• Archives of Craniofacial Surgery
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• v.24 no.2
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• pp.78-82
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• 2023

Blue nevi, which are characterized by collections of pigment-producing melanocytes in the dermis, have a variety of clinicopathological characteristics. Plaque-type blue nevus (PTBN) is a variant of blue nevi. PTBN presents at birth or arises in early childhood, and it shows a combination of the features found in common blue nevus and cellular blue nevus. It is typically found on the dorsal surface of the hands and feet or on the head and neck, and it is usually benign and stable over time. However, reports have occasionally described malignant melanomas developing in or associated with a PTBN. Malignant blue nevi are most commonly found on the scalp. We report the case of an 88-year-old woman with a malignant melanoma associated with a PTBN of the cheek.

• Journal of Marine Bioscience and Biotechnology
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• v.6 no.2
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• pp.102-109
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• 2014

Cetaceans (whales, dolphins, and porpoises) are aquatic mammals that experienced drastic changes during the transition from terrestrial to aquatic environment. Morphological changes include streamlined body, alterations in the face, transformation of the forelimbs into flippers, disappearance of the hindlimbs and the acquisition of flukes on the tail. For a prolonged diving, cetaceans acquired hypoxia-resistance by developing various anatomical and physiological changes. However, molecular mechanisms underlying these adaptations are still limited. CREB-binding protein (CREBBP) is a transcriptional co-activator critical for embryonic development, growth control, metabolic homeostasis and responses to hypoxia. Natural selection analysis of five cetacean CREBBPs compared with those from 15 terrestrial relatives revealed strong purifying selection, supporting the importance of its role in mammals. However, prediction for amino acid changes that elicit functional difference of CREBBP identified three cetacean specific changes localized within a region required for interaction with SRCAP and in proximal regions to KIX domain of CREBBP. Mutations in CREBBP or SRCAP are known to cause craniofacial and skeletal defects in human, and KIX domain of CREBBP serves as a docking site for transcription factors including c-Myb, an essential regulator of haematopoiesis. In these respects, our study provides interesting insights into the functional adaptation of cetacean CREBBP for aquatic lifestyle.

• Archives of Craniofacial Surgery
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• v.22 no.5
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• pp.254-259
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• 2021

Background: Prophylactic antibiotics are commonly used in craniofacial surgeries. Despite the low risk of surgical site infection after nasal surgery, a lack of consensus regarding the use of antibiotic prophylaxis in the closed reduction of nasal bone fractures has led to inappropriate prescribing patterns. Through this study, we aimed to investigate the status of prophylactic antibiotic use in closed reductions of nasal bone fractures in Korea. Methods: This retrospective cohort study was conducted using data from the National Health Insurance Service-National Sample Cohort of Korea from 2005 to 2015. We analyzed the medical records of patients who underwent closed reduction of nasal bone fractures. The sex, age, region of residence, comorbidities, and socioeconomic variables of the patients were collected from the database. Factors that affect the prescription of perioperative antibiotics were evaluated using multivariate logistic regression analysis. Results: A total of 3,678 patients (mean±standard deviation of age, 28.7±14.9 years; 2,850 men [77.5%]; 828 women [22.5%]) were included in this study. The rate of antibiotic prescription during the perioperative period was 51.4%. Approximately 68.8% of prescriptions were written for patients who had received general anesthesia. The odds of perioperative prophylactic antibiotic use were significantly higher in patients who received general anesthesia than who received local anesthesia (odds ratio, 1.59). No difference was found in terms of patient age and physician specialty. Second-generation cephalosporins were the most commonly prescribed antibiotic (45.3%), followed by third- and first-generation cephalosporins (20.3% and 18.8%, respectively). In contrast, lincomycin derivatives and aminoglycosides were not prescribed. Conclusion: The findings of this study showed that there was a wide variety of perioperative antibiotic prescription patterns used in nasal bone surgeries. Evidence-based guidance regarding the prescribing of antimicrobial agents for the closed reduction of nasal bone fractures should be considered in future research.

• Imaging Science in Dentistry
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• v.49 no.1
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• pp.45-51
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• 2019

Purpose: To determine the prevalence of concha bullosa (CB) and nasal septal deviation (NSD) and their impact on maxillary sinus volume (MSV). Materials and Methods: Cone-beam computed tomographic (CBCT) images of 106 Emirati people were used in this study. The direction and angle of septal deviation were calculated. The presence of CB, which could be unilateral, contralateral, or bilateral in relation to the direction of NSD, was also recorded. MSV was measured using reconstructed Digital Imaging and Communication in Medicine images on Dolphin 3D imaging software version 11.8 premium (Dolphin Imaging, Chatsworth, CA, USA). P values<0.05 were considered to indicate statistical significance. Results: CB was detected in 37.7% of the sample; 20.7% of the sample showed single unilateral CB and 16.6% had single bilateral CB. NSD was seen in 74.5% of the sample. In the participants with CB, 45.5% showed mild deviation, 34.4% showed moderate deviation, and only 12.5% showed severe septal deviation. CB, but not NSD, was associated with significantly higher MSV on the affected side (P=0.001). Conclusion: Although NSD was observed in more than two-thirds of the sample and CB was present in more than one-third of the sample, only CB had a significant impact on MSV.

• Imaging Science in Dentistry
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• v.52 no.1
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• pp.33-41
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• 2022

Purpose: This study aimed to evaluate the structural complexity of craniofacial trabecular bone in multiple myeloma by fractal analysis of panoramic and lateral skull radiography, and to compare the fractal dimension values of healthy patients (HPs), pre-treatment patients (PTPs), and patients during bisphosphonate treatment (DTPs). Materials and Methods: Pairs of digital panoramic and lateral skull radiographs of 84 PTPs and 72 DTPs were selected. After application of exclusion criteria, 43 panoramic and 84 lateral skull radiographs of PTPs, 56 panoramic and 72 lateral skull radiographs of DTPs, and 99 panoramic radiographs of age- and sex-matched HPs were selected. The fractal dimension values from panoramic radiographs were compared among HPs, PTPs, and DTPs and between anatomical locations within patient groups using analysis of variance with the Tukey test. Fractal dimension values from lateral skull radiographs were compared between PTPs and DTPs using the Student t-test. Pearson correlation coefficients were used to assess the relationship between the mandible from panoramic radiographs and the skull from lateral skull radiographs. Intra-examiner agreement was assessed using intraclass correlation coefficients (α=0.05). Results: The fractal dimension values were not significantly different among HPs, PTPs, and DTPs on panoramic radiographs or between PTPs and DTPs on lateral skull radiographs (P>0.05). The mandibular body presented the highest fractal dimension values (P≤0.05). The fractal dimension values of the mandible and skull in PTPs and DTPs were not correlated. Conclusion: Fractal analysis was not sensitive for distinguishing craniofacial trabecular bone complexity in multiple myeloma patients using panoramic and lateral skull radiography.

• Progress in Medical Physics
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• v.21 no.2
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• pp.137-144
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• 2010

The purpose of this study was to evaluate the usefulness of reducing of craniofacial radiation dose using automatic exposure control (AEC) technique in the 64 multi-detector computed tomography (MDCT). We used SOMATOM Definition 64 multi-detector CT, and head of whole body phantom (KUPBU-50, Kyoto Kagaku CO. Ltd). The protocol were helical scan method with 120 kVp, 1 sec of rotation time, 5 mm of slice thickness and increment, 250 mm of FOV, $512{\times}512$ of matrix size, $64{\times}0.625\;mm$ of collimation, and 1 of pitch. The evaluation of dose reducing effect was compared the fixed tube current of 350 with AEC technique. The image quality was measured the noise using standard deviation of CT number. The range of craniofacial bone was to mentum end from calvaria apex, which devided three regions: calvaria~superciliary ridge (1 segment), superciliary ridge~acanthion (2 segment), and acanthion~mentum (3 segment). In the fixed tube current technique, CTDIvol was 57.7 mGy, DLP was $640.2\;mGy{\cdot}cm$ in the all regions. The AEC technique was showed that 1 segment were 30.7 mGy of CTDIvol, 340.7 $mGy{\cdot}cm$ of DLP, 2 segment were 46.5 mGy of CTDIvol, $515.0\;mGy{\cdot}cm$ of DLP, and 3 segment were 30.3 mGy of CTDIvol, $337.0\;mGy{\cdot}cm$ of DLP. The standard deviation of CT number was 2.622 with the fixed tube current technique and 3.023 with the AEC technique in the 1 segment, was 3.118 with the fixed tube current technique and 3.379 with the AEC technique in the 2 segment, was 2.670 with the fixed tube current technique and 3.186 with the AEC technique in the 3 segment. The craniofacial radiation dose using AEC Technique in the 64 MDCT was evaluated the usefulness of reducing for the eye, the parotid and thyroid with high radiation sensitivity particularly.

• Imaging Science in Dentistry
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• v.31 no.4
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• pp.227-233
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• 2001

Purpose: The purpose of this study was to investigate the apoptosis induction in tissues constituting the craniofacial region of growing rat by irradiation. Materials and Methods: The submandibular gland, brain, articular cartilage of condylar head, and calvarium were extracted from 20-day-old rats irradiated 10 Gy. Apoptosis of each tissue was examined by DNA fragmentation and estimated quantitatively using apoptotic index on TUNEL assay. Apoptotic index of each tissue was calculated by the equation for apoptotic cells/total cells × 1,000 on the images of confocal laser scanning microscopy. Apoptotic index was analyzed statistically according to the time lapse after irradiation on the tissues. Results : In the submandibular gland, apoptotic index was significantly increased from 6 hours after irradiation showing the highest value at 12 hours and decreased to the control level at 3 days after irradiation. In the brain, apoptotic index was abruptly reached to the maximum value at 6 hours after irradiation and decreased to the control level at 4 days after irradiation. Articular cartilage and calvarium showed no or little apoptotic signals. The results obtained by the apoptotic index accorded with that of DNA fragmentation. Conclusion : Radiation was closely related with the apoptosis of submandibular gland and brain but, not related with the apoptosis of the articular cartilage of condylar head and calvarium. The changes induced by radiation of the hard tissues would not be explained by apoptosis.

• The korean journal of orthodontics
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• v.50 no.4
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• pp.258-267
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• 2020

Objective: This study aimed to analyze the correlation of horizontal and sagittal planes used in two-dimensional diagnosis with lip canting by using three-dimensional (3D) analysis. Methods: Fifty-two patients (25 men, 27 women; average age: 24 years) undergoing treatment for dentofacial deformity were enrolled. Computed tomography images were acquired, and digital imaging and communication in medicine files were reconstructed into a 3D virtual model wherein horizontal and sagittal craniofacial planes were measured. Subsequently, the correlations of lip canting with these horizontal and sagittal planes were investigated. Results: The mandibular symmetry plane, the occlusal plane, Camper's plane, the mandibular plane, Broadbent's plane, and the nasal axis plane were correlated with the amount of lip canting (Pearson's correlation coefficients: 0.761, 0.648, 0.556, 0.526, 0.438, and 0.406, respectively). Planes associated with the lower part of the face showed the strongest correlations; the strength of the correlations decreased in the midfacial and cranial regions. None of the planes showed statistically significant differences between patients with clinical lip canting (> 3°) and those without prominent lip canting. Conclusions: The findings of this study suggest that lip canting is strongly correlated with the mandibular symmetry plane, which includes menton deviation. This finding may have clinical implications with regard to the treatment of patients requiring correction of lip canting. Further studies are necessary for evaluating changes in lip canting after orthognathic surgery.

• The korean journal of orthodontics
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• v.51 no.5
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• pp.337-345
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• 2021

Objective: To investigate the phenotypes and predominant skeletodental pattern in pre-adolescent patients with Pierre-Robin sequence (PRS). Methods: The samples consisted of 26 Korean pre-adolescent PRS patients (11 boys and 15 girls; mean age at the investigation, 9.20 years) treated at the Department of Orthodontics, Seoul National University Dental Hospital between 1998 and 2019. Dental phenotypes, oral manifestation, cephalometric variables, and associated anomalies were investigated and statistically analyzed. Results: Congenitally missing teeth (CMT) were found in 34.6% of the patients (n = 9/26, 20 teeth, 2.22 teeth per patient) with 55.5% (n = 5/9) exhibiting bilaterally symmetric missing pattern. The mandibular incisors were the most common CMT (n = 11/20). Predominant skeletodental patterns included Class II relationship (57.7%), posteriorly positioned maxilla (76.9%) and mandible (92.3%), hyper-divergent pattern (92.3%), high gonial angle (65.4%), small mandibular body length to anterior cranial base ratio (65.4%), linguoversion of the maxillary incisors (76.9%), and linguoversion of the mandibular incisors (80.8%). Incomplete cleft palate (CP) of hard palate with complete CP of soft palate (61.5%) was the most frequently observed, followed by complete CP of hard and soft palate (19.2%) and CP of soft palate (19.2%) (p < 0.05). However, CP severity did not show a significant correlation with any cephalometric variables except incisor mandibular plane angle (p < 0.05). Five craniofacial and 15 extra-craniofacial anomalies were observed (53.8% patients); this implicated the need of routine screening. Conclusions: The results might provide primary data for individualized diagnosis and treatment planning for pre-adolescent PRS patients despite a single institution-based data.

• Journal of the korean academy of Pediatric Dentistry
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• v.44 no.2
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• pp.228-234
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• 2017

Hydrocephalus is a condition in which the volume of cerebrospinal fluid in the cerebral ventricles is abnormally elevated. Hydrocephalus patients may show macrocephaly and delayed development. Ventriculoperitoneal shunt is the most commonly used treatment but ventriculoatrial shunt is another treatment option. This report discusses the dental management process employed for a 7-year, 6-month old patient with ventriculoperitoneal shunt-treated hydrocephalus. This patient showed dental caries on the deciduous molars, facial swelling, macrocephaly and delayed development. Pulpectomy was performed on the deciduous molars under nitrous oxide sedation and mild protective stabilization. This patient did not appear to have any specific complications until the latest follow-up and was scheduled for the management of overall oral hygiene, development of permanent teeth, and craniofacial asymmetry through periodic follow-up. During dental treatment of shunt-treated patients, care should be taken to avoid applying excessive force to the catheter running along the patient's neck to prevent the displacement of the catheter. A referral to a neurosurgeon is recommended for patients with ventriculoatrial shunts for prophylactic antibiotics. As hydrocephalus patients grow, they may show craniofacial asymmetry or differences in the calcification of the permanent teeth, and require periodic oral and craniofacial assessment.