• The korean journal of orthodontics
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• v.51 no.6
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• pp.366-374
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• 2021

Objective: This study investigated the impact of a single piezocision in the maxillary alveolar process on the speed of tooth movement. The null hypothesis was that the speed of tooth movement will be equal with and without piezocision. Methods: All maxillary molars on one side were moved against the combined incisors in 10 ten-week-old male Wistar rats. Under general anesthesia, a force of 25 cN was applied on either side using a Sentalloy closed coil spring. After placing the orthodontic appliance, vertical corticision was performed using a piezotome under local anesthesia, 2 mm mesial from the mesial root of the first molar on a randomly selected side; the other side served as the control. At the beginning of the treatment, and 2 and 4 weeks later, skull micro-computed tomography was performed. After image reconstruction, the distance between the mesial root of the first molar and the incisive canal, and the length of the mesial root of the first maxillary molar were measured. Moreover, the root resorption score was determined as described by Lu et al. Results: Significantly higher speed of tooth movement was observed on the corticision side; thus, the null hypothesis was rejected. The loss of root length and root resorption score were significantly more pronounced after piezocision than before. A strong correlation was observed between the speed of tooth movement and root resorption on the surgical side, but the control side only showed a weak correlation. Conclusions: Piezocision accelerates orthodontic tooth movement and causes increased root resorption.

• Journal of Korean Neurosurgical Society
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• v.65 no.2
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• pp.224-235
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• 2022

Objective : Since the outbreak of the coronavirus disease 2019 (COVID-19) pandemic, neurointerventionists have been increasingly concerned regarding the prevention of infection and time delay in performing emergency thrombectomy procedures in patients with acute stroke. This study aimed to analyze the effects of changes in mechanical thrombectomy protocol before and after the COVID-19 pandemic on procedure time and patient outcomes and to identify factors that significantly impact procedure time. Methods : The last-normal-to-door, first-abnormal-to-door, door-to-imaging, door-to-puncture, and puncture-to-recanalization times of 88 patients (45 treated with conventional pre-COVID-19 protocol and 43 with COVID-19 protection protocol) were retrospectively analyzed. The recanalization time, success rate of mechanical thrombectomy, and modified Rankin score of patients at discharge were assessed. A multivariate analysis was conducted to identify variables that significantly influenced the time delay in the door-to-puncture time and total procedure time. Results : The door-to-imaging time significantly increased under the COVID-19 protection protocol (p=0.0257) compared to that with the conventional pre-COVID-19 protocol. This increase was even more pronounced in patients who were suspected to be COVID-19-positive than in those who were negative. The door-to-puncture time showed no statistical difference between the conventional and COVID-19 protocol groups (p=0.5042). However, in the multivariate analysis, the last-normal-to-door time and door-to-imaging time were shown to affect the door-to-puncture time (p=0.0068 and 0.0097). The total procedure time was affected by the occlusion site, last-normal-to-door time, door-to-imaging time, and type of anesthesia (p=0.0001, 0.0231, 0.0103, and 0.0207, respectively). Conclusion : The COVID-19 protection protocol significantly impacted the door-to-imaging time. Shortening the door-to-imaging time and performing the procedure under local anesthesia, if possible, may be required to reduce the door-to-puncture and door-to-recanalization times. The effect of various aspects of the protection protocol on emergency thrombectomy should be further studied.

• Journal of the Korean Orthopaedic Association
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• v.54 no.2
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• pp.120-126
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• 2019

Purpose: The efficacy of periarticular multimodal drug injection and adductor canal block after a medial opening-wedge high tibial osteotomy was compared in terms of the postoperative pain level. Materials and Methods: From November 2016 to March 2017, 60 patients underwent a medial opening-wedge high tibial osteotomy under spinal anesthesia. Preemptive analgesic medication, intravenous patient controlled anesthesia were used for pain control in all patients. Thirty patients received a periarticular multimodal drug injection (group I), and 30 patients received an adductor canal block (group II). These two groups were compared regarding the postoperative pain level, frequency of additional tramadol injections, total amount of patient-controlled analgesia, and number of times that the patients pushed the patient-controlled analgesia button at each time interval. Results: The visual analogue scale scores over the two-week postoperative period showed no statistical significance. The frequency of additional tramadol hydrochloride injections was similar in the two groups over time. The mean number of times that patients pushed the patient-controlled analgesia button was similar in two groups over time. The total amount of patient-controlled analgesia was similar in the two groups over time. Conclusion: This study shows that intraoperative periarticular multimodal drug injections and adductor canal block may have a similar effect on postoperative pain control in patients who have undergone a medial opening-wedge high tibial osteotomy for unicompartmental osteoarthritis of the knee.

• Radiation Oncology Journal
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• v.12 no.1
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• pp.117-121
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• 1994

In spite of remarkable improvement of surgical skills and anesthesia, local failure still occurred in 36-45$ \% $ of locally advanced colorectal cancer after curative resection with or without pre-or post-operative irradiation. Intraoperative radiation therapy(IORT) is the ideal modality which resectable lesions are removed surgically 3nd the remaining cancer nests are sterilized by irradiation during a surgical procedure. Therefore, the excellent local control without the damage of the adjacent normal tissues can be achieved. In IORT, judicious set up of the treatment cone on the treatment surface of the patient is required for accurate and homogenous dose distribution within treatment field, especially on the slopping surface of sacrum and pelvic sidewall which are the common sites of the local recurrence in rectal cancer. For this purpose, adequate co-ordination of gantry rotation and table tilting are essential. Adjusting gantry rotation is not difficult but tilting of the table is impossible inconventional treatment couch. Department of Therapeutic Radiology in Yeungnam University Medical Center developed the IORT table for colorectal cancer which is easy to set up and detach on the Linac treatment couch within 5 minutes. The range of tilting with head-up and head-down is about 30 degree which is efficient and easy-to-use, not only for IORT but also for colorectal surgery. So far, authors performed IORT with newly developed treatment table in 2 patients with rectal cancer and we found that this newly developed table could contribute in improving the dose distribution of IORT and surgical procedure for colorectal cancer.

• Archives of Plastic Surgery
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• v.34 no.5
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• pp.647-652
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• 2007

Purpose: Single hair transplantation for eyebrow loss has been considered as a good method of achieving natural appearance of eyebrow. To date, however, no study has reported the survival rate following single hair transplantation for cicatricial eyebrow alopecia. Methods: We performed single hair transplantation using Choi hair transplanter for 49 cases of scarring eyebrow loss from March 2003 to March 2006. Of these cases, 33 could be under a follow-up postoperatively for more than seven months. These 33 cases comprised 20 men and 13 women. Mean follow-up period was 12 months (7-36 months). In 17 patients(51.5%), 100 to 200 hairs were unilaterally transplanted. Results: Following initial hair transplantation, the surgical outcome was excellent in 11 cases(33.3%), good in 12 cases(36.4%), fair or poor in the remaining ten cases(30.3%). All procedures were done under intravenous sedation and local or regional block anesthesia. It took about one and a half hours for us to transplant 200 hairs. The shape of eyebrow was aesthetically acceptable with a good direction and an ideal inclination of hairs. No patients developed notable complications, while 30 percent had a low survival rate. Conclusion: Single hair transplantation using Choi hair transplanter is a safe, effective surgical method for scarring eyebrow loss.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.32 no.2
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• pp.183-188
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• 2010

Leiomyosarcoma is a malignant neoplasm of smooth muscle origin and mostly originate from the wall of uterus and gastrointestinal tract, but primary leiomyosarcoma of the oral cavity is extremely rare. This tumor has a very poor prognosis due to high recurrence and metastasis rate, with 5 year survival rate of 32%. And regional lymph node metastasis is uncommon event. Complete wide surgical excision is the treatment of choice. A 64-year old man who had a painful ulcerative lesion on the labial & palatal gingiva of #11, 21 visited our department, and was diagnosed as leiomyosarcoma through a biopsy. Partial maxillectomy was carried out, with no following radiotherapy or chemotherapy. After months follow-up, there has been no evidence of recurrence or metastasis. But after months, we clinically find out two enlarged immobile palpable lymph node in right submandibular area of patient. So a biopsy was performed via an extraoral incision under local anesthesia. Histopathologic diagnosis diagnosis of the biopsy was lymph node metastasis of prior existed leiomyosarcoma. We report a case of a primary leiomyosarcoma occurred in a 64 year-old male patient involving the anterior maxillary region with regional lymph node metastasis with a review of literature.

• The Korean Journal of Pain
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• v.33 no.2
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• pp.144-152
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• 2020

Background: Hemidiaphragmatic paralysis, a frequent complication of the brachial plexus block performed above the clavicle, is rarely associated with an infraclavicular approach. The costoclavicular brachial plexus block is emerging as a promising infraclavicular approach. However, it may increase the risk of hemidiaphragmatic paralysis because the proximity to the phrenic nerve is greater than in the classical infraclavicular approach. Methods: This retrospective analysis compared the incidence of hemidiaphragmatic paralysis in patients undergoing costoclavicular and supraclavicular brachial plexus blocks. Of 315 patients who underwent brachial plexus block performed by a single anesthesiologist, 118 underwent costoclavicular, and 197 underwent supraclavicular brachial plexus block. Propensity score matching selected 118 pairs of patients. The primary outcome was the incidence of hemidiaphragmatic paralysis, defined as a postoperative elevation of the hemidiaphragm > 20 mm. Factors affecting the incidence of hemidiaphragmatic paralysis were also evaluated. Results: Hemidiaphragmatic paralysis was observed in three patients (2.5%) who underwent costoclavicular and 47 (39.8%) who underwent supraclavicular brachial plexus blocks (P < 0.001; odds ratio, 0.04; 95% confidence interval, 0.01-0.13). Both the brachial plexus block approach and the injected volume of local anesthetic were significantly associated with hemidiaphragmatic paralysis. Conclusions: The incidence of hemidiaphragmatic paralysis is significantly lower with costoclavicular than with supraclavicular brachial plexus block.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.32 no.1
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• pp.37-42
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• 2010

Purpose: The mental foramen (MF) is an important anatomical structure during local anesthesia and surgical procedures in terms of achieving effective mental nerve blocks and avoiding injuries to the neurovascular bundles. Thus, understanding the anatomic features of the mandibular canal and accessory mental foramen in Korean could contribute to the surgical anatomic assessment. This study was to elucidate frequency, position and course of AMF (accessory mental foramen) in Korean using 3D cone beam computed tomography. Materials and Methods: The CBCT (Conbeam computed tomography) DICOM data (Alphard, Asahi, Japan) from 540 patients in korean were analyzed. We investigated images of 3D CBCT using Ondemand (CyberMed, Korea) software program on the incidence and anatomical characteristics of accessory foramen. Results: The accessory mental foramina were found in 17 patients. Accessory mental foramina exist predominantly in the apical area of the second premolar and posteroinferior area of the mental foramen. The accessory branches of the mandibular canal showed common characteristics in the course of gently sloping posterosuperior direction in the buccal surface area. The size of most AMF was obviously smaller than that of MF. Conclusion: We could identify frequency, position and course of AMF (accessory mental foramen) by the anatomical study of the accessory mental foramen using 3D cone beam CT in Korean.

• Journal of Korean Foot and Ankle Society
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• v.8 no.1
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• pp.26-30
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• 2004

Purpose: The infected diabetic foot patients were reviewed to analyze the result of new dressing methods using a wall-suction instruments. Materials and Methods: Eighteen patients treated with wall-suction assisted vacuum dressing were included. After debridement under local anesthesia, a sponge pad, a drain, and a surgical drape were used to seal the wound. Negative pressure applied by the wall-suction at around 200 mmHg and dressing were repeated in every two to three days. The results of repeated wound cultures, growth of granulation tissues, and CRP level were closely observed on the regular basis. Results: Rapid growth of granulation tissues was noticed around the wound in 16 cases. No organism was obtained in an average 5 days and wound coverage was possible in an average 18 days. The CRP level returned to normal in an average 4 weeks. Two patients with end stage renal disease, who were regularly hemodialised, underwent major amputation. Conclusion: New dressing method has the following advantages: a rapid wound improvement in the patients with infected diabetic foot, less expensive, less painful, impediment of bacterial contamination in the hospital room. However, further study will be needed for the end stage renal disease patients.

• International Journal of Oral Biology
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• v.37 no.1
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• pp.25-29
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• 2012

During maxillofacial surgery, the infraorbital and mental nerves are blocked at eac foramen to induce local anesthesia. This study examined the relative locations of the infraorbital foramen (IOF) and mental foramen (MF) based on softtissue landmarks. Twenty-eight hemifacial cadavers were dissected to expose the IOF and MF. The distances between the bilateral IOFs, the bilateral MFs, the alae of the nose (alares), and the corners of the mouth (cheilions) were measured directly on cadavers by using a digital vernier caliper. The vertical and horizontal distances of the IOF and MF relative to the alare and cheilion were measured indirectly on digital photographs using Adobe Photoshop (Adobe, CA, USA). The distance between the bilateral IOFs ($58.09{\pm}4.04mm$) was longer than the distance between the bilateral MFs ($50.32{\pm}1.93mm$). The distances between the bilateral alares and cheilions were $41.22{\pm}3.44mm$ and $58.43{\pm}6.62mm$, respectively. The IOF was located $12.92{\pm}3.75mm$ superior and $7.88{\pm}2.56mm$ lateral to the alare, and the vertical angle (Angle 1) between these structures was $31.67{\pm}13.36^{\circ}$ superolaterally. The MF was located $21.83{\pm}3.26mm$ inferior and $5.56{\pm}3.37mm$ medial to the cheilion, and the vertical angle (Angle 2) between these structures was $14.05{\pm}10.12^{\circ}$ inferomedially. In conclusion, these results provide more detailed information about the locations of the IOF and MF relative to soft-tissue landmarks.