• Journal of Korean Neurosurgical Society
• /
• v.59 no.1
• /
• pp.17-25
• /
• 2016

Objective : Treatment of intracranial dural arteriovenous fistulas (dAVFs) remains a challenge. However, after introduction of Onyx, transarterial approach is the preferred treatment option in many centers. We report our experience of dAVFs embolization with special emphasis on transarterial approach. Methods : Seventeen embolization procedures were performed in 13 patients with dAVFs between Jan 2009 and Oct 2014. Clinical symptoms, location and type of fistulas, embolization methods, complications, radiological and clinical outcomes were evaluated using charts and PACS images. Results : All 13 patients had symptomatic lesions. The locations of fistulas were transverse-sigmoid sinus in 6, middle fossa dura in 4, cavernous sinus in 2, and superior sagittal sinus in 1 patient. Cognard types were as follows : I in 4, IIa in 2, IIa+IIb in 5, and IV in 2. Embolization procedures were performed ${\geq}2$ times in 3 patients. Nine patients were treated with transarterial Onyx embolization alone. One of these required direct surgical puncture of middle meningeal artery. Complete obliteration of fistulas was achieved in 11/13 (85%) patients. There were no complications except for 1 case of Onyx migration in cavernous dAVF. Modified Rankin scale score at post-operative 3 months were 0 in 11, and 3 in 2 patients. Conclusion : Transarterial Onyx embolization can be a first line therapeutic option in patients with dAVFs. However, transvenous approach should be tried first in cavernous sinus dAVF because of the risk of intracranial migration of liquid embolic materials. Furthermore, combined surgical endovascular approach can be considered as a useful option in inaccessible route.

• Journal of Korean Neurosurgical Society
• /
• v.57 no.4
• /
• pp.298-302
• /
• 2015

This case report describes the symptoms and clinical course of a 35-year-old female patient who was diagnosed with a temporo-sphenoidal encephalocele. It is characterized by herniation of cerebral tissue of the temporal lobe through a defect of the skull base localized in the middle fossa. At the time of first presentation the patient complained about recurrent nasal discharge of clear fluid which had begun some weeks earlier. She also reported that three months earlier she had for the first time suffered from a generalized seizure. In a first therapeutic attempt an endoscopic endonasal approach to the sphenoid sinus was performed. An attempt to randomly seal the suspicious area failed. After frontotemporal craniotomy, it was possible to localize the encephalocele and the underlying bone defect. The herniated brain tissue was resected and the dural defect was closed with fascia of the temporalis muscle. In summary, the combination of recurrent rhinorrhea and a first-time seizure should alert specialists of otolaryngology, neurology and neurosurgery of a temporo-sphenoidal encephalocele as a possible cause. Treatment is likely to require a neurosurgical approach.

• Investigative Magnetic Resonance Imaging
• /
• v.20 no.2
• /
• pp.120-122
• /
• 2016

Arachnoid cysts (AC) are intraarachnoidal cerebrospinal fluid collections, and account for 1% of all intracranial space-occupying lesions. Intracystic hemorrhage of the AC can occur spontaneously, but this is an extremely rare event. Herein, we present a case of hemorrhagic AC in a nontraumatic patient in the left middle cranial fossa. We also performed relevant literature review on this disease.

• Journal of Korean Neurosurgical Society
• /
• v.30 no.sup1
• /
• pp.140-143
• /
• 2001

We report a case of huge trigeminal schwannoma in a 10-year-old boy with neurofibromatosis type II, extending into the three spaces of the left middle, posterior, and infratemporal fossa. Initially we thought the child had a solitary trigeminal schwannoma, and most of the mass was resected successfully through one-stage operation, cranio-orbito-zygomatic intradural approach. However during the follow-up of the patient we found radiographically other multiple intracranial tumors of bilateral acoustic schwannomas, right trigeminal schwannoma, and foramen magnum tumor. Eventually the patient was diagnosed as neurofibromatosis type II presenting multiple intracranial tumors. We think childhood trigeminal schwannoma, even though in the case of solitary tumor, should be considered as possible initial manifestation of neurofibromatosis type II and that careful follow-up for the possibility of occurrence of other brain tumors such as schwannomas or meningiomas is necessary.

• Journal of the Korea Academia-Industrial cooperation Society
• /
• v.18 no.1
• /
• pp.431-440
• /
• 2017

The purpose of this study was to investigate the effects of Iyengar yoga practice on the lower body imbalance in middle-aged women. The subjects (n=24), who had not performed yoga training prior to this study (and) were not attending any other training programs, participated after undergoing an X-RAY examination with the Gonstead Technique and then their lower body imbalance (was reevaluated). The subjects completed the yoga program for 12 weeks (3 times per week, 90 minutes per session). The data were analyzed with the paired t-test and alpha was set at 0.05. It was found that 1) the height differences between the right and left iliac crests (p < 0.001), width (p < 0.001) and length (p < 0.001) differences between the right and left iliac fossa, and width differences between the right and left sacrum (p < 0.001) were significantly reduced after the training program. In addition, 2) the lower limb length discrepancy was significantly reduced (p < 0.001). Our data suggest that Iyengar yoga training for 12 weeks reduces the pelvic imbalance and length differences between the right and left lower limbs in middle-aged females.

• The korean journal of orthodontics
• /
• v.24 no.2
• /
• pp.331-348
• /
• 1994

The purpose of this study was to investigate changes in the shape and ultrastructure of the articular disc of the rat mandibular joint with aging. Mechanical stress applied to the articular disc changes during neonatal, suckling, juvenile, adult and senile stages. Mandibular joints of 6 groups of rats(1-, 7-, 17-, 27-, 55-day and over-1-year groups) were removed en bloc and processed for light and electro microscopic study. The changes in the shape of articular disc were examined by light microscope in each group. Structural and ultrastructural changes in the articular disc were examined by light and electron microscope in each group. The results were as follows : In the 1-day and 7-day groups, the articular disc was long and slender in shape and the articular disc was not fitted with the shape of the mandibular fossa and condyle. However' after that time, the anterior and posterior portions of the articular disc were more bulged and the middle portion was shorter and biconcave. Thus the articular disc was well fitted with the shape of the mandibular fossa and condyle. The cell density decreased with aging. In the l -day and 7-day groups, the Golgi apparatus, rough endoplasmic reticulum and free ribosome, which are involved in the synthesis of intracellular and extracellular matrix, were developed. In the 17-day, 27-day and 55-day groups, not only the cell organelles involved in the synthesis of the intracellular and extracellular matrix but also the cell organelles involved in the remodeling of the extracellular matrix(i.e., finger-like cell process, lysosome and mitochondria)were well developed. With advancing age, intracytoplasmic microfilaments were more accumulated and condroid cells increased. In the over-1-year group, the majority of cells of the articular disc were chondroid cells. The majority of cytoplasmic compartment were filled with intracytoplasmic microfilaments and cell organelles were not developed. Therefore, metabolic activities of the cell was markedly reduced and cells contained structures enduring mechanical stress, and cells which were in the process of degeneration were observed occasionally.

• Journal of the korean academy of Pediatric Dentistry
• /
• v.26 no.1
• /
• pp.172-184
• /
• 1999

The present study was performed to identify morphologic sub-groupings in Korean children with Class I malocclusions, and to find out anatomic differences between the sub-groups. Standardized lateral cephalometric radiographs of 152 Korean children, aged between 6 and 12 years, with Class I malocclusions were analyzed by the Counterpart Analysis. A statistical method, Ward's Minimum Variance Cluster Analysis, was employed to divide the sample into sub-groups those with similar morphologic characteristics. The results were as follows; 1. There appeared two facial types, Type I and Type II, in Korean children with Class I malocclusions, 48.7% and 51.3%, respectively. 2. In both sub-groups, there existed strong Class III skeletal patterns due to a counterclockwise rotation of the Middle Cranial Fossa alignment, and strong Class II skeletal patterns due to the long Posterior Maxillary vertical dimension and a clockwise rotation of the Ramus alignment. 3. There were no significant differences in Upper Anterior Facial Height between Type I and Type II, $52.6{\pm}2.92mm\;and\;52.8{\pm}3.23mm$, respectively. 4. The Lower Anterior Facial Height in Type II was longer ($66.0{\pm}4.03mm$) due to the long Posterior Maxillary vertical dimension, the clockwise rotation of the Ramus alignment, and a clockwise rotation of the Mandibular plane alignment than that of Type I ($64.2{\pm}4.15mm$).

• Restorative Dentistry and Endodontics
• /
• v.21 no.1
• /
• pp.339-352
• /
• 1996

Many dentists have been taken an interest in restoration of severly damaged teeth after endodontic treatment and it is a true that there are lots of studies about it. In these days, although we have used Para-Post, pins, threaded steel post, cast gold post and core, and so on, as a method of restoration frequently, it has been in controversy with the effects of them on the teeth and surrounding periodontal tissue. In this study, we assume that the crown of the upper 1st premolar was severly damaged, and after the root canal therapy, two most common types of restoration were carried out ; 1) coronal-radicular amalgam restoration, 2) after setting up the Para-Post, restore with amalgam core and gold crown. After restoration, in order to present the concentration of stress at internal portion of the tooth and the surrounding periodontal tissue, we doveloped a 2-dimensional finite element model of labiopalatal section, then loaded forces from 2 long perpendicular to the lingual incline of buccal ridge an the middle point, parallel to the long direction axis of tooth at the fossa-were applied. The analyzed results were as follows : 1. Stress of the normal first premolar was concentrated on the most weakest anatomical structure, that is, cervical area, and no stress on the bifurcated area of the canal. 2. Crown restoration after root canal therapy causes large stress concentration on the bifurcated area of the canal. This stress concentration has larger value in case of lateral movement of mandible, and there are decrease in the stress concentration compared with natural tooth. 3. Coronal-radicular amalgam restoration method transports more stress to the tooth structure than restoration using Para-Post. 4. There are more stress concentration around Para-Post in the case of lateral movement, and we have more favo rable result when restored with Para-Post. 5. Generally, stress in the lateral movement is larger than stress in the perpendicular load.

• Journal of Korean Academy of Oral and Maxillofacial Radiology
• /
• v.27 no.1
• /
• pp.273-281
• /
• 1997

Patient with complaints of swelling, pain in the maxillaly region and discomfort visited Seoul National University Dental Hospital in August last year. Clinical examination and diagnostic imagings implied he was suffered from fungal hyphal infection but no causative fungus was found by the histopathologic and microbiologic investigation. Therefore he was diagnosed with nonspecific inflammation. But as yet, we do think this case is very similar to some kinds of mucormycosis. So we presented this case for more thorough discussion.Followings are founded in the examination. 1. Patient had suffered from Diabetes mellitus and complained of stuffness, headache, swelling in buccal cheeks and paresthesia And we found more maxillary bony destruction and ulcer with elevated margin in the palate by clinical examination. 2. In the first visit, Plain films revealed general bony destruction of the maxilla, radiopaqueness in the sinonasal cavities. or and MRI showed soft tissue mass filled in the paranasal sinus except frontal sinus and bony destruction in involved bones. 3. No causative bacteria and fungus was found in the biopsy and microbiologic cultures. 4. Caldwell-Luc operation and curettage were carried and antJbiotics were taken for 4 months. But now he was worse than in the past 5. In the second visit, involvement of orbit, parapharyngeal sinus, clivus, cavernous sinus and middle cranial fossa were seen clearly in the or and MRI.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
• /
• v.41 no.3
• /
• pp.133-138
• /
• 2015

Objectives: To evaluate the influence of the type of osteotomy in the inferior aspect of the mandible on the mechanical performance. Materials and Methods: The study was performed on 20 polyurethane hemimandibles. A sagittal split ramus osteotomy (SSRO) was designed in 10 hemimandibles (group 1) with a vertical osteotomy in the buccal side (second molar level) and final osteotomy was performed horizontally on the lingual aspect, while the mandible body osteotomy was finalized as a straight osteotomy in the basilar area, perpendicular to the body. For group 2, the same osteotomy technique was used, but an oblique osteotomy was done in the basilar aspect of the mandibular body, forming continuity with the sagittal cut in the basilar area. Using a surgical guide, osteosynthesis was performed with bicortical screws using an inverted L scheme. In both groups vertical compression tests were performed with a linear load of 1 mm/min on the central fossa of the first molar and tests were done with models made from photoelastic resin. Data were analyzed using Student's t-test, establishing a statistical significance when P<0.05. Results: A statistical difference was not observed in the maximum displacements obtained in the two osteotomies (P<0.05). In the extensiometric analysis, statistically significant differences were identified only in the middle screw of the fixation. The photoelastic resin models showed force dissipation towards the inferior aspect of the mandible in both SSRO models. Conclusion: We found that osteotomy of the inferior aspect did not influence the mechanical performance for osteosynthesis with an inverted L system.