• Korean Journal of Bronchoesophagology
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• v.17 no.1
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• pp.57-60
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• 2011

Spontaneous tonsillar bleeding is a rare condition in ENT unit. Almost reported cases have been related to infection of tonsils. Prior to introduction of antibiotics, spontaneous tonsillar bleeding was usually related to superficial capsular bleeding due to acute or chronic tonsillitis. The presented case is a 36-year old healthy man without history of acute, chronic tonsillitis, and coagulation disorder who complained of dyspnea and oropharyngeal foreign body sensation after vomitting. Examination revealed a reddish polypoid mass of the right tonsil. Furthermore, the mass pushed uvula and tongue base, caused nearly total obstruction of oropharynx. All rountine laboratory test results were within normal limits. Computed tomography (CT) showed low density mass of attached in upper pole of right tonsil without enhancement. We performed tonsillectomy including the reddish polypoid mass under general anesthesia. The pathology revealed lymphoepithelial tissue with reactive hyperplasia. This is the first reported tonsillar hematoma presenting as a large oropharyngeal mass which was caused by vomitting.

• Journal of Veterinary Clinics
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• v.14 no.2
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• pp.244-253
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• 1997

This study was performed to evaluate the possibility of inducing analgesia by electroacupuncture stimulation at single acupoint or combined acupoints and to examine the analgesic effects following the combination of premedication and electroacupunrture analgesia(EA). Analgesia was induced by EA with the current of 1-4 volts and the frequency of 10-45 Hz to the acupoints Uown to be related to analgesia on the head/necIL axial part thoracic and pelvic limb. In Yi Feng acupoint of head/neck part pain responses were not disappeared after electroacupunrture stimulation to the head/necIL thoracic limbo thoraxl abdomen, loin, rear and pelvic limb. Pain responses were remained after EA of Tian Men-Tian Ping and Shen Yu arupoints of axial park whereas hypoalgesia was observed after EA of Tian Ping-Bai Hui acupoint in all parts of body. There was no analgesic effects after EA stimulation of the brachial plexus and Wai Kuan acupoint, whereas after EA stimulation of San Yang Lo, pain responses were disappeared in headfnecll, thoracic limb and pelvic limbo and in the other parts of body hypoalgesia was shown. In EA stimulation of Tsu San Li acupoint pain responses were disappeared in pelvic limb and in San Yin Chiao acupoint pain responses were disappeared in head/necIL thoracic and pelvic limb, and hypoalgesia was shown in abdomen. On the combination of San Yang Lo Pli Men) and San Yin Chiao (Pu Yan6 acupoints, pain response in heauneck was decreased in 5 minutes, whereas analgesia in thoracic and pelvic limb was induced after 20-30 minutes and in abdomen was noted after 50 minutes. The more frequrncy was increased, the more rapid analgesic e11%t was induced. The analgesic effects wert not good in laparotomy under EA at the combination of San Yang Lo (Xi Men) and San Yin Chiao (Pu Yang) arufoints. Enteroanastomosis could not be continued under acrpromazine, xylazine and diazepam with EA. However, under EA followed by tiletaminetzolazepam, the operation could be completed without additional anesthesia and the analgesic effects were good. There were no changes in clinical signs, hematological and serological values after combination of the premeditation of tiletamine+zolaEepam and EA. It is considered that EA alone is not suitable for the main surgery, but the combination method of EA and sedatives can be utilized in practice.

• Journal of Veterinary Clinics
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• v.35 no.3
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• pp.107-110
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• 2018

A 5-year-old Thoroughbred race horse was presented to Busan Korea Racing Authority equine hospital with a 3-year history of a slow-growing left rostral maxillary mass. The location and progressive growth of the mass eventually resulted in poor food prehension, quidding and mouth bit placement. The mass was solitary and hard, and covered by normal smooth oral mucosa. Radiographic examination of the maxillae showed a flocculated and mixed radiolucent lesion protruding outward and displacing the 202 and 203 teeth caudally. The 202 tooth was in normal size and the 203 tooth was hypoplastic on radiography. Under general anesthesia, a partial surgical resection of the mass was performed to minimize functional loss and facilitate prompt return to track. After surgery, there was improvement in food intake, mouth bit placement, and cosmetic appearance. Histopathological examination determined the resected maxillay mass to be an ossifying fibroma. However, there was continued growth of remnant mass in the maxilla. Equine ossifying fibroma is a rare condition and primarily affects the rostral mandible, and less commonly, the maxillae. In this case, the lesion was slow-growing, and caused cosmetic and functional impairments, including poor food intake and reduced trainability. Surgical resection was performed, but the effect of treatment was limited due to advanced size / stage of the tumor. Early dental care is suggested for horse owners to prevent belated identification and improve successful treatment of oral disorders like ossifying fibroma.

• The Korean Journal of Pain
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• v.8 no.2
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• pp.244-250
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• 1995

Many clinical and laboratory experiments have been developed to prevent or decrease post-operative pain. One of these methods is pre-operative administration of opioid. Recently there have been differing and debatable results reported of pre-operative treatment for post-operative pain management. It was our study to determine whether pre-operative epidural fentanyl prevented central facilitation or wind up of spinal cord from nociceptive afferent input through c-fibers. We evaluated the effect of epidural fentanyl 50 mcg 10 minutes before operation and 10 minutes before the end of surgery. 28 parturient women for Cesarean Section were randomly allocated to receive the epidural fentanyl either at 10 minutes before operation (Group 1, n=14) or 10 minutes before the end of surgery (Group 2, n=14). All of the 28 parturient women were anesthetized with epidural block using (22 ml of) 2% lidocaine supplemented with light general anesthesia ($N_2O$ 2 L/min-$O_2$, 2 L/min), we controlled post-operative pain with epidural PCA(patient controlled analgesia) infusion of meperidine and 0.07% bupivacaine. The action duration of epidural fentanyl from the end of surgery to the first requirement of analgesics with epidural PCA were not significantly different between the two groups. No significant differences between two groups were observed in VAS pain score at 1, 2, 3, 6, 12, 24, and 48 hours after the operation. The number of self administration of narcotics with PCA during 48 hours after surgery were the same between the two groups. The hourly infusion rates of demerol were the same. Pre-operative administration of fentanyl was not clinically effective compared to administration just before the end of surgery for postoperative pain control.

• The Korean Journal of Physiology and Pharmacology
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• v.21 no.6
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• pp.579-589
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• 2017

Anesthetics are used extensively in surgeries and related procedures to prevent pain. However, there is some concern regarding neuronal degeneration and cognitive deficits arising from regular anesthetic exposure. Recent studies have indicated that brain-derived neurotrophic factor (BDNF) and cyclic AMP response element-binding protein (CREB) are involved in learning and memory processes. Genistein, a plant-derived isoflavone, has been shown to exhibit neuroprotective effects. The present study was performed to examine the protective effect of genistein against isoflurane-induced neurotoxicity in rats. Neonatal rats were exposed to isoflurane (0.75%, 6 hours) on postnatal day 7 (P7). Separate groups of rat pups were orally administered genistein at doses of 20, 40, or 80 mg/kg body weight from P3 to P15 and then exposed to isoflurane anesthesia on P7. Neuronal apoptosis was detected by TUNEL assay and FluoroJade B staining following isoflurane exposure. Genistein significantly reduced apoptosis in the hippocampus, reduced the expression of proapoptotic factors (Bad, Bax, and cleaved caspase-3), and increased the expression of Bcl-2 and Bcl-xL. RT-PCR analysis revealed enhanced BDNF and TrkB mRNA levels. Genistein effectively upregulated cAMP levels and phosphorylation of CREB and TrkB, leading to activation of cAMP/CREB-BDNF-TrkB signaling. PI3K/Akt signaling was also significantly activated. Genistein administration improved general behavior and enhanced learning and memory in the rats. These observations suggest that genistein exerts neuroprotective effects by suppressing isoflurane-induced neuronal apoptosis and by activating cAMP/CREB-BDNF-TrkB-PI3/Akt signaling.

• The Korean Journal of Physiology
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• v.17 no.1
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• pp.23-28
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• 1983

In order to clarify the effect of steroid on the pulmonary pressure-volume curve in the pneumonectomized rabbit, the right side pneumonectomy was performed under general anesthesia with pentobarbital sodium and the remaining lung was excised on the fifth day after surgery. The intrapulmonic pressure in the excised left lung was measured at 20, 25, and 30 ml lung volume during inflation and deflation period. In the steroid treated group, the intrapulmonic pressure at 20, 25, and 30 ml lung volume during inflation was significantly decreased compared with intrapulmonic pressure of the control group. But in the pneumonectomy group the decreasing tendency of the pressure was observed. During deflation, the intrapulmonic pressure at 25 ml and 20 ml was not significantly different from the control group in pneumonectomy and steroid treated pneumonectomy group. And the lung weight was measured in each experimental group and also the lung weightbody weight ratio(L/B) was calculated. The lung weight was significantly increased in both pneumonectomy and steroid treated pneumonectomy group. Calculated L/B was increased significantly in both group. Above results suggest that steroid increases the secretion of pulmonary surfactant or affects the catabolic effect on protein metabolism of connective tissue in lung parenchyma.

• Imaging Science in Dentistry
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• v.33 no.1
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• pp.5-14
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• 2003

Purpose: To observe the histologic pattern of healing in molar tooth extraction sockets of streptozotocin-induced diabetic rats following irradiation. Materials and Methods: Mature Sprague-Dawley rats were divided into three groups: control, diabetic, and diabetic-irradiated groups. Diabetes mellitus was induced by injecting streptozotocin. Control rats were injected with a citrate buffer only. After 5 days, the right maxillary first molar was extracted under general anesthesia from each of the rats. After the extraction, rats in the diabetic-irradiated group were irradiated with a single absorbed dose of 10 Gy to the head and neck region. The rats were killed at 1, 3, 7, 14, 21, and 28 days after treatment. Tissue sections were stained with hematoxylin-eosin and Masson's trichrome. Results: In the diabetic and diabetic-irradiated groups, the early healing process of the socket extraction was similar to the control group, but bone formation was delayed at 7 days after the treatment. In the diabetic-irradiated group, alveolar bone surrounding the extraction socket showed signs of necrosis at 3 days after treatment, and hemorrhage was observed in connective tissue within the extraction socket at 14 days after treatment. Conclusion: This experiment revealed that the healing process of the extraction socket was severely delayed and retarded by irradiation in the diabetic state.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.37 no.4
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• pp.255-263
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• 2011

Introduction: Maxillomandibular fixation (MMF) is essential before surgery under general anesthesia in maxillofacial trauma patients. MMF is used basically to reconstruct the occlusion and occlusal stability to recover the facial shape and oral functions. The arch bar and wire is a traditional method for MMF, but it can not only bring pressure to the periodontal ligaments and teeth but also cause a penetrating injury to the surgeons. Materials and Methods: In this study, 198 patients with an open reduction using a manual reduction without MMF from September 2005 to May 2010 in Dankook University Dental Hospital were subjected to a follow-up evaluation during the postoperative 4 months periods. This study evaluated the incidence of complications according to the condition of the patient (gender, age), the state of bony union of the fracture sites and a numeric rating scale evaluation for postoperative pain scoring. Results: 1. The complications were classified into major and minor according to the seriousness, and the major complication rate was as low as 2.02%. Only 2 cases of re-operations (1.01%) were encountered. In the classification according to the fracture line, plate fracture was observed in both cases of mandibular symphysis fracture, and angle fractures and loosening of two screws were noted in the case of mandibular angle fracture. 2. The complication rate was similar regardless of gender and age. 3. The degree of bony union was satisfactory, and the complication rate was reduced as the bony union improved. 4. More patients complained of pain as the operation time was increased. Conclusion: The use of MMF is not always necessary if a skilled assistant is provided to help manually reduce the fracture site. Compared to other studies of mandibular fracture surgery using MMF, the complication rate was similar using only manual reduction and the patients' discomfort was reduced without MMF.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.40 no.6
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• pp.285-290
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• 2014

Objectives: We compared resorbable plates with titanium plates for treatment of combined mandibular angle and symphyseal fractures. Materials and Methods: Patients with mandibular angle and symphysis fractures were divided into two groups. The control (T) group received titanium plates while the experimental (R) group received resorbable plates. All procedures were carried out under general anesthesia using standard surgical techniques. We compared the frequency of wound dehiscence, development of infection, malocclusion, malunion, screw breakage, and any other technical difficulties between the two groups. Results: Thirteen patients were included in the R group, where 39 resorbable plates were applied. The T group consisted of 16 patients who received 48 titanium plates. The mean age in the R and T groups was 28.29 and 24.23 years, respectively. Primary healing of the fractured mandible was obtained in all patients in both groups. Postoperative complications were minor and transient. Moreover, there were no significant differences in the rates of various complications between the two groups. Breakage of 3 screws during the perioperative period was seen in the R group, while no screws or plates were broken in the T group. Conclusion: Resorbable plates can be used to stabilize combined mandibular angle and symphysis fractures.

• Journal of Periodontal and Implant Science
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• v.26 no.2
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• pp.522-530
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• 1996

Most dentists are very interested in laser therapy on the intraoral soft tissue lesions because they want to accomplish the analgesic and aseptic surgery with little or no bleeding. In order to determine the difference of pain threshold according to different gingival tissues with or without inflammation, 25 patients with inflammatory periodontal disease and 10 volunteers with good general and oral health were selected as the inflamed group and the normal group, respectively. Interdental papilla, marginal gingiva, attached gingiva, and alveolar mucosa were irradiated by the contact delivery($300{\mu]m$ fiber optic, for 5 seconds) of a pulsed Nd:YAG laser(EN.EL.EN06O, Italy). And the laser power was gradually increased from 0.5W by the increment of 0.1W. The highest laser power was recorded as the first painful power when the painful gesture was recognized at first. The difference of the first painful power of laser according to different gingival tissues with or without inflammation was statistically analyzed by paired t-test in MICROSTAT program. Following results were obtained: 1. In the comparison related with the inflammation, the first painful power was significantly lower in the inflamed group than in the normal group, regardless of interdental papilla and marginal gingiva(p<0.05). 2. In the comparison related with the tissue structure, the first painful. power was significantly lower in alveolar mucosa than in attached gingiva(p<0.05). The results suggest that, for the painless therapy by a pulsed-Nd:YAG laser irradiation, the laser surgery over 2.0W of power should be necessarily accomplished under the local anethesia, and the local anesthesia should be considered according to the degree of inflammation, the tissue structure, and the purpose of laser therapy.