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가토 하악골 골신장 후 맥동전자기장이 조기 골경화에 미치는 효과에 대한 연구
황경균,조태형,송윤미,김도균,한성희,김인숙,황순정,Hwang, Kyung-Kyun,Cho, Tae-Hyung,Song, Yun-Mi,Kim, Do-Kyun,Han, Sung-Hee,Kim, In-Sook,Hwang, Soon-Jung 대한악안면성형재건외과학회 2007 Maxillofacial Plastic Reconstructive Surgery Vol.29 No.2
Introduction: Distraction osteogenesis is widely used as for bone lengthening in patients with maxillofacial deformity and alveolar bone atrophy. One of the major problems in distraction osteogenesis is long consolidation period for 2-3 months, in which the devices have to be fixed on the bone to prevent relapse. It results in scar formation on the face, disturbance of mastication and speech. This study was performed to evaluate the stimulating effect of pulsed electromagnetic field on the early bone consolidation in distraction osteogenesis. Materials and methods: Total 10 rabbit were used (5 for control group, 5 for experimental group). A vertical osteotomy in the mandibular body was performed and the distraction device was fixed. After 5 days distraction was done 1mm per a day for 7 days. A pulsed electromagnetic field (38 Gauss, 60 Hz) was applied for 8 hours per day and it continued for 5 days immediately after distraction in the experimental group. Both groups were sacrificed after 2 weeks. Histological specimens with H&E and Masson Trichrome staining were made and histomorphometrically analysed with image analyser. Results: The device for distraction osteogenesis was displaced in one animal for each group, therefore, only four animals in both groups were evaluated. In both groups, a new bone formation was observed in the distracted area after 2 weeks. The bone formation was enhanced in the experimental groups ($31.76{\pm}8.68%$) compared with control group ($9.94{\pm}3.23%$), its difference was statistically significant (p<0.001). Conclusion: This study suggests that electrical stimulation with electromagnectic field may be effective in the early bone formation after distraction osteogenesis. Further studies with large number of animals are needed before clinical application.
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성견하악골의 신연 부위에서 골형성에 대한 혈소판-풍부 혈장의 효과
류수장,이충국,최병호,Ryu, Soo-Jang,Yi, Choong-Kook,Choi, Byung-Ho 대한구강악안면외과학회 2001 대한구강악안면외과학회지 Vol.27 No.6
Distraction osteogenesis refers to the biological process responsible for new bone formation between bone segments by gradual distraction after osteotomy. For the past several years, various inconveniences including a protracted consolidation period that requires patients to wear a distractor frame longer, as well as higher medical costs, have not been remedied by improvements in osteotomy, distraction rate and monitoring system. Furthermore, side effects such as pin tract infections and soft tissue swelling may arise due to the long treatment period. These drawbacks form the rationale of this study which purports to seek a method by which the consolidation period can be reduced. This paper examines how platelet-rich plasma(PRP), known to facilitate osteogenesis, influences bone formation when applied in distracted area. Ten mongrel dogs, which were made to wear external distractor frames after osteotomy in both sides of the mandible, were used as subjects. After a 7day period of latency, distraction was carried out at a rate of 1mm/day for 14 consecutive days. After the onset of distraction, 2ml of PRP and a mixture of calcium gluconate and thrombine were injected into the center of the distracted callus on the left side of the mandible. The left was injected with PRP while the right side was set as the control site without PRP treatment. Execution at the onset of distraction and in 2 weeks, 4 weeks and 8 weeks after the consolidation period, clinical and radiographic tests, bone mineral density examination, histological examination and histomorphometric analysis were conducted to compare both sides. The results are summarized as follows: 1. Based on the clinical examination at two weeks, more remarkable cortical bone formation was found on the buccal and lingual side of the distracted area in the PRP treatment site than in the control site. No visual difference was found between the PRP treatment site and the control site at four eight weeks. 2. Based on the radiological examination, a distinct increase in the radiopaque appearance of the PRP treatment site was revealed at two weeks, but this increase appeared to slow down at four and eight weeks. 3. Examination of bone mineral density revealed a significant difference at two weeks with the PRP treatment site yielding density two times higher than the control site. This difference lessened after four weeks, and disappeared at eight weeks. 4. The histomorphometric examination revealed that about 20% more bony trabeculae area(20%, higher) was formed in the PRP treatment site than in the control site. In conclusion, it can be said that PRPs effect on stimulating bone formation in the PRP treatment site manifest as early as two weeks. Trabeculae formation likewise increased throughout the whole period. If this result can be applied to humans, the consolidation period can be reduced by injecting PRP into the distracted area.
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성인 급성 골수성 백혈병 환자의 관해후 장기 생존율을 얻기 위한 치료 방침 - 골수이식과 항암요법의 생존율 비교 -
이종욱 ( Lee Jong Ug ),민창기 ( Min Chang Gi ),김동욱 ( Kim Dong Ug ),진종률 ( Jin Jong Lyul ),한치화 ( Han Chi Hwa ),민우성 ( Min U Seong ),박종원 ( Park Jong Won ),김춘추 ( Kim Chun Chu ),김동집 ( Kim Dong Jib ),한창순 ( Han Cha 대한내과학회 1993 대한내과학회지 Vol.44 No.4
Background: Although substantial progress in the treatment of acute myelogenous leukemia (AML) has produced complete remission (CR) in 60% to 80% of patients receiving induction chemotherapy, the median remissio duration is about 12 months and only 20% to 35% of patients undergoing consolidation chemotherapy achive long-term disease-free survival (DFS). Allogenei bone marrow transplantation (BMT) in first remission has resulted in a 45% to 65% overall survival rate. Methods: From July 1986 to December 1991, 92 patients with AML who had reached a CR following induction chemotherapy were assigned to a retrospective study comparing allogeneic BMT with consolidation chemotherapy as a postremission treatment. The results in 16 patients, aged 16 to 40 years, who underwent a HLA matched BMT in first remission were compared with those in 41 patients, age-matched, lacked an HLA-identical sibling, treated with one or more cycles of consolidation chemotherapy. Results: 1) After a median follow-up of 21 months (3~57 months), the acturaial DFS at 4 years was significantly higher in the transplantation group than in the chemotherapy group (66% v 27%; p<0.05), and the actuarial probability of leukemic relapse was considerably lower in the group treated with BMT (24% v 69%; p<0.005). 2) The median survival and DFS has not yet been reached for BMT group, and 17 months, 13 months, respectively for chemotherapy group. 3) Treatment-reached mortality was similar in both groups (13% in BMT group, 10% in chemotherapy group). Conclusion: Our results show that allogeneic BMT appears to be superior to consolidation chemotherapy and offers the best chance of long-term DFS in patients with AML in first remission. It will therefore be appropriate postremission treatment strategy to undergo allogeneic BMT for patients with AML in first remission under the age of 40 who have an HLA-identical sibling donor.
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