• Journal of Physiology & Pathology in Korean Medicine
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• v.18 no.4
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• pp.1218-1224
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• 2004

Tardive Dyskinesia(TD) may be defined as a syndrome consisting of abnormal, stereotyped involuntary movements, which occurs relatively late in the course of drug treatment and in the etiology of which the drug treatment is a necessary factor like schizophrenia, The frequently involved parts of the body in the schizophrenic patients who have TD were tongue, upper extremity, lips and perioral area, jaws, lower extremity, muscle of facial expression, trunk respectively. The last few years have seen a number of well-conducted clinical, biochemical, neuropathological, and therapeutic studies in patients with TD, but there is no satisfactory treatment for the majority of patients with TD. I used herb medicines and some acupoints like GV20(百會), Extra-point(鎭靜), Extra-point(間谷), Liv20(行間), of the chennel of Gall bladder to treated 2 schizophrenic patients with TD from December 2003 to May 2004. The patients with TD were somewhat improved. Nonetheless for just 2 cases, I might thought that this acupuncture therapy could be helpful to treat schizophrenic patients with TD.However, further studies should be followed.

• Archives of Plastic Surgery
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• v.34 no.6
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• pp.799-802
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• 2007

Purpose: The masserteric space is an important tissue compartment of the face, but a disease in it is difficult to diagnose and treat. The submasseteric abscess is located between the masseter muscle and mandibular ramus with different appearances such as sepsis, infection, or tumor. Especially the common misdiagnosis of submasseteric abscess is acute or chronic parotitis. The purpose of this report is to pay special attention to the possible diagnosis of submasseteric abscess for the symptoms of unilateral cheek swelling and tenderness that accompany marked trismus. Methods: A 11-year-old boy came to our hospital because of facial swelling, tenderness, and trismus in a history of left cheek swelling and toothache. We diagnosed his case as submasseteric abscess by CT scan and surgical intervention was performed. Under general anesthesia, the abscess was opened by the intraoral incision and considerably massive pus was drained. Results: Swelling, tenderness, and trismus became to subside during postoperative 10 days and general condition and vital signs became stable. After 6 months, CT scan showed that both masseteric muscles were symmetric and there was no periosteal reaction of the mandible. Conclusion: In conclusion, submasseteric abscess is a rare infection with the symptoms of cheek tenderness and marked trismus. A detailed medical history and clinical examination of a patient as well as computed tomography(CT) are important tools in the accurate diagnosis and efficient treatment of the submasseteric abscess. Adequate drainage, removal of cause, and antibiotic infusion are the management of choice.

• The Journal of the Korean dental association
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• v.48 no.11
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• pp.819-828
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• 2010

Activator is a removable functional appliance used for correcting the skeletal Class II malocclusion in children with the mandibular deficiency. Berlin standard activator modified from Andresen activator has following characters; do not cover the palatal surface for tongue space, relief on lingual surface of mandibular incisors and resin capping 1/3-1/2 of crown height on mandibular incisors for preventing labioversion of mandibular incisors, L-hook between maxillary lateral incisor and canine for anterior high pull headgear, relief on mandibular posterior bite block for differential eruption of posterior teeth. Two cases presented here had a mandibular deficiency and slight maxillary protrusion. First case (an 11-year-old girl) treated with Berlin standard activator and anterior high pull headgear for 13 months followed by fixed orthodontic appliance for another 29 months. Second case (a 12-year-old boy) treated with Berlin standard activator for 6 months followed by fixed appliance for another 24 months. Treatment results showed a significant improvement in sagittal skeletal and occlusal relationship without premolar extraction. Mandibular condyles were concentric in TMJ [ossa, and masticatory muscle activities were normalized after treatment. In the retention period facial harmony and occlusal stability was maintained.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.23 no.4
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• pp.376-379
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• 2001

There are many causes of trismus. Aetiology can be roughly divided into muscle spasm, mechanical interference, extracapsular ankylosis, intracapsular ankylosis. Trismus caused by mechanical interference between postero-lateral wall of zygoma-maxillary complex and coronoid process following reduction of fractured facial bone is rare. Especially on maxillary bone fracture, when we faced the trismus following removal of intermaxillary fixation, we got used to solve that problem by physical exercise. We obtained good results by coronoidectomy on patients with limited mouth opening who were referred from department of plastic surgery, St. Marys' hospital, the Catholic university of Korea. We report our experience with literature review.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.28 no.1
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• pp.74-80
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• 2002

Necrotizing fasciitis is rare acute infection showing rapidly necrosis involve the subcutaneous tissue and fascia. If treatment is delayed, infection can spread to involve the subcutaneous tissue, skin, deep fascia, and even muscle in rapid sequence, resulting in widespread necrosis and moderate to severe systemic toxicity. Most commonly this disease presents in the extremities, trunk, and perineum; it is relatively rare in the head and neck regions. If not diagnosed and treated in its early stages, necrotizing fasciitis can be potentially fatal, with a motality rate approaching 40%. Historically, the clinical entity now referred to as necrotizing fasciitis was described in the literature under various name. : hospital gangrene, necrotizing erysipelas, streptococcal gangrene, suppurative fasciitis. Necrotizing fasciitis was first described by Wilson in 1952. We experienced 3 cases of necrotizing fasciitis and will report review of literature with diagnosis, treatment, complication and consideration.

• Archives of Craniofacial Surgery
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• v.18 no.2
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• pp.128-131
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• 2017

With advances in diagnostic technology, radiologic diagnostic methods have been used more frequently, and physical examination may be neglected. The authors report a case of pediatric medial orbital trapdoor fracture in which the surgery was delayed because computed tomography (CT) findings did not indicate bone displacement, incarceration of rectus muscle, or soft tissue herniation. A healthy 6-year-old boy was admitted to the emergency room for right eyebrow laceration. We could not check eyeball movement or diplopia, because the patient was irritable. Thus, we performed facial CT under sedation, but there was normal CT finding. Seven days later, the patient visited our hospital due to persistent nausea and dizziness. We were able to perform a physical examination this time. Lateral gaze of right eye was limited. CT still did not show any findings suggestive of fracture, but we decided to perform exploratory surgery. We performed exploration, and found no bone displacement, but discovered entrapped soft tissue. We returned the soft tissue to its original position. The patient fully recovered six weeks later. To enable early detection and treatment, thorough physical examination and CT reading are especially needed when the patient shows poor compliance, and frequent follow-up observations are also necessary.

• Journal of The Korean Dental Society of Anesthesiology
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• v.10 no.1
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• pp.13-19
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• 2010

Bruxism is nonfunctional jaw movement that includes clenching, grinding and gnashing of teeth. It usually occurs during sleep, but with functional abnormality of brain, it can be seen during consciousness. Oromandibular dystonia (OMD) can involve the masticatory, lower facial, and tongue muscles and may result in trismus, bruxism, involuntary jaw opening or closure, and involuntary tongue movement. Its prevalence in the general population is 21%, but its incidence after brain injury is unknown, Untreated, bruxism and OMD cause masseter hypertrophy, headache, temporomandibular joint destruction and total dental wear. We report a case of successful treatment of bruxism and OMD after brain injury treated with botulinum toxin A and occlusal appliance. The patient was a 59-year-old man with operation history of frontal craniotomy and removal of malformed vessel secondary to cerebral arteriovenous malfomation. We injected with a total 60 units of botulinum toxin A each masseteric muscle and took impression for occlusal appliance fabrication under general anesthesia. On follow up 2 weeks and 2 months, the patient remained almost free of bruxism. We propose that botulinum toxin A and occlusal appliances be considered as a treatment for bruxism and OMD after brain injury.

• Clinical and Experimental Pediatrics
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• v.55 no.7
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• pp.224-231
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• 2012

Prader-Willi syndrome (PWS) is a complex multisystem genetic disorder characterized by hypothalamic-pituitary dysfunction. The main clinical features include neonatal hypotonia, distinctive facial features, overall developmental delay, and poor growth in infancy, followed by overeating with severe obesity, short stature, and hypogonadism later in development. This paper reviews recent updates regarding the genetic aspects of this disorder. Three mechanisms (paternal deletion, maternal disomy, and deficient imprinting) are recognized. Maternal disomy can arise because of 4 possible mechanisms: trisomy rescue (TR), gamete complementation (GC), monosomy rescue (MR), and postfertilization mitotic nondisjunction (Mit). Recently, TR/GC caused by nondisjunction at maternal meiosis 1 has been identified increasingly, as a result of advanced maternal childbearing age in Korea. We verified that the d3 allele increases the responsiveness of the growth hormone (GH) receptor to endogenous GH. This paper also provides an overview of endocrine dysfunctions in children with PWS, including GH deficiency, obesity, sexual development, hypothyroidism, and adrenal insufficiency, as well as the effects of GH treatment. GH treatment coupled with a strictly controlled diet during early childhood may help to reduce obesity, improve neurodevelopment, and increase muscle mass. A more active approach to correct these hormone deficiencies would benefit patients with PWS.

• Archives of Plastic Surgery
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• v.42 no.5
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• pp.580-587
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• 2015

Background Descent of the lateral aspect of the brow is one of the earliest signs of aging. The purpose of this study was to describe an open surgical technique for lateral brow lifts, with the goal of achieving reliable, predictable, and long-lasting results. Methods An incision was made behind and parallel to the temporal hairline, and then extended deeper through the temporoparietal fascia to the level of the deep temporal fascia. Dissection was continued anteriorly on the surface of the deep temporal fascia and subperiosteally beyond the temporal crest, to the level of the superolateral orbital rim. Fixation of the lateral brow and tightening of the orbicularis oculi muscle was achieved with the placement of sutures that secured the tissue directly to the galea aponeurotica on the lateral aspect of the incision. An additional fixation was made between the temporoparietal fascia and the deep temporal fascia, as well as between the temporoparietal fascia and the galea aponeurotica. The excess skin in the temporal area was excised and the incision was closed. Results A total of 519 patients were included in the study. Satisfactory lateral brow elevation was obtained in most of the patients (94.41%). The following complications were observed: total relapse (n=8), partial relapse (n=21), neurapraxia of the frontal branch of the facial nerve (n=5), and limited alopecia in the temporal incision (n=9). Conclusions We consider this approach to be a safe and effective procedure, with long-lasting results.

• Nuclear Medicine and Molecular Imaging
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• v.43 no.6
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• pp.596-599
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• 2009

A 24 year-old female presented for a $^{99m}Tc$-methylene diphosphonatae (MDP) whole body bone scan due to chronic pain in the bilateral lower extremities that has aggravated since 2002. She was diagnosed with Camurati-Engelmann disease (CED) based on the clinical and radiological findings in 2002, and she re-visited our institute to evaluate disease status at this time. CED is a rare autosomal dominant type of bone dysplasia characterized by progressive cortical thickening of long bones, and narrowing of medullary cavity, and thus presents with typical clinical symptoms and signs such as chronic pain in the extremities, muscle weakness, and waddling gait. On the $^{99m}Tc$-MDP bone scan performed to evaluate disease status, intense increased uptake was seen in the skull, facial bones, bilateral scapulae, bilateral long bones, and bilateral pelvic bones, which clearly demonstrated the extent of CED involvement.