• Journal of Periodontal and Implant Science
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• v.33 no.3
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• pp.519-531
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• 2003

The aim of present investigation was to clinically measure the thickness of palatal masticatory mucosa in the hard palate as potential donor site for mucogingival surgery, to determine the relation to shape of palatal vault, form of tooth, gender, and to serve the clinical criteria t o choose the proper surgical technique. 84(mean age:25yrs) systemically and periodontally healthy volunteers participated in this study and 18 standard measurement points were defined in the hard palate, located on 3 lies which ran at different distances parallel to the gingival margin. 6 positions were designated on each of these 3 lines between the level of canine and 2nd molar and a bone sounding technique using a periodontal probe with minimal local anesthesia was utilized to assess the thickness of palatal masticatory mucosa. Student t-test was used to determine the difference in mucosal thickness between 2 groups gender, shape of palatal vault (high palatal vault vs. low palatal vault), tooth form (short-wide vs. long narrow) The result of this study were as follows: 1. Soft tissue thickness progressively increased in sites further away from the gingival margin (p<0.01). 2. Depending on position, in line a and line c the masticatory mucosal thickness increased from Ca to M2(p<0.01), but in line b the thickness increased from Ca to P2, and decreased to M1 and increased again to M2. 3. Gender did not influence the thickness of masticatory mucosa. 4. Palatal vault shape was associated with the thickness of masticatory mucosa. Thickness of low palatal vault group was thicker than high palatal group between P2 and M2 position. 5. Form of tooth did not influence the thickness of masticatory mucosa. In conclusion, palatal vault shape was associated with the thickness of masticatory mucosa. So, mucogingival surgery can be considered as a treatment modality in high palatal vault group. But, Gender and tooth form did not influence the thickness of masticatory mucosa.

• Journal of Periodontal and Implant Science
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• v.24 no.2
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• pp.340-356
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• 1994

The purpose of this study was to assess the clinical and microbiological effect of chlorhexidine rinse and supragingival plaque control following scaling and root planing on adult periodontal disease. 14 patients with adult periodontitis were selected for the study . They had not taken antibiotics for 6 months and history of dental treatment for 6 months before the study. Patients received a supragingival scaling and root planing under local anesthesia, plaque control group was subjected to professional plaque control 2 times for a period 2 week, chlorhexidine rinse group were subjected to twice daily 0.2% chlorhexidine rinse for a period 2 week. Clinical examination (plaque index, gingival index, probing pocket depth) and distribution of the bacteria morphology of subgingival plaque were monitored on baseline (0 week), 1 week, 2 week, 4 week and 6 week. The results were as follows : 1. Plaque index in chlorhexidine rinse group , plaque control group and control group was significantly reduced during all weeks (P<0.05). 2. Probing pocket depth was significantly reduced at 2, 4, 6 week (P<0.05) in chlorhexidine rinse group and control group, plaque control group was significantly reduced during all weeks (P<0.05). 3. Gingival index was significantly improved at 2, 4, 6 weeks(P<0.05) in chlorhexidine group and plaque control group, control group was significantly improved at 1, 2, 4 weeks (P<0.05). 4. Percentage of cocci was significantly increased at 1, 2, 4 and 6 weeks in chlorhexidine rinse group and control group, plaque control group was significantly increased at 2, 4 and 6 weeks(P<0.05). 5. Percentage of non-motile rods in all group were not significantly changed when compared with those of baseline (0 week) (P<0.05). 6. Percentage of motile rods was significantly reduced during all weeks (P<0.05) in chlorhexidine rinse group, plaque control group was significantly reduced at 2, 4, 6 weeks and 1, 2 and 4 weeks in control group. 7. Percentage of spirochetes was significantly reduced during all weeks (P<0.05), plaque control group was significantly reduced at 2, 4, 6 weeks and 1, 2, 4 weeks in control group. This results were suggested that clinical and microbiological effect of chlorhexidine rinse and supragingival plaque control following scaling and root planing on periodontal disease

• Journal of the korean academy of Pediatric Dentistry
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• v.36 no.1
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• pp.114-118
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• 2009

Sialolithiasis is the formation of calcific concretions within the ductal system of major or minor salivary glands. The submandibular gland is most involved because of its high viscosity of the saliva and the long, curved duct. It may occur at any age but, it is most common in middle-aged adults and rare in childhood. Clinical symptoms in sialolithiasis are variable but, swelling is the most common, followed by the pain. Clinical examination and radiographic examination(panoramic and mandibular occlusal radiographs, sialography, intraoral-, extraoral- ultrasound, CT scan, MRI and sialoendoscopy) can help to confirm a diagnosis and localize a stone. The treatment is surgical intervention, either removal of the sialolith or sialoadenectomy. However, non-invasive techniques including shock-wave lithotripsy, $CO_2$ laser and endoscopic treatment used in selected cases. A 5-Year-old girl referred from private practice for evaluation of a yellowish mass on the floor of the mouth. She complained that it had became three times bigger than four months ago when it was found for the first time and she had some pain on submandibular gland area occasionally. On physical examination, a firm and yellowish mass could be seen at the orifice of the submandibular duct. Diagnosis is the submandibular sialolithiasis in the anterior Wharton`s duct. Under local anesthesia, stone was removed.

• Tuberculosis and Respiratory Diseases
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• v.68 no.1
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• pp.6-9
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• 2010

Background: The efficacious use of interventional bronchoscope for patients with central airway obstruction due to malignant or benign lesions has been proven. Among many therapeutic bronchoscopic procedures, endobronchial cryotherapy is an established recanalization method for the obstruction of the respiratory tract. Recently, the use of this procedure has been increasing in Korea. However, limited data are available in the literature regarding its efficacy in Korea. Methods: Thirty patients, who had been treated with a flexible cryoprobe for cryotherapy were enrolled; clinical characteristics and treatment outcomes were analyzed. The patients had been treated with the technique using nitrous oxide as a cryogen under local anesthesia. Objective outcomes were 3 different degrees of therapeutic success by use of follow-up bronchoscopic findings as follows: successful, partially successful, and unsuccessful response. Subjective outcomes were evaluated as an improvement in symptoms. Results: The mean age of enrolled patients was $59{\pm}11$ years and there was a male (22/30) dominance. Twenty-three patients had malignant tumor and 7 patients had benign lesions with central airway obstruction. Successful recanalization was achieved in 11 (37%) patients, and partially successful response was achieved in 15 (50%) patients. Dyspnea was improved in 84.2% (16/19) of patients. At least one respiratory symptom was resolved in 91.3% (21/23) patients. Seven patients (23.3%) needed additional bronchoscopic electrocautery because of the bleeding as a complication of cryotherapy. Conclusion: Endobronchial cryotherapy is an effective and less expensive procedure for the management of central airway obstruction. However, the procedure should be performed under the preparing for an emergency situation, such as massive bleeding.

• The Journal of the Korean bone and joint tumor society
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• v.10 no.2
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• pp.113-119
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• 2004

Purpose: To determine the utility of sonographically guided percutaneous core needle biopsy to diagnose musculoskeletal soft tissue masses. Methods: A prospective study was performed in 55 patients referred for image-guided needle biopsy of primary or recurrent soft tissue masses and bone lesion or suspected solitary metastasis with extraosseous masses. Tissue samples were obtained with a 14-gauge or 18-gauge cutting needle coupled to an automated biopsy device under local anesthesia and sonographic guidance. Statistical analysis was based on 49 biopsies confirmed by successful clinical treatment (11 cases) or surgical resection (38 cases). Results: An accurate diagnosis was obtained in 47 (97%) of 49 biopsies; sensitivity was 95%, and specificity was 100%. The method did not yield sufficient tissue to establish a diagnosis in 6 cases. Considering all 55 biopsies, high-quality specimens were obtained in 87%. There were no serious complications. Conclusions: Sonographically guided core needle biopsy is accurate and safe, in soft tissue masses and bone tumors with extraosseous masses in the appendicular skeleton. In such patients, the sonographically guided procedure is the most prompt and effective method for obtaining tissue samples.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.27 no.1
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• pp.25-29
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• 2016

Background and Objectives : The clinical reports for the treatment of vocal fold scar and sulcus vocalis are limited, also there is no best one for the treatment of them. This study is to evaluate the effect of Injection laryngoplasty (IL) for the treatment of vocal fold scar and sulcus vocalis. Materials and Methods : from January 2013 to May 2015, the Nineteen patients who were diagnosed as vocal fold scar, sulcus and atrophy, and underwent IL, were engaged in this study. Clinical information and voice parameters were analyzed by retrospective chart review. Pre and post voice parameters were compared. Results : Subgroups of diagnosis were classified into sulcus vocalis for 12 patients, vocal fold scar for 5, and atrophy for 2. IL was performed under local anesthesia through cricothyroid membrane except one patient. Atesense$^{(R)}$, Radiessess$^{(R)}$, and Rofilan$^{(R)}$ were used as injected materials in 9, 9, and 1 patients respectively. Maximal phonation time (p=0.0124), dynamic range (p=0.0028), pitch range (p=0.0141), voice handicap index (p=0.028), glottal closure (p=0.0229), and mucosal wave (p=0.0132) had significant improvement for post-IL voice assessment than Pre-IL. While GRBAS, Mean flow rate, Jitter, Shimmer, Harmony to Noise ratio didn't have improvement. Conclusion : IL is a feasible option for the treatment of glottis incompetence with normally mobile vocal folds such as sulcus vocalis and vocal fold scar.

• Radiation Oncology Journal
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• v.10 no.2
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• pp.267-275
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• 1992

Remote afterloading high dose rate brachytherapy (HDRB) is a new technology and needs new biological principle for time and dose schedule. Here, authors attempt to evaluate the technique and clinical outcome in 116 patients, 590 procedures peformed at Asan Medical Center for 3 years. From Sep. 1989 to Aug 1992, 471 procedures of intracavitary radiation in 58 patients of cervical cancer and 26 of nasopharyngeal cancer,79 intraluminal radiation in 12 of esophageal cancer, 11 of endobronchial cancer and 1 Klatskin tumor and 40 interstitial brachytherapy in 4 of breast cancer, 1 sarcoma and 1 urethral cancer were performed. Median follow-up was 7 months with range $1\~31$ months. All procedures except interstitial were performed under the local anesthesia and they were all well tolerated and completed the planned therapy except 6 patients. 53/58 patients with cervical cancer and 22/26 patients with nasopharynx cancer achieved CR. Among 15 patients with palliative therapy, $80{\%}$ achieved palliation. We will describe the details of the technique and results in the text. To evaluate biologic effects of HDRB and optimal time/dose/fractionation schedule, we need longer follow-up. But authors feel that HDRB with proper fractionation schedule may yield superior results compared to the low dose rate brachytherapy considering the advantages of HDRB in safety factor for operator, better control of radiation dose and volume and patients comfort over the low dose brachytherapy.

• Journal of Chest Surgery
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• v.6 no.2
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• pp.131-142
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• 1973

Studies of cardiopulmonary function and acid-base balance were performed on 29 dogs during control period, during oligemic hypotension and following return of blood to the animals. Intravenous morphine and local anesthesia were used. Fifteen of the 29 animals survived the complete experiment. The 14 animals that failed to survive the experimental period died between 15 to 90 minutes after the onset of bleeding. The results were as follows. 1. The heart rate increased after the onset of bleeding and failed to return to control level following reinfusion. Stroke volume decreased markedly after bleeding and failed to recover after return of blood from the reservoir. Cardiac output also decreased during oligemic hypotension and was maintained at this level after re-infusion. Total peripheral resistance decreased significantly immediately after bleeding, however it increased soon over the pre-bleeding level. Central venous pressure decreased after the onset of bleeding and remained at lower level for the rest of the experimental period. Arterial blood pressure, clown to 40-45 mmHg by acute hemorrhage, was elevated near to control level. Left ventricular work decreased tremendously during oligemic hypotension and failed to return to control level with the re-infusion of blood. Hematocrit value showed no significant decrease after bleeding and increased after re-infusion. Hemoglobin decreased after the onset of bleeding and recovered to control value after re-infusion. 2. The respiratory rate fell rapidly after bleeding from 124 to 29 and remained at this lower level for the remainder of the experiment. The tidal volume increased after bleeding and was maintained at this level for the remainder of the experiment. The respiratory minute volume showed no significant changes throughout the experimental period. Oxygen consumption fell lightly in all animals during oligemic hypotension and returned to normal levels following re-infusion. Arterial oxygen content and arterial oxygen saturation decreased following bleeding and the values returned to normal levels after the return of blood from the reservoir The arterio-venous oxygen difference increased after the onset of bleeding. It failed to return to normal values following re-infusion. Arterial $Pco_2$ decreased in all animals after the beginning of the bleeding. Partial pressure of $Co_2$ continued to fall until re-infusion, after which the values returned toward normal. Animals became acidotic. The pH fell to lower level following bleeding. Lactic acid and lactate: pyruvate ratio also increased during same period. Arterial pH and lactic acid failed to return to control value and lactate: pyruvate ratio increased more after re-infusion. Sodium bicarbonate decreased after bleeding and returned to control value following re-infusion.

• Archives of Plastic Surgery
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• v.36 no.3
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• pp.318-321
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• 2009

Purpose: The bony mallet finger injury is generally managed by conservative treatments, but operative treatments are needed especially when the fractures involve above 30% of articular surface or distal phalanx is accompanied by subluxation in the volar side. This is the reason they often result in chronic instability, articular subluxation and unsatisfactory cosmetic. In this report, We describe new method using the hook plate as an operative treatment of Mallet finger deformity. Methods: Among 13 patients with Mallet finger deformity who came from February 2006 to February 2008, six patient were included in surgical indication. Under local anesthesia, H or Y type incision was made at the DIP joint area. After the DIP joint extension, the hook plate was put on the fracture line, and one self tapping screw was used for fixation. 2 hole plate which was one of the holes in 1.5 mm diameter was cut in almost half and bended through approximately $100^{\circ}$. Results: In all six cases which applied the hook plate, complications such as loss of reduction or nail deformity were not seen. In only one patient, hook pate was removed due to inflammatory reaction after surgery. At 2 weeks after operation, active motion of DIP joint was performed. The result was satisfactory not only cosmetically but also functionally. At 6 weeks after operation, the range of motion of DIP joint was average $64^{\circ}$. Conclusion: The purpose of the operative treatment for mallet finger deformity using the hook plate is to provide anatomical reduction with rigid fixation and to prevent contracture at the DIP joint. While other operations take 6 weeks, the operation using the hook plate begins an active motion at 2 weeks after operation. Complication rate was low and the method is rather simple. Thus, the operation using the hook plate is recommended as a good alternative method of the mallet finger deformity treatment.

• Archives of Plastic Surgery
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• v.33 no.6
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• pp.784-788
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• 2006

Purpose: For the reconstruction of the ankle joint as well as the soft tissue defect in the distal lower leg, a free flap or a local flap has been used, and because of the condition of patients, if a complex microvascular surgery under general anesthesia could not be performed, it could be reconstructed by using the distally based lateral supramalleolar fascio-cutaneous island flap using the perforating branch of the peroneal artery in the ankle area. Methods: The study subjects were 4 male patients between 53 years and 73 years of age. 2 cases were tissue defect in the medial malleolus area due to systemic diseases such as gouty arthritis accompanied traffic accident, diabetes mellitus foot, atherosclerotic obliterans, etc., 1 case was the defect in the pretibia area, and 1 case was the defect underneath the lateral malleolus, which was reconstructed by the distally based lateral supramalleolar fascio-cutaneous island flap. The donor area was the skin harvested from the groin, and the full thickness skin graft was performed. The size of the flap varied from $4{\times}3cm$ to $9{\times}6cm$. As the flap border, the medial side was to the tibialis anterior tendon, the lateral side was to the fibula crest, and the proximal area was less than the fibula size. Results: The consequence is that, in total 4 cases, the congestion in the flap began from 12 hours after the surgery, and the progression of congestion was ceased on the 5th day after the surgery, and finally epidermal bulla and sloughing, partial necrosis was developed. After the end of necrosis, the defect area was reconstructed successfully by the second full thickness skin graft. Conclusions: Although the distally based lateral supramalleolar fascio-cutaneous island flap has the shortcoming of requiring the second skin graft, it has the advantages that it does not require a long complex microsurgery, the flap itself is thin, it is similar to the color of the skin in the recipient area, and it does not leave a big scar in the donor area. Therefore, it is thought that for the cases who could not undergo a long complex surgery due to systemic diseases or the cases of patients whose condition of the recipient area is not suitable for microsurgery, the lateral supramalleolar fascio-cutaneous island flap is very useful for the reconstruction of the distal lower leg and the ankle joint area.