on the surface microstructure and roughness of TiO2 implant.
Jang Hyuk AN ; Young Hyuk KWON ; Joon Bong PARK ; Yeek HERR ; Jong Hyuk CHUNG
The Journal of the Korean Academy of Periodontology 2008;38(1):67-74
PURPOSE: The aim of this study was to evaluate the effect of Er:YAG laser on microstructure and roughness of TiO2 blasting implant surface. MATERIALS AND METHODS: Ten TiO2 blasting implant were used in this experiment. One implant was control group, and nine TiO2 blasting implant surfaces were irradiated with Er:YAG laser under 100 mJ/pulse, 140 mJ/pulse, and 180 mJ/pulse condition for 1 min, 1.5 min, and 2 min respectively. Optical interferometer and scanning electron microscopy was utilized to measure roughness and microstructure of specimens. RESULTS: The surface roughness was decreased after Er:YAG laser irradiation in all groups, but there was no significant difference. 100 mJ/pulse and 140 mJ/pulse group did not alter the TiO2 blasting implant surface in SEM study while 180 mJ/pulse group altered the TiO2 blasting implant surface. Implant surfaces showed melting, microfracture and smooth surface in 180 mJ/pulse group. CONCLUSION: Detoxification of implant surface using Er:YAG laser must be irradiated with proper energy output and irradiation time to prevent implant surface alteration.
Freezing
;
Microscopy, Electron, Scanning
3.The Correlations Between Landmark of Inferior Oblique Muscle Recession and Adjacent Globe Structures.
Dae Hong KIM ; Seung Hyuck LEE ; Jong Bok LEE ; In Hyuk CHUNG
Journal of the Korean Ophthalmological Society 2002;43(8):1528-1535
PURPOSE: This study aimed to find out whether there are relationships among anatomic characteristics of inferior oblique muscle insertion, corneal diameter, axial length and inferior oblique recession landmark. METHODS: Thirty-one Korean cadaver orbits were dissected to expose the full length of extraocular muscles and sclera, and then we measured the length from the recession landmark of inferior oblique to the lateral edge of insertion of inferior rectus and to the inferior edge of insertion of lateral rectus. RESULTS: The mean of angles between the inferior oblique muscle insertion and lateral rectus direction is 27.9+/-9.0degrees and the range is from 15 degrees to 50 degrees . There is a statistically significant correlation between cord length of 8 mm recession landmark of inferior oblique and angles of inferior oblique insertion with lateral rectus direction. We divided the shapes of inferior oblique insertion into straight and convexed curves. Twelve insertions are straight and thirteen insertions are curved. There is no statistically significant correlation between shape of inferior oblique insertion and cord length from recession landmark. In corneal diameter and axial length, we found correlations with cord length of 8 mm and 10 mm recession landmark of inferior oblique. CONCLUSIONS: We conclud that there are some correlations among anatomic characteristics, axial length and corneal diameter with recession landmark of inferior oblique.
Cadaver
;
Muscles
;
Orbit
;
Sclera
4.Effects of Mycoplasmal Antigens on Production of Tuansforming Growth Factor-beta1 in Human Tumor Cells.
Myung Woong CHANG ; Kwang Hyuk KIM ; Jong Won HWANG ; Hyun Kee CHUNG
Journal of the Korean Society for Microbiology 2000;35(5):362-362
No Abstract Available.
Humans*
5.Malignant Granular Cell Tumor of the Shoulder: A case report.
Jae Hun CHUNG ; Jae Hyuk LEE ; Jong Hee NAM ; Chan CHOI ; Min Cheol LEE
Korean Journal of Pathology 2000;34(6):475-479
A malignant granular cell tumor (MGCT) occurred in the left shoulder of a 62-year-old man. The patient underwent wide marginal excision followed by chemotherapy and radiotherapy. A metastatic tumor was identified in the axillary lymph node 22 months after the excision of the shoulder mass. The primary tumor was a poorly circumscribed mass measuring 5 5 4 cm. On cut section, it was a solid mass with yellowish tan color. Histologically, both primary and metastatic tumor consisted of polygonal cells with abundant granular cytoplasm and a vesicular nucleus with a prominent nucleolus. Two to three mitotic figures per ten high power fields at 200 were counted. Tumor cells were weakly stained with periodic acid-Schiff (PAS) preparation both before and after diastase digestion, and were positive for S-100 protein, neuron-specific enolase (NSE), and vimentin. By electron microscopy, the cytoplasm was filled with numerous autophagolysosomes containing myelin figures, mitochondria, and fragmented rough endoplasmic reticula. Basal laminae and angulated bodies were also noted. These findings suggest schwannian differentiation of this tumor.
Amylases
;
Basement Membrane
;
Cytoplasm
;
Digestion
;
Drug Therapy
;
Granular Cell Tumor*
;
Humans
;
Immunohistochemistry
;
Lymph Nodes
;
Microscopy, Electron
;
Middle Aged
;
Mitochondria
;
Myelin Sheath
;
Phosphopyruvate Hydratase
;
Radiotherapy
;
S100 Proteins
;
Shoulder*
;
Triacetoneamine-N-Oxyl
;
Vimentin
6.The effect of irradiated cancellous human bone on exophytic bone formation in residual ridge of the beagle dog.
Mi Hyun CHUNG ; Yeek HERR ; Young Hyuk KWON ; Joon Bong PARK ; Jong Hyuk CHUNG
The Journal of the Korean Academy of Periodontology 2007;37(4):791-803
The purpose of this study was to evaluate exophytically vertical bone formation in residual ridge of the beagle dog by the concept of guided bone regeneration with a titanium reinforced e-PTFE membrane combined with irradiated cancellous human bone. Twelve male beagle dogs(mean age 1.5 years and mean weight 12kg) were used for this study. The alveolar ridges after extraction of all mandibular premolars were surgically and horizontally removed. At 8 weeks after extractions, full-thickness flap was reflected and cortical bone was removed with round bur and copious irrigation. Rectangular parallelepiped(10mm in length, 5mm in width, and 4mm in height) bended with titanium-reinforced e-PTFE(TR e-PTFE) membrane was placed on the decorticated alveolar ridge, fixed with metal pins and covered with full-thickness flap and assigned as a control group. Test groups were treated with TR e-PTFE membrane filled with irradiated cancellous human bone. Of twelve beagle dogs, four control dogs and four test dogs without membrane exposure to oral cavity were sacrificed at 8 and 16 weeks respectively. The surgical sites were dissected out, fixed in 4% buffered formaldehyde, dyed using a Villanueva staining technique, and processed for embedding in plastic resin. The cutting and grinding methods were routinely processed for histologic and histomophometric analyis of exophytic bone formation as well as statistical analysis. The results of this study were as follows: 1. Exophytic bone formation in the both of experimental groups was increased respectively after surgery from 23.40% at 8 weeks to 46.26% at 16 weeks in the control groups, from 40.23% at 8 weeks to 47.11% at 16 weeks in the test groups(p<0.05). 2. At 8 weeks after surgery, exophytic bone formation was made 40.23% in the test groups and 33.40% in the control groups. Exophytic bone formation was significantly made in the test group more than in the control group. At 16 weeks after surgery, exophytic bone formation was made 44.11% in the test groups and 46.26% in the control groups. Exophytic bone formation was made in the test groups more than in the control groups, but there was no statistically significant differences. 3. The membrane was fixed with metal pins to closely contact it to the bone surface. So, collapse and deviation of the membrane could be prevented and in growth of connective tissue also could be blocked from the periphery of the membrane. On the basis of these findings, we suggest that intraoral experimental model for exophytic bone formation may be effective to evaluate the effect of bone graft material. And it indicates that combined use of membrane and ICB graft material is more effective than use of membrane only for exophytic bone formation.
Alveolar Process
;
Animals
;
Bicuspid
;
Bone Regeneration
;
Connective Tissue
;
Dogs*
;
Formaldehyde
;
Humans*
;
Male
;
Membranes
;
Models, Theoretical
;
Mouth
;
Osteogenesis*
;
Plastics
;
Titanium
;
Transplants
7.Root coverage using subepithelial connective tissue graft.
Jeong Hyun KIM ; Yeek HERR ; Young Hyuk KWON ; Joon Bong PARK ; Jong Hyuk CHUNG
The Journal of the Korean Academy of Periodontology 2008;38(1):91-96
PURPOSE: One of the main objectives of periodontal reconstructive surgery is the coverage of exposed roots that occur due to gingival recession. and Aestheic concerns are usually the reason to perform root coverage procedure. This case report was performed to evaluate the effect of root coverage using subepithelial connective tissue graft(SCTG) on Miller's Class I marginal tissue recession. MATERIALS AND METHODS: One patient, with two Miller's class I marginal tissue recession on both maxiallay canines, was treated with root coverage using SCTG (modified Nelson's technique). At baseline, the following measurements were recorded: 1) recession depth; 2) width of keratinized giniga. At 9, 10 months post-surgery, all clinical measurements were repeated. RESULT: 1) The mean root coverage from baseline to 9, 10 months post-surgery was 92.3%. 2) The mean recession depth decreased from 6.5 mm to 0.5 mm. 3) The mean width of keratinized gingiva increased from 1.25 mm to 3.5 mm. CONCLUSION: Within the above results, root coverage using SCTG is an effective procedure to cover Miller's class I marginal tissue recession defect. Also, patient with aesthetic concern could be satisfied with this result.
Connective Tissue
;
Gingiva
;
Gingival Recession
;
Humans
;
Keratins
;
Transplants
8.The effect of erbium-doped: yttrium, aluminium and garnet laser irradiation on the surface microstructure and roughness of double acid-etched implants.
Ji Hyun KIM ; Yeek HERR ; Jong Hyuk CHUNG ; Seung Il SHIN ; Young Hyuk KWON
Journal of Periodontal & Implant Science 2011;41(5):234-241
PURPOSE: One of the most frequent complications related to dental implants is peri-implantitis, and the characteristics of implant surfaces are closely related to the progression and resolution of inflammation. Therefore, a technical modality that can effectively detoxify the implant surface without modification to the surface is needed. The purpose of this study was to evaluate the effect of erbium-doped: yttrium, aluminium and garnet (Er:YAG) laser irradiation on the microstructural changes in double acid-etched implant surfaces according to the laser energy and the application duration. METHODS: The implant surface was irradiated using an Er:YAG laser with different application energy levels (100 mJ/pulse, 140 mJ/pulse, and 180 mJ/pulse) and time periods (1 minute, 1.5 minutes, and 2 minutes). We then examined the change in surface roughness value and microstructure. RESULTS: In a scanning electron microscopy evaluation, the double acid-etched implant surface was not altered by Er:YAG laser irradiation under the condition of 100 mJ/pulse at 10 Hz for any of the irradiation times. However, we investigated the reduced sharpness of the specific ridge microstructure that resulted under the 140 mJ/pulse and 180 mJ/pulse conditions. The reduction in sharpness became more severe as laser energy and application duration increased. In the roughness measurement, the double acid-etched implants showed a low roughness value on the valley area before the laser irradiation. Under all experimental conditions, Er:YAG laser irradiation led to a minor decrease in surface roughness, which was not statistically significant. CONCLUSIONS: The recommended application settings for Er:YAG laser irradiation on double acid-etched implant surface is less than a 100 mJ/pulse at 10 Hz, and for less than two minutes in order to detoxify the implant surface without causing surface modification.
Dental Implants
;
Inflammation
;
Microscopy, Electron, Scanning
;
Peri-Implantitis
;
Yttrium
9.The effects of microcrystalline hydroxyapatite containing toothpaste in the control of tooth hypersensitivity.
Jung Ju PARK ; Joon Bong PARK ; Young Hyuk KWON ; Yeek HERR ; Jong Hyuk CHUNG
The Journal of the Korean Academy of Periodontology 2005;35(3):577-590
The purpose of this study was to evaluate the effects of toothpaste containing hydroxyapatite for patients who complained dental hypersensitivity. Before baseline of application of toothpaste with hydroxyapatite, tooth brushing instruction was done respectively and the several indices were measured at baseline, 2, 4, 8 weeks. Clinical indices were estimated, and responses to cold, compressive air, tactile stimulus were evaluated with verbal rating score. Relief effects and visual analogue scale were also evaluated. The results of this study were as follows 1. The occurrence rate of hypersensitivity in upper jaw was higher than that of lower jaws, and molar area showed more hypersensitivity than premolar and incisor area. Buccal site was hypersensitive followed by interproximal and lingual site. 2. Plaque index, gingival index and probing depth reduction were gradually improved after Tooth Brushing Instruction and using toothpaste. 3. Subjects showed most sensitive response to cold stimuli than compressive air and tactile stimuli. 4. The relief effect was increased during using tooth paste and complete relief was increased especially at 8 weeks. 5. Visual analogue scale was increased. In conclusion, it was confirmed that toothpaste containing microcrystalline hydroxyapatite have the relief effect of tooth hypersensitivity. During 8 weeks, stimulus responses were decreased and hypersensitivity relief effect was increased.
10.The influence of adjacent tooth to the microbiology of implant sulcus.
Dong Young LEE ; Man Sub LEE ; Young Hyuk KWON ; Joon Bong PARK ; Yeek HERR ; Jong Hyuk CHUNG
The Journal of the Korean Academy of Periodontology 2005;35(3):563-575
The aim of present study is to evaluate the influence of adjacent tooth to the microbiology of clinically healthy implant. Control group included patients who had clinically healthy implant and tooth with healthy periodontium(PD< or =3mm), test group was composed of patients who had clinically healthy implant and tooth with periodontal pocket(PD > 3mm). The criteria of clinically health implant are no pain or discomfort, the restorative suprastructure provide satisfactory fit and function, and the tissue around the fixtures were firm and probing with standard periodontal probe with a rounded tip 0.5mm in diameter resulted in penetration of no more than 5mm when using a force of 0.5N at any location. 38 patients, partially edentulous subjects with endosseous root-form implants were selected. All subjects were medically healthy and had not taken systemic antibiotics and professional plaque control 3 months before sampling. Number of control group is 25(mean age 52+/-13, 26 teeth, 34 implants) and test group is 13(mean age 60+/-13, 13 teeth, 17 implants). All teeth and implants of each patient were examined probing depth(PD), bleeding on probing(BOP), and plaque index(PI), and samples of subgingival plaque were obtained at each site with sterile curet or fine paper points, then the plaque transferred to PBS. Obtained samples were examined for the presence of P. gingivalis, T. forsythensis, and T. denticola by the polymerase chain reaction(PCR). The relationship among clinical parameters and the colonizations by the 3 bacterial species from natural teeth and implants region were analyzed by student t-test. The results of this study were as follows: 1. PD was different in teeth between 2 groups(p<0.05), but the other parameters were not. 2. Statistically significant difference was not found in clinical parameters of implants between 2 groups. 3. All bacterial prevalences of teeth were higher in test group than in control group, and prevalence of T. forsythensis had statistically significant difference between 2 groups(p<0.05). 4. Prevalences of P. gingivalis and T. forsythensis are higher in test group than control group, and that of T. denticola is higher in control group than in test group. But there were no statistically significant differences between 2 groups. In conclusion, there is no statistically significant difference in prevalence of implant microbiology between 2 groups. But if the number of samples increased, it will be possible to find out statistical significance in prevalence of P. gingivalis. It seems that pocket of adjacent tooth influences prevalence of P. gingivalis. These results mean that improvement of the periodontal condition before implantation is very important.