• Journal of Oral Medicine and Pain
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• v.17 no.2
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• pp.75-86
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• 1992

Of the many first-occuring major manifestations of Behcet's disease, the oral ulcer is most frequently observed, shows the highest mean recurrence rate, and the longest mean duration period. A study of the relationship between mechanical irritation buy local factors and the recurrence of oral ulcers was carried out to see if there is a correlation. The subjects chosen for the study were 81 patients who were referred to the Department of Oral Diagnosis at Yonsei University Dental Hospital from the Behcet clinic of Severace Hospital after being diagnosed as Behcet's disease patients. 1. By Shimuzu's classification, possible type was the most numerous with 55.55% ; while suspected type was 19.76% ; incomplete type, 17,28% ; and complete type, 7.41% were observed in that order. The male to female ration was 1 to 1.61, and the average age of onset was 17.63 years. 2. Oral ulcers developed most frequently on the tongue (48.28%), and lip(23.15%), buccal mucosa (20.69%), palate\pharynx(4.43%), and gingiva(3.45%) also showed ulceration. 3. 38.27% of the patients were HSV positive : 27.16% were CRP positive ; 12.34% were ASO positive ; 9.87% were RF positive ; and 3.7% were ANA positive. 4. According to the answers to the survey, fatigue(85.18%) was most frequently associated with Behcet's diseage. Trauma by tooth brushing (22.22%), un specified reasons (20.98%), hard food chewing (12.35%), and irritation by dentition and/or prosthesis (13.58%) were observed in association with Behcet's disease. 23.46% had a history of tonsilitis. 5. Oral ulcers on the anterior part of tongue and buccal mucosa were associated with local irritatants. 6. Oral ulcers on the lip and posterior portion of tongue were not associated with local irritants. Local irritation by dentition and oral ulcer on the anterior part of tongue and buccal mucosa was observed to coexit with one another : in other words, lo9cal factors can act to cause of recurrence of an oral ulcer and to delay the healing process in Behcet's disease. Therefore, elimination of local factors along with systemic therapy must be recommended when treating oral ulcers.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.34 no.2
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• pp.230-236
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• 2008

Purpose: This study was performed to investigate the incidence, types of fracture, treatment, associated fracture and complications in patients with nasal bone fracture. Materials and methods: Clinical examination, patient's records and radiographic images were evaluated in 230 cases of nasal bone fractures who were treated at the Department of Oral and Maxillofacial Surgery, Chonnam National University Hospital for recent 5 years; from January 2002 to December 2006. Results: 1. The age of patient was ranged from 4 to 77 years (mean age=36.6 years); Males was 75.7% (n=174), and females 24.3% (n=56). 2. The cause of the nasal bone fracture in this study was a fall or slip down (28.8%, n=66), sports accident (26.0%, n=60), fighting (21.3%, n=49), traffic accident (9.6%, n=22), industrial trauma (7.8%, n=18), and the others (6.6%, n=15). 3. For the patterns of fracture, simple fracture without displacement occured in 10.4% (n=24). Simple fracture with displacement without septal bone fracture was found in 49.5% (n=114). Simple fracture with displacement in company with septal bone fracture showed in 32.6% (n=75). Commiuted fracture with severe depression was presented in 7.4% (n=17). 4. The reduction the displaced nasal bone was carried out in 2 to 10 days (mean 6.8 days) after the injury. 5. Nasal bone fracture associated with Le Fort I fracture (6.5%, n=6.5), Le Fort II fracture (7.4%, n=17), Le Fort III fracture (1.3%, n=3), NOE fracture (13.9%, n=32), ZMC fracture (17.4%, 40), maxillary bone fracture (8.3%, n=19), orbital blow-out fracture (15.7%, n=36), frontal bone fracture (1.3%, n=3) and alveolar bone fracture (10.9%, n=25). 6. The major type of treatment method was closed reduction in 90% (n=207), open reduction in 3% (n=7), and observation in 7% (n=16). 7. There were some complications such as ecchymosis, hyposmia, hypo esthesia and residual nasal deformity which are compatible. Open rhino-plasty was conducted for 3 patients who had residual nasal deformity. Conclusions: These results suggest that most of nasal bone fractures are occurred physically active aged groups(age 10-49 years) and could be treated successfully with closed reduction at 7 days after the injury.

• Journal of Periodontal and Implant Science
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• v.32 no.3
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• pp.539-554
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• 2002

It has been approximately 40 years since $Br{{\aa}}nemark$ first introduced osseo-integration for implants in the early 1960s. Unlike crown and bridge or denture treatment, implant treatment helps preserve existing bone and improve masticatory functions. Thus, the awareness of implant treatment has grown rapidly among dentists and patients alike in Korea, as it becomes a widely accepted treatment. The following results on patients type and implant distribution were compiled from 1814 implant cases of 640 patients treated at the periodontal dept. of Y University Hospital during 1992 to 2001. 1. There are no dissimilarities between men and women, with patients in their 40,50s accounting for 49% of patients and 56% of implant treatments; the largest share of patients and implant treatments. 2. Mn. posterior area accounted for 59% of implant treatments followed by Mx. posterior area(21%), Mx anterior area(l4%) and Mn anterior area 2%. 3. Partial edentulous patients treated by single crown and bridge-type prosthesis accounted for 98% and fully edentulous patient accounted for the remaining 2% 4. The major cause of tooth loss is periodontal disease, followed by dental caries, trauma and congenital missing. Compared to women, men are more likely to suffer from tooth loss due to periodontal disease. Also, older people are more likely to suffer from tooth loss due to periodontal disease rather than dental caries. 5. The distribution of bone quality for maxillae was 52% for type III, followed by 23% for type II, 20% for type IV and 0% for type I. As for mandible, the distribution was 52% for type II, followed by 37% for type III, 7% for type IV and 4% for type I. 6. The distribution of bone quantity for maxillae was 49% for type C, followed by 34% for type B, 14% for type D, 3% for type A, and 0% for type E. As for mandible, the distribution was 52% for type B, followed by 35% for type C, 6% for type D, 3% for type A and 0% for type E. 7. The majority of implants were those of 10-14mm in length (80%) and regular diameter in width (79%). The results provided us with basic data on patient type, implant distribution, bone condition, etc. We wish that our results coupled with other research data helps assist in the further study for better implant success/survival rates, etc.

• Journal of Trauma and Injury
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• v.25 no.4
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• pp.115-121
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• 2012

Purpose: Severe pancreaticoduodenal injuries are relatively uncommon, but may result in high morbidity and mortality, especially when management is not optimal, and determining the appropriate treatment is often difficult. The objective of this study was to review our experience and to evaluate the role of a pancreaticoduodenectomy (PD) in treatment of pancreaticoduodenal injuries. Methods: We performed a retrospective review of 16 patients who underwent an emergency PD at our hospital for severe pancreaticoduodenal injury from 1990 to 2011. Demographic data, clinical manifestations, mechanism and severity of the injury, associated injuries, postoperative complications and outcomes were reviewed. Results: The mean age of the 16 patients was $45{\pm}12years$ ($mean{\pm}standard$ deviation), and 15(93.8%) patients were male. All patients underwent an explorative laparotomy after a diagnosis using abdominal computed tomography. Almost all patients were classified as AAST grade higher than III. Thirteen(83.3%) of the 16 patients presented with blunt injuries; none presented with a penetrating injury. Only one(6.3%) patients had a combined major vascular injury. Fifteen patients underwent a standard Whipple's operation, and 1 patient underwent a pylorus-preserving pancreaticoduodenectomy. Two of the 16 patients required an initial damage-control procedure; then, a PD was performed. The most common associated injured organs were the small bowel mesentery(12, 75%) and the liver(7, 43.8%). Complications were intraabdominal abscess(50%), delayed gastric emptying(37.5%), postoperative pancreatic fistula(31.5%), and postoperative hemorrhage (12.5%). No mortalities occurred after the PD. Conclusion: Although the postoperative morbidity rate is relatively higher, an emergency PD can be perform safely without mortality for severe pancreaticoduodenal injuries. Therefore, an emergency PD should be considered as a life-saving procedure applicable to patients with unreconstructable pancreaticoduodenal injuries, provided that is performed by an experienced hepatobiliary surgeon and the patient is hemodynamically stable.

• Archives of Plastic Surgery
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• v.38 no.2
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• pp.161-165
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• 2011

Purpose: Zygomaticomaxillary complex (ZMC) fracture is one of the most common facial injuries after facial trauma. As ZMC composes major facial buttress, it is a key element of the facial contour. So, when we treat these fractures, the operator should have a concern with the symmetry to restore normal appearance and function. But sometimes, unfavorable results may occur. The aim of this study is to analyze the unsatisfied midfacial contour after ZMC fractures reduction retrospectively and to point out the notandum. Methods: 369 patients, treated for fractures of the ZMC were included in the study. After the operation, such as open reduction and internal fixation (ORIF with titanium or absorbable materials), open reduction, and closed reduction, midfacial contour was evaluated with plain films and 3-dimensional computed tomography. And unfavorable asymmetric midfacial contours were correcterd by secondary correction and re-evaluated. Gross photographs were obtained at outpatient clinic. Results: Total of 38 patients had got a facial asymmetry and among of them 24 patients were treated secondary revisional ORIF operations for correction of unfavorable result of after primary reduction. Two of them had received tertiary operations, three patients had got osteotomy more than after one year and six patients had got minor procedures. The etiology of asymmetry were lateral displaced simple fracture of arch (n=2), lateral displaced comminuted fracture of arch (n=6), comminuted arch fracture combined posterior root fracture (n=9), and communited arch and body fracture (n=12), severely contused soft tissue (n=9). After the manipulations outcomes were acceptable. Conclusion: To prevent the asymmetry in ZMC fracture reduction, complete analysis of fracture, choice of appropriate operation technique, consider soft tissue, and secure of zygoma position are important. Especially, we should be more careful about communited fracture of zygomatic body and lateral displacement, root fracture of zygomatic arch. Because they are commom causes that make facial asymmetry. To get optimal result, ensure the definite bony reduction.

• Journal of Physiology & Pathology in Korean Medicine
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• v.19 no.6
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• pp.1676-1680
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• 2005

There are few topic about a pulmonary thromboembolism(PTE) especially in Korean medical research. This case report is dealt with a rare situation that a PTE and a lacunar infarction are complicated in one patient. They have a similarity in that both are caused by the thrombosis. The former is the thrombosis in lung and the latter is the cerebral infarcion within the territory of a single perforating artery Recently the attack rate of PTE somewhat grow because of the development of medicine such as the increasing use of indwelling catheters, trauma or surgery of pelvis and lower extrimity, major surgery especially in senior, the use of estrogen containing compounds, cerebrovascular disease, obesity, etc. A 70 year-old lady was stroked by the cerebral infarction and has been getting rehabilitating therapy. She had the sudden onset of dyspnea, chest pain and those symptoms looked like a myocardial infarction. But she was diagnosed as PTE by ventilation perfusion lung scan. We cured her with the integrated therapy of Korean and Western medicine.

• Journal of Chest Surgery
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• v.8 no.1
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• pp.37-44
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• 1975

Authors have reviewed the records of seven patients of multiple rib fractures with severe flail chest who were admitted to Hanyang University Hospital during the 3 years period from 1972 through 1975. Of the seven patients studied, automobile accidents led to the injuries in 4 cases, two patients were injured in fall from a tree and on the ox-heading. All who had a blunt trauma without any open wound on the chest. The numbers of the fractured ribs accounted for 6 to 9 of the ribs including double fractures from 3 to 5 ribs. The left side fractures occurred in the 6 patients and in the right only one patient. Thus the flail segment was more often located in the left antero-lateral position than in the right lateral position [the ratio was 6:1].. All cases had associated injuries. The injuries and multiple fractures were the most common associated injuries occurring in four and five of the patients respectively. The patients were classified as having associated head injuries when they were admitted in comatose or semicomatose state. When a major degree of instability of the thoracic cage exists, adequate respiratory change is not possible. For this reason the tracheostomy was performed in five patients in an acutely injured patient with flail chest only after an endotracheal tube has been inserted or after an endotracheal suction. All patients had secondary complications in the pleural cavity, such as hemothorax or hemopneumothorax with or without intrapulmonary hemorrhage and subcutaneous emphysema. Therefore, closed thoracostomy was performed in five patients in the emergency room. The thoracotomy was required in four patients: immediate operation without closed thoracostomy was performed in two patients and the thoracotomy was indicated in two patients after closed thoracostomy, because of increasing intrathoracic hemorrhage. As to the fixation of the flail segments, authors employed two techniques; one was towel clip traction of the flail segments and the other was intramedullary insertion of Kirschner`s wire in to the double fractured rib fragments for the fixation of the flail segments [Kirschner`s wire fixation]. Because` of an different results in the course of treatment between two techniques, data from patients with towel clip traction was compared with those from patients with thoracotomy and Kirschner`s wire fixation of the flail segments. Of the three patients with towel clip traction, two patients required bronchoscopic toilet due to lung atelectasis which developed because of inadequate motion of thoracic cage and poor expectoration. This was in contrast to the four patients with thoracotomy and Kirschner`s wire fixation, who didn`t these complication because of adequate motion of the thoracic cage and subsequent good expectoration.

• Korean Journal of Head & Neck Oncology
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• v.14 no.2
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• pp.169-174
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• 1998

Background: To avoid the major mobidity associated with bilateral radical neck dissection, modified radical neck dissection has become established as an effective adjunctive procedure in the management of head and neck cancer. But several studies reported early postoperative internal jugular vein(IJV) occlusion in patients who underwent modified radical neck dissection. Objectives: To determine internal jugular vein patency following modified radical neck dessection performed in various head and neck cancer and to identify factors associated with venous occlusion. Materials and Methods: From Aug. 1996 to Oct. 1997, twenty three patients underwent either unilateral or bilateral modified radical neck dissection; 19 males and 4 females, ranging in age from 28 to 75 were retrospectively examined. All patients had a preoperative doppler imaging or CT or both for their initial evaluation. A follow-up examination was obtained(after a minimum postoperative period of 2 months and a maximum one of 4 months). Results: Thirty-four IJVs were examined. All but six IJVs examined were found patent postoperatively. The preservation rate of patency of the IJV in modified radical neck dissection was found to be high(28 of 34 IJVs or 82%). Conclusion: The preservation rate of patency of the IJV in modified radical neck dissection was found to be high. These results favor the use of modified radical neck dissection for IJV preservation, particularly in bilateral neck dissection. A retrospective chart review revealed that trauma of the vessel and extrinsic compression of the vein by the musculocutaneous flap or recurrent carcinoma in the neck may be the cause of the vein occlusion.

• Journal of Periodontal and Implant Science
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• v.34 no.3
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• pp.563-572
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• 2004

Since bacterial plaque is known as the major cause of every oral disease, it is necessary to control plaque to maintain periodontal health. Although tooth brushing has been the typical method of plaque control, additional use of plaque control devices are necessary for cleansing interdental areas. Dental floss has been used for a long time as the additional plaque control device and proved to be effective. The newly developed embossed new dental pick is composed of elastic plastic material in form with its tip longer than other toothpick. In addition, as thickness of the tip gradually increases, it can be adapted easily with minimal trauma to interdental gingiva. The embossed tip can remove dental plaque easily, and the opposite end can approach lingual and palatal areas through triple angulation. Therefore, the authors studied the effect of embossed new dental pick and dental floss on periodontally involved 15 patient. The following results were obtained. 1. For embossed new dental pick, probing depth at baseline, 1 week, 4 weeks were $3.6{\pm}0.6mm$, $3.4{\pm}0.5mm$, $3.2{\pm}0.5mm$, respectively, and $4.2{\pm}0.9mm$, $4.1{\pm}0.9mm$, $4.0{\pm}0.9mm$, respectivly for clinical attachment level. 2. In case of embossed new dental pick, bleeding on probing at baseline, 1 week, 4 weeks were $43.0{\pm}4.4%$, $28.5{\pm}5.1%$, $22.2{\pm}5.6%$, respectively, and, at 1 week and 4 weeks, they were significantly different from that of dental floss. 3. Gingival index of toαhpick at baseline, 1 week, 4 weeks were $1.7{\pm}0.5$, $1.0{\pm}0.3$, $0.9{\pm}0.2$, respectively, and, $1.7{\pm}0.5$, $1.1{\pm}0.4$, $1.0{\pm}0.4$, respectively for plaque index, and $3.0{\pm}0.5$, $1.7{\pm}0.5$, $1.4{\pm}0.4$, respectively for proximal plaque index. proximal plaque index at 4 weeks was significantly different from that of dental floss. 4. The result of questionnaire showed that the two types of device were both satisfactory, however, embossed new dental pick had higher preference as well as satisfaction. As a result, embossed new dental pick is thought to be clinically effective for its simplicity and good accessibility.

• Journal of the korean academy of Pediatric Dentistry
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• v.33 no.1
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• pp.53-61
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• 2006

When routine behavior control is impossible, midazolam is often used for sedation, because it has wide margin of safety, relatively few side-effects and multiple route of administration. Although intramuscular administration of all administration route is frequently used, it is a major source of anxiety, discomfort, and trauma in children. To the contrary, oral administration of midazolam is easily administered and accepted by children. But, it's therapeutic drug concentration has not been established. The purpose of this study was to compare sedation effect and physiologic parameter of oral midazolam which palliate demerits of intramuscular administration in sedating young pediatric patients with intramuscular midazolam Twelve negative children, mean age 62.5 months, who needed at least two separate restorative visits, requiring local anesthesia participated in this study On every visit, one of the following 2 different sedative regimen was given : (1) 0.30mg/kg midazolam by intramuscular administration (2) 0.75mg/kg by oral administration. Physiologic parameter(oxygen saturation, heart rate) was recorded by ten procedure and behavior was videotaped and rated using Ohio State University Behavior Rating Scale and Automated Counting System by one investigator, blind to administration route The analyzed sedative effect of oral midazolam resulted in good sedative effect, comparing to intramuscular route, And there is no statistically difference between oral and intramuscular administration of midazolam (p>0.05).