Dental implants were used for reconstruction of oromaxillofacial defects and they were widely used in dental and medical fields. The implant materials are various , including titanium and ceramics such as zirconium. The property of implant materials have biocompatibility and mechanical strength. Titanium has direct bone anchorage without any other tissues between implant's interface. many researcher's had studied for raising the osseointegration success rate through various method. It was reported over 95% success ratio. many researcher's study the enhancing the speed of bone remodelling and osseointegration. Low Level Laser Therapy is one of the method to accelerlate the speed of bone remodelling and osseointegration. Thus it raise initial stability. The purpose of this study was to evaluate the effect of diode laser irradiation for ossoeintegration in implant interface and between the implants threads. 24 New Zealand white rabbits which were about 3Kg, used for experiment. 2 implant's were implanted every rabbit's tibia. 2 weeks, 4 weeks, 8 weeks after implantation, tissue sample were removed from sacrificed rabbit's tibia. 8 rabbit's were sacrificed every 2, 4, 8 weeks and undecalcified sample were got from tissue sample. The undecalcified samples were investigated by optical microscope. 2 weeks, 4 weeks, 8 weeks experimental groups which were irradiated low level laser therapy showed rapid bone remodelling than control groups. it showed many difference especially in initial stage. Low level laser irradiation increase the volume of new bone formation in implant interface . It was suggested that there were many influence in bone remodelling in early stage, because these were many differences between experimental and control groups. Low level laser irradiation were helpful for immediate loading implant

Currently, Low-level laser therapy (LLLT) is widely used in medicine and dentistry. It has been suggested that LLLT may be beneficial in management of many different medical conditions, including pain, wound healing and nerve injury. Stimulation with LLLT can enhance bone repair as reported in experimental studies on bone defects and fracture healing also. As far as hard tissue is concerned, the biostimulating effect of laser has been demonstrated more rapid healing of tibial bone fracture in mice. This study was performed to compare new bone formation between with LLLT and without LLLT. Two cylinder implants(5mm diameter, 5mm length) were implanted on rabbit's tibia. LLLT was done to one implant with 632mm diode laser. And than Rabbit's were sacrificed after 2nd, 4th, 6th, 8th weeks after implantation. Bone with implant were removed and fixed with 10% formaline. Undecalfied sample were prepared after spurr low resin embedding. Sample were grind and polished to 100㎛. The results were as follows. The amount of trabeclue of experimental group were superior to that of control group from 2 weeks to 8 weeks. There were no difference in arrangement of trabecule between two groups. Bone implant contact were significantly increased at 4th weeks in experimental group. The number of ostecytes in trabecule were different at 4th weeks experimental group. Osteone were appeared dominantly at 6th weeks experimental group, while at 8th weeks experimental group were superior than control group. LLLT group showed increased amount of trabecule, bone implant contact, number of osteocytes & osteone. It suggested that LLLT might be increase the bone formation rate and accelerate the bone formation time.

Currently, implants are widely used in dental and medical fields. Especially dental implants are widely used for reconstruction of oral and maxillofacial defects. Many researcher's had studied for raising the osseointegration through various method. It was reported high success rate. Also they study the enhancing the speed of bone remodelling and osseointegration. Low level laser therapy is introduced one of the methods to accelerate the speed of bone remodelling and osseointegration. The purpose of this study was to evaluate the effect of diode laser irradiation about to raise ossoeintegration. Twenty four New Zealand white rabbits which were about 3Kg were used for experiment. Two implants were implanted same side of rabbits tibia. Diode laser was irradiated 1cm diameter, 0.5 watt power, 1 minute duration at periphery of one of implants. Eight rab b its were sacrificed every 2, 4, 8 weeks, made undecalcified sample. We investigated in the undecalcified samples histological and histomorphometrc analysis by light microscope. The results were as follows. 2 weeks, 4 weeks, 8 weeks experimental groups which were showed rapid bone remodelling than control groups. They showed many difference especially in early healing time. Bone Implant contact rate were 47% in 2 weeks experimental group. 28% in 2 weeks control groups, 82% in 4 weeks experimental groups, 62% in 4 weeks control groups, 98% in 8 weeks experimental groups and 84% in 8 weeks control groups then experimental groups show statistically significant difference(p＜0.05). Bone remodelling area rate inside the implant threads were 49% in 2 weeks experimental groups. 31% in 2 weeks control groups, 90% in 4 weeks experimental groups, 82% in 4 weeks control groups, 99% in 8 weeks experimental groups and 97% in 8 weeks control groups then 2,4 weeks experimental groups show statistically significant difference(p＜0.05). Implant-bone contact length rate and bone remodelling area rate were no significant difference of linear regression equation of control and experimental groups then bone remodelling were different at early healing time but there were no differences of time changes. According to above results, one of the low level lasers diode laser irradiation was effected on the volume of new bone formation in implant interface and between the implants threads. Low level laser irradiation were helpful for initial stage of bone remodelling.

This research was designed to investigate changes of growth factors and bone matrix proteins during the bone healing processes using immunohistochemistry and in situ hybridization. Especially this study was focused on the changes of bone matrix and growth factors around the titanium implant. Threaded implants were introduced into the long bone of tibia. Time dependent changes of several bone associated protein and and its mRNAs were observed. Proteins investigated in this study are collagen, osteonectin(ON), osteopontin(OPN), osteocalcin(OC). Expression of the proteins were measured using immunohistochemistry. VEGF and ON were measured using in situ hybridization, and northen blot technique. Bone regeneration were observed as early as the third day of experiment. Matrix proteins and growth factors observed around implant were identical to the proteins observed in the control group. The expression of the ON, OC and VEGF were observed mainly in the osteoblast-like cell on the surface of new bone around the implant and the cells lining the margin of bone defect apart from the implant. The observation may not result from direct osteoconducting activities of titanium but by passive adsorption of extracellular factors which has bone inducing capacities. These passive adsorption results in the immobilization of the growth factors and consequent prolongation of the activities.

Hydroxyapatite(HA) has been widely used as bone substitutes to rehabilitate bone loss area by new bone formation. But there were some problem of bone formation around HAs due to a little space between HAs embedded in bone loss area. The purpose of this study was to observe morphologically new bone formation around HAs mixed with PLGA block (5.5㎜ in diameter, 4 mm in depth) in Newzealand white rabbit tibia. Before 1 week of sacrification, Alizarin red was injected intraperitoneally into rabbit. At 3 day, 1, 2, 4, 10, 18, 32 weeks, bones with HA as control group(CG)and HA mixed with PLGA block as experimental group (EG)were fixed with 10 % neutral formalin, dehydrated, and embedded with Spurr low viscosity resin. After the specimens were cut by 500 ㎛ with slow diamond wheel saw, these were coated with carbon and examined by REM, LSM and qualifative analysis of calcium and phosphorous deposition were done with EPMA. The obtained results were as follows. 1. Both group showed scattered HA around compact bone under REM and little AZ labelled bone under LSM at 3 days. 2. Both group showed active AZ labelled bone, while EG showed higher Ca(calcium) and P(phosphate) deposition than that of CG at 1 wk. 3. There was decreased AZ labelled bone of both group under LSM. REM of EG showed HA associated with new bone from compact bone, while EPMA features showed similar to Ca and P deposition at 1 wk and EG showed higher than that of CG. 4. REM features of both group showed resorbed HA associated with new bone. There was decreased AZ labelled bone of both group under LSM. EPMA features showed higher Ca and P deposition at 4 wks than that of 2 wks. 5. New bone of both group was well demarcated from compact bone under REM at 10 wks. LSM features showed various AZ labelled bone, but weak AZ labelled than that of CG. 6. LSM features of 14 wks showed discontinuous AZ labelled on osteon formation. EPMA of both group showed increased Ca deposition, while there was higher Ca deposition of EG and similar P deposition to CG. 7. REM featureless of 18 wks in EG showed similar gray color to compact bone. LSM features showed osteon formation with little concentric lamellars. EPMA of both group showed increased Ca deposition, while there was higher Ca and P deposition of EG. 8. New bone was ill demarcated from compact bone and increased otseon formation of REM features at 32 wks. There was little AZ labelled bone. EPMA features showed higher Ca and P deposition of EG than that of compact bone. From the aboving results, there was early active AZ labelled bone of both group within 1-2 weeks and since 18 weeks new bone with active osteon formation was poorly demarcated from compact bone. Calcium deposition of EG was early increased than that of CG deposition since 4 weeks after experiments. It was suggested that EG showed active and rapid new bone formation and similar bone mineralization of compact bone

Alfatoxin과 비타민의 상호작용(相互作用)을 구명(究明)하기 위하여 브로이러 병아리 336수(首)를 8구(區)로 나누고 aflatoxin 을 0 또는 0.5 ppm, 비타민를 0, 500, 1,000 또는 1,500 IU/Kg 급여(給與)하는 3주간(週間)의 요인시험(要因試驗)을 실시(實施)하였다. 증체량(增體量), 사료섭취량(飼料攝取量), 사료전환율(飼料轉換率), 정강이 색상(色相), 폐사율(斃死率) 및 각약증발생율(脚弱症發生率)에 있어서 각구간(各區間) 유의차(有意差)를 나타내지 않았다. 건물(乾物), 조단백질(粗蛋白質), 조지방(粗脂肪), 가용무질소물(可溶無窒素物) 및 조회분(粗灰分)의 이용율(利用率)에 있어서 각(各) 구간(區間) 유의차(有意差)를 나타내지 않았다. 조섬유(粗纖維)의 이용율(利用率)에 있어서 대조구(對照區)에 비(比)하여 aflatoxin 급여구(給與區)가 매우 낮은 값을 보였다(P<.01). 그러나 비타민 첨가수준간(添加水準間)에는 유의차(有意差)를 나타내지 않았으며 aflatoxin과 비타민간(間)의 교호작용(交互作用)도 인정(認定)되지 않았다. Ca, P 및 Na의 이용률(利用率)에 있어서 각(各) 구간(區間) 유의차(有意差)를 보이지 않았으나 aflatoxin 급여구(給與區)의 Ca이용율(利用率)이 무급여구(無給與區)보다 약간 높았다. 탈지건조경골(脫脂乾燥脛骨)의 회분함량(灰分含量)은 각처리간(各處理間) 유의차(有意差)가 없었으나 Ca함량(含量)에 있어서도 aflatoxin 0.5 ppm구(區)에서 무급여구(無給與區)보다 더 많았으며(P<.05), 비타민를 더 많이 급여(給與)할수록 조금씩 높게 나타났다. Aflatoxin과 비타민가 경골내(脛骨內) Ca을 가속적(加速的)으로 증가(增加)시킨다는 것을 보여 주었다(P<.01). 그리고 P의 함량(含量)에 있어서도 aflatoxin 급여(給與)로 증가(增加)되었다(P<.05). 그러나 비타민 수준간(水準間)에는 유의차(有意差)가 없었으며 2요인간(要因間)의 교호작용(交互作用)도 없었다. Aflatoxin 급여(給與)는 Na함량(含量)에 영향(影響)을 주지 않았으나 비타민 수준간(水準間)에는 유의차(有意差)가 나타나(P<.01) 1,000 IU/Kg수준(水準)이 가장 높게 나타났다. 2요인간(要因間)의 교호작용(交互作用)은 인정(認定)되지 않았다. 혈청중(血淸中)의 Ca농도(濃度)에 있어서 aflatoxin 급여구(給與區)에서 매우 높게 나타났으며(P<.01), 유의성(有意性)은 없었으나 비타민 첨가수준(添加水準)이 높아질때 조금씩 증가(增加)되는 경향(傾向)을 보였다. 2요인간(要因間)의 교호작용(交互作用)이 인정(認定)되었다(P<.05). P의 함량(含量)은 각(各) 처리간(處理間)에 유의차(有意差)가 없었으며 Alkaline Phosphatase 역가(力價)에 있어서 aflatoxin 급여구(給與區)가 높은 값을 보였다(P<.01). 그리고 비타민 수준(水準)이 높아짐에 따라 조금씩 증가(增加)하는 추세(趨勢)를 보였으나 유의차(有意差)는 없었으며 Aflatoxin과 비타민간(間)에는 교호작용(交互作用)이 없었다.

We report the good results of two stage treatment in split depression type pilon fractures. A retrospective study of 9 cases among the 12 cases of split depression type pilon fractures from January 2009 to December 2015, who underwent two stage treatment of pilon fractures with minimum 24 months follow-up. And mean follow-up periods are 29 (24-41) months. In the first stage of the operation, reduction of articular surface using minial incision and external fixation were performed. As soft tissue heals, locking compression plate fixation was done with MIPO (Minimally Invasive Plate Osteosynthesis) technique. Radiographic evaluation was graded by the criteria of Burwell and Charnley. And functional assessment of ankle were evaluated by American Orthopaedic Foot and Ankle Society ankle-hindfoot score. Fractures were united in all cases within 17 (12-24) weeks. Radiologic results were showed anatomical reduction in 8 cases and the mean AOFAS score is 87.8 (80-96). The mean range of ankle motion is 44 degree. There are one superficial wound complications and 3 cases of ankle osteoarthritis. Two stage treatment of split depression type pilon fractures is one of the good treatment methods, because of definitive second stage operation is more easier after first stage opertation designed to get early anatomical reduction, and shows good radiological and clinical outcomes.

본 연구는 영상의학과에 내원한 족부환자를 대상으로 족부 X선 검사 시 주상골(navicular)의 관찰이 어려운 점을 바탕으로 환자의 position과 X선관 각도의 변화를 주어 어떠한 position과 X선관 각도에서 주상골의 관찰이 용이한지를 알아보고자 하였다. 주상골 관찰을 위해 실험대상자의 position은 Foot AP, internal oblique, external Oblique position의 세 가지로 하였다. T-F angle(Tibia-Foot angle)은 90°와 135°로 정의하였고, X선관 각도는 0°, 5°, 10°, 15°, 20°, 25°로 정의하여 실험한 후 획득한 영상을 비교 평가하였다. 실험결과, Foot AP position에서 T-F angle이 90°인 경우 X선관 각도가 15°일 때 설상골과 주상골의 겹침 정도는 3%이었고 블라인드 테스트 결과는 4.89점으로 골절의 판독 용이성이 가장 높았으며, T-F angle이 135°경우에는 X선관 각도가 15°일 때 설상골과 주상골의 겹침 정도는 5%이었고 블라인드 테스트 결과는 4.30점으로 판독 용이성이 가장 높았다. Foot internal oblique position에서는 T-F angle이 90°인 경우 X선관 각도가 0°일 때 설상골과 주상골의 겹침 정도는 4%이었고 블라인드 테스트 결과는 4.70점으로 가장 높았으며, T-F angle이 135°경우에는 X선관 각도가 0°일 때 그 겹침 정도는 5%이었고 블라인드 테스트 결과는 4.55점으로 가장 높게 나타났다. Foot external oblique position에서 T-F angle이 90°인 경우 X선관 각도가 15°일 때 설상골과 주상골의 겹침 정도는 4%이었고 블라인드 테스트 결과는 4.85점으로 가장 높았으며, T-F angle이 135°경우에는 X선관 각도가 15°일 때 그 겹침 정도는 5%이었고 블라인드 테스트 결과는 4.75점으로 가장 높게 나타났다. 결론적으로, 본 연구를 통하여 X 선 족부검사에서 각 position에 해당하는 주상골 관찰에 용이한 T-F 각도와 X선관 각도를 확인할 수 있었으며, 향후 본 연구 결과를 바탕으로 주상골 골절 판독에 유용한 참고자료가 될 수 있을 것으로 여겨진다.