• Maxillofacial Plastic and Reconstructive Surgery
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• v.38
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• pp.22.1-22.6
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• 2016

Background: The aim of this study is to quantitatively evaluate the effect of rhBMP-2 for repair of bone defects after cyst enucleation using the osteogenesis index (OI). Methods: Under general anesthesia, 10 patients (12 lesions) underwent oral or maxillofacial surgery for cyst enucleation. Postoperatively, 12 lesions were divided into two groups: group A (six lesions) was treated with absorbable collagen sponge (ACS) in combination with rhBMP-2, and group B (six lesions) was treated with ACS alone. After 3 months, cone-beam computed tomographic scans were obtained to measure changes in the volume of the lesions. We then calculated the OI of each group at two different Hounsfield units to determine any statistically significant difference between these two groups (Mann-Whitney U test). Results: As tested at the level of new bone, the mean OI was 72.37 % in group A and 55.08 % in group B -a statistically significant difference (p = 0.041). As tested at the level of mature bone, the mean OI was 27.47 % in group A and 18.88 % in group B, but the difference was not statistically significant (p = 0.394). Conclusions: The application of rhBMP-2 after maxillofacial cyst enucleation accelerated new bone formation in the bone defects. Thus, the use of rhBMP-2 in combination with ACS may be considered an alternative to conventional bone grafting in some patients with postoperative bone defects.

• The Journal of the Korean dental association
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• v.54 no.1
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• pp.49-56
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• 2016

An oro-antral fistula(OAF) is one of the most common complications after procedures at the maxillary posterior area. The purpose of this study was to introduce the closure of OAF with repair of the Schneiderian membrane. This case report includes three patients with OAF arising after dental surgery on molar region of maxilla. Under general anesthesia, fistulectomy was achieved in all three patients and the full thickness flap around OAF was raised. After removal of inflammatory tissue, the Schneiderian membrane was repaired with suture or application of fibrin sealant. Additional closures were then performed with a buccal fat pad flap and a buccal mucoperiosteal flap. All OAF in three patients enrolled in this study were closed successively without recurrence of fistula. Treatment of oroantral fistula using repair of the Schneiderian membrane is a good alternative option for patients with OAF accompanied by chronic maxillary sinusitis.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.36 no.5
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• pp.423-426
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• 2010

Hemangioma is a benign vascular proliferation. Intramuscular hemangiomas are rare, accounting for less than 1% of all hemangiomas, and occur normally in the trunk and extremities. Approximately 10-20% of intramuscular hemangiomas are found in the head and neck region, most often in the masseter muscles. The typical clinical characteristic is a painful soft tissue mass without cutaneous changes. The suggested treatment is a surgical excision. We report a case of an intramuscular hemagnioma of the masseter muscle. The patient was a 56 year old male who visited our clinic complaining of left facial swelling after 2 years of follow up at a different clinic. After magnetic resonance imaging (MRI), the mass was excised under general anesthesia. The biopsy revealed the mass to be an intramuscular hemangioma. We report the clinical and pathological characteristics as well as the treatment of a case of an intramuscular hemangioma of the masseter muscle.

• Journal of Korean Biological Nursing Science
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• v.20 no.3
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• pp.177-186
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• 2018

Purpose: Increasing number of older adults are receiving cancer surgeries especially for gastrointestinal cancers, which brings forth attention to age-related postoperative complication prevention. Postoperative delirium (POD) is a common complication that rises after surgical procedures involving general anesthesia, largely in the elderly population. Due to its sudden onset and fluctuating symptoms, POD often goes underdiagnosed and undertreated even though it may lead to various adverse outcomes. POD in GI cancer surgical elderly patients is poorly understood in terms of prevalence, pathophysiology, assessment, treatment and nursing management. We aimed to identify available literature and investigate study results to broaden our understanding of geriatric GI cancer POD. Methods: The search process involved six databases to identify relevant studies abided by inclusion criteria. Results: Eleven studies were selected for this review. Geriatric POD is closely related to frailty and surgical complications. Frailty increases vulnerability to surgical stress and causes cerebral changes that affect stress-regulating neurotransmitter proportions, brain blood flow, vascular density, neuron cell life and intracellular signal transductions. These conditions of frailty result in increased risks of surgical complications such as blood loss, cardiovascular events and inflammation, which all may lead to the POD. Mini Metal State Examination (MMSE), Confusion Assessment Method (CAM) and Delirium Rating Scale-revised-98 (DRS-R-98) are recommended for POD assessment to identify high-risk patients. Conclusion: The POD prevalence ranged from 8.2% to 51.0%. The multifactorial causative mechanism suggests nurses to identify highrisk elderly GI-cancer surgical patients by reviewing patient-specific factors and surgery-specific factors.

• Journal of The Korean Dental Society of Anesthesiology
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• v.12 no.3
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• pp.165-171
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• 2012

Background: The aim of this study was to investigate and compare the oral health conditions of Autism Spectrum Disease (ASD) and cerebral palsy(CP) patients visiting the Kyung Hee University Dental Hospital from January 2003 to december 2010. Methods: This study analyzed the data (patient's chart and radiograph) of fifty-eight ASD patients and fifty-seven CP patients. The oral health conditions of patients were surveyed by DMFT (dmft) and periodontal condition at the first visit. The performed dental procedure, behavior management methods and follow-up check were analyzed. Results: The average age of patients having ASD and CP was 12 year 2 month (ASD; 11 year 9 month and CP; 12 year 4 month). Within the limit of this study, the rate of dental caries was higher in CP patients than autism patients. Both of diseases showed the periodontal problem. Autistic patients showed more difficult management problems according to the rate of general anesthesia experiences. Conclusions: This article would contribute for dental practitioners to provide appropriate and specialized treatment to ASD patients and CP patients.

• Journal of Dental Anesthesia and Pain Medicine
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• v.16 no.4
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• pp.253-261
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• 2016

Background: Evidence-based clinical practice guidelines (CPGs) are defined as "statements that are scientifically reviewed about evidence and systematically developed to assist in the doctors' and patients' decision making in certain clinical situations." This recommendation aims to promote good clinical practice for the provision of safe and effective practices of conscious sedation in dentistry. Method: The development of this clinical practice guideline was conducted by performing a systematic search of the literature for evidence-based CPGs. Existing guidelines, relevant systematic reviews, policy documents, legislation, or other recommendations were reviewed and appraised. To supplement this information, key questions were formulated by the Guideline Development Group and used as the basis for designing systematic literature search strategies to identify literature that may address these questions. Guideline documents were evaluated through a review of domestic and international databases for the development of a renewing of existing conscious sedation guidelines for dentistry. Clinical practice guidelines were critically appraised for their methodologies using Appraisal of guidelines for research and evaluation (AGREE) II. Results: A total of 12 existing CPGs were included and 13 recommendations were made in a range of general, adult, and pediatric areas. Conclusion: The clinical practice guidelines for conscious sedation will be reviewed in 5 years' time for further updates to reflect significant changes in the field.

• Applied Microscopy
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• v.28 no.3
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• pp.307-314
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• 1998

The author has undertaken this study for demonstrating the relationship between keratinization and proliferation as well as remodeling of epidermis. Healthy ICR strain male mice, weighing about $20\sim25gm$, were used as experimental animals. Under the general anesthesia with ether the skins of experimental animals were subjected to a dorsal, transverse, full-thickness incision with 0.5cm in length, and removed them on 3rd day, 7th day and 2nd week after operation Specimens were prepared for electron microscopic study. The results obtained were as follows: The epidermis of 3rd day group is made up of $7\sim8$ keratinocytes. The new epidermal cells are grown beneath the necrotic tissue. Keratohyaline granules (KHGs) are visible in some granular cells. Various sited-KHGs are seen in granular layer cell, and in spinous cell ribosomes, tonofilaments and lamellar granules are seen. The epidermis of 7th day group is made up of $7\sim8$ keratinocytes. Numerous KHGs are seen in granular layer cells. KHGs are located in granular layer cells as well as spinous layer cells. The epidermis of End week group is composed of one-layered basal cell and $1\sim2$ layered superficial cells. Various sized-KHGs are observed in granular layer cells. The results of the present study suggest that as the epidermis should be keratinized during proliferation and remodeling process, so keratinization of the epidermis would play a major role of wound healing process.

• Korean Journal of Head & Neck Oncology
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• v.11 no.1
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• pp.63-67
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• 1995

Clincal observation was made on 76 cases of thyroglossal duct cyst and fistula with brief review of literature. All of the cases were diagnosed and treated surgically in Kyung Hee University Hospital from 1971 to 1993. The following results were obtained. 1) Most cases were under 20 years old(72.3%). and 49(64.5%) cases were male and 27(35.5%) cases were female. 2) Morphologically cystic type were found in 60(78.9%) cases and fistula type were 16(21.1%) cases. 3) Fluctuating cystic mass and pus discharge from fistula on just below the hyoid bone at midline of anterior neck were most common symptoms and signs. 4) 9(11.8%) cases were recurrent type and 4(5.3%) cases were recurred twice, at the time of first visit. 5) There were 2(2.6%) cases of having connection with the thyroid gland which were identified grossly on the operation field. 6) The entire cases were operated according to the Sistrunk procedure under the general anesthesia. 7) There was no recurrence and other complication except 4(5.3%) cases of wound infection.

• Archives of Plastic Surgery
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• v.35 no.3
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• pp.345-348
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• 2008

Purpose: Fracture of the frontal sinus accounts for 5-15% of all facial fractures. Only anterior table fracture occupies one third of the frontal sinus fracture. Conventional coronal approach is the standard treatment, but this method is very aggressive, especially in patient with simple, depressed, anterior frontal sinus wall fracture. We introduce new, simple technique for these patients, using small incision and Dual-top screws. Methods: A 27-year-old male patient was introduced to our department under the impression of fracture of frontal sinus, involving only anterior table. Under general anesthesia, 1.5 cm-sized, small incision was made on the suprabrow area. We reduced fractured fragment with two dual-top screws and 25G wires. Fixation was not necessary Results: The operation took about forty minutes, and the patient discharged 2 days after the operation. Postoperative 2 months follow up CT shows maintenance of reduction site. Gross depression of the forehead and visible scar was not observed. Conclusion: Although the indication of this procedure is limited, less aggressive, simple and very effective to the patient with simple. depressed, anterior frontal sinus fracture.

• Archives of Plastic Surgery
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• v.35 no.3
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• pp.321-324
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• 2008

Purpose: Lymphoma originated from mucosa associated lymphoid tissue(MALT) is most common in gastrointestinal system, and rarely found in salivary gland, thyroid, bronchus or orbit. We experienced a case of MALT lymphoma which was originated from conjunctiva and involving lower eyelid without metastasis. Methods: A 40-year-old man suffered palpable mass on right lower eyelid without pain. Orbital computed tomographic and ultrasonographic findings showed a conical mass($1.9{\times}1.2{\times}0.9cm$ size) inside lower eyelid. The mass was completely excised under local anesthesia and histopathological examination was followed. Results: Microscopic finding showed a multiple follicular colonization. In the follicle, small lymphocytes and plasma cells differentiated to centrocyte-like cell, monocyte B cell, plasma cell were diffusely infiltrated. Immunophenotyping was preformed on fixed section. The majority of the small cells were immunoreactive for the B cell marker CD20. Based on the typical histological findings supported by immunostaining, the mass was defined as MALT lymphoma. After excision, SPECT, abdominal CT was carried out and there were no evidence of extraorbital disease. Conclusion: Biopsy and pathological examination should be performed in patients who complain palpable mass on lower eyelid because of possibility of MALT lymphoma. Although MALT lymphoma is rarely metastasized, it is necessary to evaluate the extraorbital involvement using SPECT or other radiologic exams. For detecting extraorbital involvement, periodic follow-up examination is need.