• Journal of the korean academy of Pediatric Dentistry
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• v.30 no.3
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• pp.341-347
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• 2003

Smith-Magenis syndrome (SMS) is a clinically recognizable multiple congenital anomaly and mental retardation syndrome caused by an interstitial deletion of chromosome 17 p11.2. Physical features include short stature, characteristic facial appearance: flattened mid-face, down-turned mouth, prominent and often rosy cheeks; prominent jaw in older children and adults, chronic ear infections, hearing impairment, eye problems, including: strabismus (an eye which turns in or out) and myopia (nearsightedness), hoarse voice, short fingers and toes, heart defects or murmurs, problems related to the urinary system, scoliosis (curvature of the spine), an unusual gait (walking pattern), and decreased sensitivity to pain. Behavioral and developmental characteristics include speech delay and articulation problems, developmental delay, learning disability, mental retardation, hyperactivity, self-injury, including: head banging; hand biting; picking at skin, sores and nails; pulling off finger- and toenails; inserting foreign objects into ears, nose, or other body orifices, explosive outbursts, prolonged tantrums, destructive and aggressive behavior, excitability, arm hugging or hand squeezing when excited. This report is the case of a Korean 3-year-3-month old male with Smith-Magenis syndrome referred from local clinic for the treatment of dental caries. The patient was treated by physical restraint after prophylatic administration of antibiotic(Amoxacillin 50mg/kg).

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.27 no.2
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• pp.167-173
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• 2001

Cystic lesion of the jaw are frequently encountered clinically. Although they rarely lead to development of tumors, they can result in resorption of the jaw bone or asymmetry of the face may occur. The purpose of this study is to find the clinical and histopathological pattern of cysts and to help better understanding for the diagnosis and treatment of jaw cysts. The hospital chart, out-patient chart, panorama X-ray, histopathological report and operation report of 246 patients were reviewed who had been diagnosed as cyst. Sex distribution, age distribution, classification, anatomic distribution, clinical sign & symptoms, treatment, post-operation complications, recurrence rate were studied. Then significant difference between the diameter of cyst with bone graft and none-bone graft was calculated with SAS program. The results were as follows. 1. Among the total patient of 246 cases, male were 163 case(67.0%), and female were 83 case(37.0%), male predominated by the ratio of 1.98. 2. By age group, the 20's accounted for the largest proportion of the cases(27.2%) and the 30' accounted for the 2nd largest proportion of the case(19.5%). 3. Radicular cyst and dentigerous cyst were most common cysts, irrespective of 166 case(67.5%) and 62 case(25.2%). 4. Clinical sign & symptoms were swelling(167case), pain(85case), pus discharge(53case), teeth discoloration(28case), indicating that most complaints were related to inflammation and facial asymmetry. 4.9% of the total cases were discovered accidentally. 5. The primary site of cysts were maxillary anterior area(43.9%), the others were, in descending order, mandibular posterior area(25.6%), maxillary posterior area(14.6%). 6. Enucleation with endodontic treatment was a main treatment method(133 case, 54.1%) and 38 cases(15.4%) were enucleation with extraction, and 37 cases(15.0%) were only enucleation, and 21 cases(8.5%) were enucleation with bone graft. 7. The average diameter of cysts with bone graft was significally greater than with non-bone graft(p<0.05). 8. Post-operation complications occurred in 10 case(4.1%), all of this were due to secondary infection.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.30 no.6
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• pp.545-550
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• 2004

Salivary glands, major and minor, are susceptible to a wide variety of pathologic conditions. Excision of the submandibular gland is a surgical procedure often undertaken. The procedure is the treatment of choice for patients with neoplasm of the submandibular gland and those with non-neoplastic submandibular disorders which are not controlled with conservative medical measures. Extirpation of the submandibular gland may also be undertaken for diagnostic purposes. We evaluated 84 patients who had been admitted to the dept. of oral and maxillofacial surgery of Pusan National University Hospital from January, 1989 to December, 2002 and had been performed submandibular gland excision. The results are as follows : 1. The patients undertaken the excision of the submandibular gland showed an age range of 16 to 71 years. The average was 49.1. 2. They consisted of 60 males(71.4%) and 24 females(28.6%), having 2.5 : 1 of genda ratio. 3. The most common symptom was swelling in 41 cases(48.8%), followed by the pain in 23 cases(27.4%). Other symptoms included mass, dysphagia, facial abnormaly and neck dyscinesia. 4. 42 cases(50.0%) showed sialadenitis and sialodochitis associated with salivary calculus. 5. According to the histopathologic study, all cases consisted of 17 neoplasmatic conditions(20.3%) and 67 non-neoplasmatic(79.7%). The neoplasmatic cases included 13 benign tumors and 4 primary malignant tumors. Sialadenitis and sialodochitis associated with or without salivary calculus were most marked, found in 50 cases(59.3%), in the non-neoplasmatic conditions. Pleoomorphic adenoma showed the highest frequency of the benign tumor.

• Journal of Korean Neurosurgical Society
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• v.63 no.3
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• pp.397-405
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• 2020

Objective : We retrospectively evaluated the efficacy of Gamma Knife radiosurgery (GKS) for recurrent nasopharyngeal carcinoma (NPC) in patients who previously underwent radiotherapy, and analyzed the treatment outcomes over 14 years. Methods : Ten patients with recurrent NPC who had previously received radiotherapy underwent stereotactic radiosurgery using a Gamma Knife^® (Elekta Inc, Atlanta, GA, USA) between 2005 and 2018. The median target volume was 8.2 ㎤ (range, 1.7-17.8), and the median radiation dose to the target was 18 Gy (range, 12-30). The median follow-up period was 18 months (range, 6-76 months). Overall and local failure-free survival rates were determined using the Kaplan-Meier method. Results : The NPCs recurred at the primary cancer site in seven patients (70%), as distant brain metastasis in two (20%), and as an extension into brain in one (10%). The recurrent tumors in seven of the 10 patients (70%) were found on the routine follow-up imaging studies. Two patients presented with headache and one with facial pain. Local failure after GKS occurred in five patients (50%) : two of whom died eight and 6 months after GKS, respectively. No adverse radiation effects were noted after GKS. The 1- and 3-year overall survival rates after GKS were 90% and 77%, respectively. The local failure-free survival rates at 6 months, 1 year, and 3 years after GKS were 80%, 48%, and 32%, respectively. The median interval from GKS to local failure was 8 months (range, 6-12). Univariate analysis revealed that using co-registration with positron emission tomography-computed tomography (PET-CT) and magnetic resonance imaging (MRI) was associated with a lower local failure rate of recurrent NPC (p=0.027). Conclusion : GKS is an acceptable salvage treatment option for patients with recurrent NPC who previously received radiation therapy. PET-CT and MRI co-registration for dose planning can help achieve local control of recurrent NPC.

• The Journal of Korean Medicine
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• v.29 no.1
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• pp.146-155
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• 2008

Objectives : This study was to assess the effectiveness of oriental medical therapy (OM) on acute Bell's palsy, comparing its outcome with that of oriental-western medical therapy (OWM). Methods : Subjects were enrolled atKyung Hee Medical Center from March 2007 to December 2007. We prescribed Igigeopung-san and acupuncture therapy to both the OM and OWM groups, and prednisolone only to the OWM group. Effectiveness was assessed by the House-Brackmann facial nerve grading system (HBGS) and Yanagihara's unweighted grading system (YUGS) every week. Results : There were 31 patients in the OM group and 34 in the OWM group. About grading system scores and weekly score gaps, no significant differences were revealed between the two groups, but statistical significant difference was detected at recovery time. After 2 weeks of treatment, the OM group's HBGS score showed significant difference from baseline score, but the OWM group showed it after 1 week. After 3 weeks of medication, pain was reduced in 22% of OM group patients, but 50% in the OWM group (p=0.028). We made the same comparison study for patients treated within 4 days from onset, but there was no significant difference between the two groups. 3 cases of adverse effect of hyperglycemia were found in the OWM group, which could be due to hyperglycemic side-effect of prednisolone. Conclusion : This work could help us to understand the effectiveness of OM compared to OWM on acute Bell's palsy.

• The Korean Journal of Nuclear Medicine
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• v.26 no.1
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• pp.72-81
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• 1992

Pharmacologic coronary vasodilation in conjunction with myocardial scintigraphy has become an accepted alternative to dynamic exercise testing for the diagnosis of coronary artery disease. Although dipyridamole has traditionally been used for this purpose, it causes frequent side effect, which at times can be life-threatening. Moreover, dipyridamole dose not elicit maximal coronary vasodilation in a substantial number of patients receiving the usual i.v. dose. Adenosine is an endogenously produced compound that has significant effects as a coronary vasodilator and rapid onset action and extremely short half-life (< 10 seconds). The diagnostic accuracy and safety profile of adenosine $^{99m}Tc-MIBI$ myocardial scintigraphy were evaluated and comparison with exercise $^{99m}Tc-MIBI$ was performed. Twenty-eight subjects underwent $^{99m}Tc-MIBI$ imaging after adenosine infusion and exercise $^{99m}Tc-MIBI$ imaging. Adenosine was infused intravenously at a dose of 0.14mg/kg/body weight per minute for 6 min and MIBI was injected at 3 minute. Adenosine caused an incerease in heart rate ($64{\pm}12$ at baseline versus $74{\pm}16$ beats/min at peak effect, p<0.001), a mild decrease in systolic and diastolic blood pressure and a slightly increase in PR interval(p; NS). Side effects were reported in 92% of patients and were mostly mild in nature and promptly resolved within 1 or 2 minutes of termination of adenosine infusion. Facial flushing (53%), chest pain (36%), mild dyspnea (39%), headache (21%), throat discomfort (21%) were frequent symptoms. ST segment depression (> 1 mm) and second degree AV block in electrocardiography occured in 11% of the patients, respectively. The overall sensitivity and specificity for individual coronary stenoses in 16 patients underwent coronary angiography were 88% and 95%, respectively. The agreement ratio of segmental perfusion between adenosine and exercise images was 92% (Kappa index=0.82). In conclusion, $^{99m}Tc-MIBI$ myocardial perfusion scintigraphy with intravenous adenosine is a feasible, safe and highly accurate noninvasive technique for the detection of coronary artery disease and results are at least comparable with those of exercise $^{99m}Tc-MIBI$ scintigraphy.

• Journal of International Academy of Physical Therapy Research
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• v.4 no.2
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• pp.573-587
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• 2013

The purpose of this study was conducted in order to analyze the effects of the manual intervention and self-corrective exercise models of general coordinative manipulation(GCM) on the balance restoration of spine & extremities joints with distortions and mal-alignment areas. The subjects were the members who visited GCM Musculoskeletal Prevent Exercise Center from March 1 2012 to December 31 2013 because of spine & extremities joints distortion and mal-alignments, poor posture, and body type correction. All subjects were diagnosed with the four types of the GBT diagnosis. And according to the standards of the mobility vs stability types of the upper & lower body, they were classified into Group 1(40 persons) and Group 2(24 persons). For every other day for three times a week, GCM intervention models were applied to all subjects for four weeks, adding up to 12 times in total. Then the balance restoration effects were re-evaluated with the same methods. The results are as follows. 1) Balance restoration effects of VASdp(Visual analysis scale pain & discomfort) and ER(Equilibrium reaction: ER) came out higher in GCM body type(GBT) II III IV of Group 1. 2) In case of balance restoration effects in Moire and postural evaluation areas, Group 1 was higher and cervical and scapular girdle were higher in Group 2. The balance restoration of the four GBT types was significant in all regions(p<.05), and the scapular girdle came out as high in the order of GBTII IV I. 3) In case of thoracic-lumbar scoliosis and head rotation facial asymmetric cervical scoliosis ribcage forward, the balance restoration effects of the upper body postural evaluation areas came out the highest in Group 1 and Group 2, respectively. The balance restoration effects of the four GBT types were significant in all regions(p<.05), and came out the highest in lumbar scoliosis GBTIII I, ribcage forward and thoracic scoliosis GBTII IV. 4) The balance restoration effects of the lower body postural evaluation areas came out higher in Group 1 and Group 2 for pelvis girdle deviation patella high umbilicus tilt and hallux valgus foot longitudinal arch: FLA patella direction, respectively. The balance restoration effects of the four GBT types were significant in all regions(p<.05), and came out the highest in pelvis girdle deviation GBTIII I and patella high-direction GBTIV II I. 5) The balance restoration effects between the same GBT came out significant (p<.05) in all evaluation areas and items. The conclusions of this study was the manual intervention and self-corrective exercise models of the GCM about the mal-alignment of the spine & extremities joints across the whole body indicated high balance restoration effects(p<.05) in spine & extremities joints in all evaluation areas.

• Journal of Acupuncture Research
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• v.22 no.5
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• pp.133-140
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• 2005

Objectives : This study was to evaluate the effect of Chuna on Temporomandibular Disorder Patients with idiopathic Scoliosis, utilizing Cobb's angle to determine the degree of curvature progression in the thoracic and lumbar regions. Methods: From October 1st 2004 to June 31st 2005, the clinical comparison study was carried out 40 cases of Temporomandibular Disorder Patients with idiopathic Scoliosis treated by both Chuna and General oriental method(Experimental Group) & only General oriental method(Control Group), who had been treated at Dept. of Acupuncture and Moxibustion Daejon Oriental Medical Hospital. Results : The results obtained as follows; 1. The facial pain of Experimental Group and Control Group was improved significantly. but the difference of two groups is not significant.(p<0.05) 2. The function of Temporomandibular joint of Experimental Group and Control Group was improved significantly. Experimental Group is more effective than Control Group significantly.(p<0.05) 3. The limitation of activity of Temporomandibular joint of Experimental Group and Control Group was improved significantly. Experimental Group is more effective than Control Group significantly. (p<0.05) Conclusion : This result sugests that the Chuna be effective treatment modality on Temporomandibular Disorder Patients with idiopathic Scoliosis. So further research is needed continuously.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.17 no.4
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• pp.447-455
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• 1995

Cavernous sinus thrombosis is one of the major complications of abscesses of the maxillofacial region. The initial symptoms of CST are usually pain in the eye and tenderness to pressure. this is associated with high fluctuating fever, chills, rapid pulse, and sweating. Venous obstruction subsequently causes edema of the eyelids, lacrimation, proptosis, chemosis and retinal hemorrhages. Blindness is sometimes an accompaniment of cavernous sinus thrombosis when the infection also involves the orbit. There is also cranial nerve involvement (oculomotor, troclear, abducence) and ophthalmoplegia, diminished or absent corneal reflex, ptosis, and dilation of the pupil occur. The terminal stages bring signs of advanced toxemia and meningitis. Infections of the face can cause a septic thrombosis of the cavernous sinus. Furunculosis and infected hair follicles in the nose are frequent causes. Extractions of maxillary anterior teeth in the presence of acute infection and especially curettage of the sockets under such circumstances can cause this condition. The infection is usually staphylococcal. The inflection may spread directly through the pterygoid plexus of veins and the pterygomaxillary space and then ascend into the sinus or it may spread directly from the pterygopalatine space to the orbit. This is possible because of the absence of valves in the angular, facial, and ophthalmic veins. The treatment is empirical antibiotic therapy followed by specific anbibiotic therapy based on blood or pus culture. The inflection usually involves one side, however, it may easily spread to the opposite side through the circulus sinus. Unless it is treated early, the prognosis is poor even in this doses. Occasionally the antibiotics will not adequately resolve the septic thrombus, and death ensues. the use of anticoagulants to prevent venous thrombosis has been recommended, but the efficacy of such therapy has not been substantiated. Surgical access through eye enucleation has been suggested. We report a case which demonstrates cavernous sinus thrombosis by the infection after the functional neck dissection and the intraoral reconstruction with auriculomastoid fascio-cutaneous island flap.

• The korean journal of orthodontics
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• v.30 no.6 s.83
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• pp.669-675
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• 2000

Excessive production of parathyroid hormone causes bony disorder such as periosteal bone resorption and bone pain due to excessive skeletal demineralization. A Class III facial deformity case with generalized root resorption presented bete was fumed out to be due to hyperparathyroidism. Clinical and cephalometric analysis revealed a straight skeletal profile with a retruded maxilla and a prognathic mandible. The x-ray findings demonstrated generalized root resorption of entire dentition to different degree. There also appeared osteoporosis like immature trabecular structure with the evidence of ground glass appearance. Serum test showed elevated 1evel of parathyroid hormone and growth hormone. Change of cranial growth by hyperparathyroidism can be dependent up(In a decreased bone apposition in viscerocranial growth site and abnormalities in cranial suture growth. It is possible to hypothesize that growth retardation of maxilla at least partially be accounted lot hyperparathyroidism. Therefore, regarding to the definite etiology of skeletal Class III and orthodontic treatment planning considering root resorption and osteoporosis, the early diagnosis for the hyperparathyroidism should be carefully carried by clinical and laboratory studies.