• Imaging Science in Dentistry
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• v.51 no.4
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• pp.351-361
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• 2021

Purpose: The clivus is a region in the anterior section of the occipital bone that is commonly imaged on large-volume cone-beam computed tomography (CBCT). There have been several reports of incidental clivus variations and certain pathological entities that have been attributed to the variations. This study aimed to evaluate the effects of these variations within the scope of dentistry. Materials and Methods: Medical databases (PubMed, Scopus, and Web of Science) were searched using a controlled vocabulary (clival anomalies, cone-beam CT, canalis basilaris medianus, fossa navicularis magna, clival variation). The search was limited to English language, humans, and studies published in the last 25 years. The articles were exported into RefWorks^® and duplicates were removed. The remaining articles were screened and reviewed for supporting information on variations of the clivus on CBCT imaging. Results: Canalis basilaris medianus and fossa navicularis magna were the most common anomalies noted. Many of these variations were asymptomatic, with most patients unaware of the anomaly. In certain cases, associated pathologies ranged from developmental (Tornwaldt cyst), to acquired (recurrent meningitis). While no distinct pathognomonic aspects were noted, there were unique patterns of radiographic diagnosis and treatment modalities. Most patients had a normal course of follow-up. Conclusion: Interpretation of CBCT volumes is a skill every dentist must possess. When reviewing large-volume CBCT scans, the clinician should be able to distinguish pathology from normal anatomic variations within the skull base. The majority of clivus variations are asymptomatic and will remain undetected unless incidentally noted on radiographic examinations.

• Journal of the Korean Society of Visualization
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• v.19 no.3
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• pp.115-122
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• 2021

Oral cancer surgery typically consists of resection of lesion, neck dissection and reconstruction, and it has an impact on the position of hyoid bone. Therefore, morphological change of airway can occur since the geometric parameter of airway is correlated with the hyoid bone. Airflow is affected by geometry of the airway. In this study, flow characteristics were compared between pre- and post-surgery models by both particle image velocimetry (PIV) and numerical simulation. 3D model of upper airway was reconstructed based on CT data. Velocity is accelerated by the reduced channel area, and vortex and recirculation region are observed in pre- and post-surgery models. For the post-surgery model, high pressure distribution is developed by significantly decreased hydraulic diameter, and the longitudinal flow stream is also interrupted.

• Journal of Korean Academy of Oral and Maxillofacial Radiology
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• v.20 no.2
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• pp.253-264
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• 1990

The purpose of this study was to estimate the distribution of absorbed doses of each important organs of head and neck region in panoramic radiography. Radiation dosimetry at internal anatomic sites and skin surfaces of phantom (RT-210 Humanoid Head & Neck Section/sup R/) was performed with lithium fluoride (TLD-100/sup R/) thermoluminescent dosimeters according to change of kilovoltage (65kVp, 75kVp and 85kVp) with 4 miliamperage and 20 second exposure time. The results obtained were as follows; Radiation absorbed doses of internal anatomic sites were presented the highest doses of 1.04 mGy, 1.065 mGy and 2.09 mGy in nasopharynx, relatively high doses of 0.525 mGy, 0.59 mGy and 1.108 mGy in deep lobe of parotid gland, 0.481 mGy, 0.68 mGy and 1.191 mGy in submandibular gland. But there were comparatively low doses of 0.172 mGy and 0.128 mGy in eyes and thyroid gland that absorbed dose was estimated at 85kVp. Radiation absorbed doses of skin surfaces were presented the highest doses of 1. 263 mGy, 1.538 mGy and 2.952 mGy in back side of first cervical vertebra and relatively high doses of 0.267 mGy, 0.401 mGy and 0.481 mGy in parotid gland. But there were comparatively low doses of 0.057 mGy, 0.068 mGy and 0.081 mGy in philtrum and 0.059 mGy in middle portion of chin that absorbed dose was estimated at 85kVp. According to increase of kilovoltage, the radiation absorbed doses were increased 1.1 times when kilovolt age changes from 65kVp to 75kVp and 1.9 times when kilovolt age changes from 75kVp to 85kVp at internal anatomic sites. According to increase of kilovoltage, the radiation absorbed doses were increased 1.3 times when kilovolt age changes from 65kVp to 75kVp and 1.6 times when kilovoltage changes from 75kVp to 85kVp at skin surfaces.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.22 no.2
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• pp.164-173
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• 2000

The p16 protein is a cyclin dependent kinase inhibitor that inhibits cell cycle progression from $G_1$ phase to S phase in cell cycle. Many p16 gene mutations have been noted in many cancer-cell lines and in some primary cancers, and alterations of p16 gene function by DNA methylation have been noticed in various kinds of cancer tissues and cell-lines. There have been a large body of literature has accumulated indicating that abnormal patterns of DNA methylation (both hypomethylation and hypermethylation) occur in a wide variety of human neoplasma and that these aberrations of DNA methylation may play an important epigenetic role in the development and progression of neoplasia. DNA methylation is a part of the inheritable epigenetic system that influences expression or silencing of genes necessary for normal differentiation and proliferation. Gene activity may be silenced by methylation of up steream regulatory regions. Reactivation is associated with demethylation. Although evidence or a high incidence of p16 alterations in a variety of cell lines and primary tumors has been reported, that has been contested by other investigators. The precise mechanisms by which abnormal methylation might contribute to carcinogenesis are still not fully elucidated, but conceivably could involve the modulation of oncogene and other important regulatory gene expression, in addition to creating areas of genetic instability, thus predisposing to mutational events causing neoplasia. There have been many variable results of studies of head and neck squamous cell carcinoma(HNSCC). This investigation was studied on 13 primary HNSCC for p16 gene status by protein expression in immunohistochemistry, and DNA genetic/epigenetic analyzed to determine the incidence, the mechanisms, and the potential biological significance of its Inactivation. As methylation detection method of p16 gene, the methylation specific PCR(MSP) is sensitive and specific for methylation of any block of CpG sites in a CpG islands using bisulfite-modified DNA. The genomic DNA is modified by treatment with sodium bisulfate, which converts all unmethylated cytosines to uracil(thymidine). The primers designed for MSP were chosen for regions containing frequent cytosines (to distinguish unmodified from modified DNA), and CpG pairs near the 5' end of the primers (to provide maximal discrimination in the PCR between methylated and unmethylated DNA). The two strands of DNA are no longer complementary after bisulfite treatment, primers can be designed for either modified strand. In this study, 13 paraffin embedded block tissues were used, so the fragment of DNA to be amplified was intentionally small, to allow the assessment of methylation pattern in a limited region and to facilitate the application of this technique to samlples. In this 13 primary HNSCC tissues, there was no methylation of p16 promoter gene (detected by MSP and automatic sequencing). The p16 protein-specific immunohistochemical staining was performed on 13 paraffin embedded primary HNSCC tissue samples. Twelve cases among the 13 showed altered expression of p16 proteins (negative expression). In this study, The author suggested that low expression of p16 protein may play an important role in human HNSCC, and this study suggested that many kinds of genetic mechanisms including DNA methylation may play the role in carcinogenesis.

• Asian Pacific Journal of Cancer Prevention
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• v.13 no.12
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• pp.6059-6062
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• 2012

Regional cancer epidemiology is an important basis for determining the priorities for cancer control in different countries worldwide. There is no reliable information about the pattern of head and neck cancer in western Nepal and hence an attempt was here made to evaluate the situation based on hospital data, which provide the only source in the western region of Nepal. A clinicopathological analysis of head and neck cancers treated between 2003 and 2006 in Manipal Teaching Hospital affiliated to Manipal College of Medical Sciences, Pokhara, Western Development Region, Nepal was performed. A total of 105 head and neck cancer cases were identified with a male to female ratio of 1.8:1. The median ages of male and female patients were 62 and 64 years, respectively. Ninety-seven (92.4%) of the cancer patients were suffering from carcinoma, three (2.9%) had blastoma, three (2.9%) had sarcoma, and two (1.9%) had lymphoma. The majority (61.9%) of carcinoma cases were squamous cell carcinoma followed by anaplastic carcinoma (7.2%). Of the carcinoma cases, the most common site of primary lesion was larynx (19.6%), followed by the thyroid (14.4%), the tongue and hypopharynx with 10.3% cases each. Comparative analysis among males and females did not reveal any sex difference in type of head and neck cancers. The head and neck cancer pattern revealed by the present study provides valuable leads to cancer epidemiology in western Nepal and useful information for health planning and cancer control, and future research in western Nepal.

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.10
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• pp.4335-4338
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• 2015

Background: Oral cancer is the third most common malignancy in Saudi Arabia, the highest incidence of which is reported from Jazan province. The objective of this study was to evaluate the association of various locally used substances, especially shamma, with oral cancer in the Jazan region of Saudi Arabia. Materials and Methods: A hospital-based case-control study was designed and patient records were scanned for histologically confirmed oral cancer cases. Forty eight patients who were recently diagnosed with oral cancer were selected as cases. Two healthy controls were selected for each observed case and they were matched with age (+/- 5 years) gender and location. Use of different forms of tobacco such as cigarettes, pipe-smoking and shamma (smokeless-tobacco) was assessed. Khat, a commonly used chewing substance in the community was also included. Descriptive analysis was first performed followed by multiple logistic regression (with and without interaction) to derive odds ratios (ORs) and 95% confidence interval (CIs). Results: Mean age of the study sample (56% males and 44% females) was 65.3 years. Multinomial regression analysis revealed that shamma use increased the odds of developing oral cancer by 29 times (OR=29.3; 10.3-83.1). Cigarette (OR=6.74; 2.18-20.8) was also seen to have an effect. With the interaction model the odds ratio increased significantly for shamma users (OR=37.2; 12.3-113.2) and cigarette smokers (OR=10.5; 2.88-3.11). Khat was observed to have negative effect on the disease occurrence when used along with shamma (OR=0.01; 0.00 - 0.65). Conclusions: We conclude that shamma, a moist form of smokeless tobacco is a major threat for oral cancer occurrence in the Jazan region of Saudi Arabia. This study gives a direction to conduct further longitudinal studies in the region with increased sample size representing the population in order to provide more substantial evidence.

• Journal of Korean Academy of Oral and Maxillofacial Radiology
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• v.22 no.1
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• pp.43-53
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• 1992

The purpose of this study was to investigate the effects of irradiation on the microvascular structure of the submandibular gland in rats. For this study, 110 male rats were singly irradiated with the dose of 10Gy or 20Gy to their neck region by 6MV X-irradiation and sacrificed on the 1st, 3rd, 7th, 14th and 28th day after irradiation. The author observed distribution and structural changes of the microvasculature in rat submandibular glands using a scanning electron microscope by forming vascular resin casting. The author observed ultrastructural changes of the endothelial cells using a transmission electron microscope, and also histologic changes using a light microscope at Hematoxylin and Eosin staining and PAS staining process. The results of the irradiation effects on the microvasculature in rat submandibular gland were as follows: By light microscopic examination, the dilation of small vessels were observed until the 7th day after irradiation. After then, the vascular constriction and decrease in number of small vessels were noticed. Changes were greater on 20Gy irradiated group than on lOGy irradiated group. The reaction to PAS staining at acinar cells was decreased just after irradiation, but gradually recovered with days. There was no specific difference between two irradiated groups. By scanning electron microscopic examination, general findings on the two irradiated groups were similar. The dilation of conduits and meandering were observed on the 3rd day after irradiation. Decrease of capillary density and blunt ended small vessels were appeared on the 7th day after irradiation. After that, findings of the tortuous and twisted vascular running and coarseness of capillary lumen were increased. Changes were greater on 20Gy irradiated group than on l0Gy irradiated group. By transmission electron microscopic examination, increase of the formation of cytoplasmic process was observed on the 3rd day after irradiation. After that, swelling of endothelial cell and bridge formation of cytoplasmic processes were also observed, but destruction of endothelial cell and loss of basement membrane were observed only on 20Gy irradiated group on the 28th day after irradiation.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.31 no.5
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• pp.399-408
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• 2005

In the progression of the Temporomandibular Joint Disorder(TMD), not only deformation and perforation of disc occur. But also fibrotic adhesion and inflammatory changes to the retrodiscal tissue can be seen in addition to the condylar degenerative change (e.g. osteoarthritis). However, the correct diagnosis,?planning for appropriate treatment, and prediction of prognosis are limited, because there are no means to stage the progression of the disorder. In this study relative signal intensity of retrodiscal tissue in MRI and the synovial fluid concentration of matrix metalloproteinase-2 (MMP-2), MMP-9, and Interleukin-6(IL-6) in the 23 temporomandibular joints(TMJ), from 17 patients with TMD were evaluated as a possible diagnostic marker. The relative signal intensity of retrodiscal tissue was referenced to brain gray matter with same region of interest(ROI) size. The concentrations of MMP-2, MMP-9, and IL-6 were evaluated by Enzyme Linked Immunosorbent Assay (ELISA). The collected data were compared with condylar degenerative change, joint effusion and disc position observed in MRI. The relative signal intensity of the retrodiscal tissue was increased significantly when degenerative changes were present. In addition, there was significantly high signal intensity in the presence of a disc displaced without reduction. The concentration of IL-6 was significantly increased when condylar degenerative change was no observed. And there were no changes in the levels of IL-6 according to disc position and joint effusion measurement. Moreover, there were no significant relevance between the concentration of total MMP-2 and active MMP-9 in synovial fluid, relative to degenerative changes in the mandibular condyle, to joint effusion, and to disc position observed on MRI images. In conclusion, the relative signal intensity of the retrodiscal tissue can be regarded as a mean of diagnosing the procession of TMD in a non-invasive manner. But more additional studies are required for the levels of MMP-2. MMP-9, and IL-6 to determine their potentials as a diagnostic marker for TMD.

• Journal of Korean Academy of Oral and Maxillofacial Radiology
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• v.24 no.1
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• pp.67-77
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• 1994

The purpose of this study was to investigate the irradiatiion effects on the capillary and endothelial cell in the submandibular gland. Sprague-Dawley strain male rats were singly irradiated to their neck region with the dose of 5Gy by 6MV X-irradiation and sacrificed on the 6 hours, 12 hours, 1, 3, 7, and 14days after irradiation. The authors observed the histological changes of the capillary at H & E and PAS staining under a light microscope, and also observed the ultrastructural changes of the endothelial cell using a transmission electron microscope. The obtaining results were as follows: 1. In the light microscopic examination, the capillary density was slightly increased on the 1day after irradiation, and increased until the 7 days after irradiatiion. After then, capillary density was apparently decreased. 2. The reaction to PAS staining at acinar cells was decreased on the 6 hours after irradiation, and recovered on the 7days after irradiation. But reaction was decreased on the 14days after irradiation agan, after then, gradually recovered with days. 3. In the transmission electron microscopic examination, mild proliferation of cytoplasmic process of the endothelial cell and reduction in luminal size were observed just after irradiation. After then, nuclear degeneration, marked proliferation of cytoplasmic process, thickened basal lamina, and numerous cytoplasmic vesicles were observed on the 1day after irradiation. These changes were recovered to normal on the 14days after 5Gy group, but not with 10Gy irradiation group. And destruction of endothelial cell and loss of basal lamina were not observed in both groups. 4. From the above results, reduction in luminal size, proliferation of cytoplasmic process and thickening of basal lamina were observed as the irradiation effects on the capillary and endothelial cell of the submandibular gland. And also, these changes may induce increase in capillary number and endothelial permeability by means of increase of cytoplasmic vesicle formation. The changes appeared earlier and more prominent in 10Gy irradiated group than in 5Gy irradiated group.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.26 no.6
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• pp.636-643
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• 2000

Facial asymmetry is the most frequent disease in craniofacial deformities. And the primary causing area of that is mostly placing in mandible. That is to say, it is known that primarily, mandible grows excessively or deficiently, and other facial region involving maxilla undergoes compensatory growth secondarily, so asymmetric face develops. In facial asymmetry, the surgical correction of undergrowth is more difficult than that of overgrowth and the reason of it is the postoperative relapse caused by stress of surrounding soft tissues. It means the stress of surrounding soft tissues occurring after bone lengthening and reducing above stress is the same meaning with reducing postoperative relapse. Among various areas, mandibular ramus is the most difficult area to lengthen vertically and maintain its length. The reason of it is considered by many authors as the stress of surrounding pterygomasseteric sling which is enveloping lower border of mandible and interrupting elongation of ramal height. So we applied two different surgical procedures in which pterygomasseteric slings have different stress respectively to monkeys which have similar masticatory function and anatomy to human being and compared relapse by radiographic film and observed periodically the histochemical change of masseteric muscle fiber. So we could see the following results. The relapse was less in EVRO group in which we separated pterygomasseric sling in inferior border and didn't approximate muscle sling after vertical lengthening to minimize the stress of soft tissues than IVRO group in which we elongated ramal height preserving pterygomassetric sling. Of course, we could see a problem in EVRO group such as bone resorption in inferior border caused by uncovering the periosteum of inferior border. But we expect that such problem will be solved by developing periosteum substitutes for covering the exposed bone and minimizing the surgical trauma. In histochemical study of masseteric muscle fiber, the fiber constituents of EVRO group in which we minimized soft tissue stress was changed immediately after operation and maintained it for 1 year, whereas that of IVRO group in which we preserved soft tissue stress was changed in more portion after operation and recovered it by 1 year. By the histochemical results, we can see that the recovery of fiber constituents reflect the recovery of muscle stress and it is closely related with relapse phenomenon.