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Long-term results of ipsilateral radiotherapy for tonsil cancer

  • Koo, Tae Ryool;Wu, Hong-Gyun
    • Radiation Oncology Journal
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    • v.31 no.2
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    • pp.66-71
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    • 2013
  • Purpose: We evaluated the effectiveness and safety of ipsilateral radiotherapy for the patient with well lateralized tonsil cancer: not cross midline and <1 cm of tumor invasion into the soft palate or base of tongue. Materials and Methods: From 2003 to 2011, twenty patients with well lateralized tonsil cancer underwent ipsilateral radiotherapy. Nineteen patients had T1-T2 tumors, and one patient had T3 tumor; twelve patients had N0-N2a disease and eight patients had N2b disease. Primary surgery followed by radiotherapy was performed in fourteen patients: four of these patients received chemotherapy. Four patients underwent induction chemotherapy followed by concurrent chemoradiotherapy (CCRT). The remaining two patients received induction chemotherapy followed by radiotherapy and definitive CCRT, respectively. No patient underwent radiotherapy alone. We analyzed the pattern of failure and complications. Results: The median follow-up time was 64 months (range, 11 to 106 months) for surviving patients. One patient had local failure at tumor bed. There was no regional failure in contralateral neck, even in N2b disease. At five-year, local progression-free survival, distant metastasis-free survival, and progression-free survival rates were 95%, 100%, and 95%, respectively. One patient with treatment failure died, and the five-year overall survival rate was 95%. Radiation Therapy Oncology Group grade 2 xerostomia was found in one patient at least 6 months after the completion of radiotherapy. Conclusion: Ipsilateral radiotherapy is a reasonable treatment option for well lateralized tonsil cancer. Low rate of chronic xerostomia can be expected by sparing contralateral major salivary glands.

THE CORRECTION OF CLASS III MANDIBULAR ASYMMETRY USING BILATERAL SAGITTAL SPLIT RAMUS OSTEOTOMY AND LATERAL ANGLE REDUCTION (외측 하악각 골절제술을 동반한 시상분할골절단술을 통한 골격성 3급 하악골 비대칭 환자의 치료)

  • Kang, Hee-Jea;Song, In-Woo;Kang, Yung-Ki;Kim, Jong-Ryoul
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.32 no.2
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    • pp.132-140
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    • 2010
  • Purpose: The aim of this study is to identify the usefulness of unilateral mandibular angle ostectomy, so-called "Lateral Angle Reduction", in asymmetric prognathism patients by the assessment of postoperative stability and esthetic results Patients and methods: For the retrospective study, 10 skeletal class III mandibular asymmetry patients who were performed SSRO and unilateral mandibular angle ostectomy, Lateral Angle Reduction, was selected. Lateral and posterioanterior cephalogram was taken before surgery (T0), 1day after surgery (T1) and 6month after surgery (T2). To know the esthetic results the facial width and lateral facial contour were examined on posterioanterior cephalogram and to know the postoperative stability B point and Incisor inferius was examined on lateral cephalogram. Statistical analysis was performed. Results: From T0 to T1, Intergonial width was significantly decreased, dominantly at shortened side but no significant changes at lengthened side. Those were well-maintained during 6 months. Lateral facial angle and Ramus angle was significantly decreased on only shortened side from T0 to T1. As a result, after surgery, there were no significant differences in all measurements between shortened side and lengthened side. Ramus deviation angle in shortened side and ramus angle in lengthened side which reflect the angulation of ramus on frontal plane didn't show significant changes after surgery and during postsurgical periods. Lower dental midline showed no statistical changes during postsurgical period. The relapse rate on B-point was 11.92%. Conclusion: Unilateral "Lateral angle reduction" in the asymmetric mandible is valuable to obtain the narrow lower face and symmetric facial contour with a good stability.

Repair of Unilateral Cleft Lip using Mulliken's Modification of Rotation Advancement (회전-신전법의 Mulliken 변형을 이용한 편측 구순열 수술)

  • Lee, Gyu-Tae;Lim, Jae-Seok;Jung, Hwi-Dong;Jung, Young-Soo
    • Korean Journal of Cleft Lip And Palate
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    • v.15 no.1
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    • pp.21-28
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    • 2012
  • Unilateral cleft lip is not a simple and independent problem in all aspects. nasal deformity results from the cleft lip, maxillary hypoplasia, and abnormal muscular pull on the nasal structures, including abnormal muscular tension on the alar base and abnormal position of the orbicularis oris muscle. Its gross and histopathologic characteristics include widening of the alar base, a midline deviation of the columella and septum to the noncleft side, dorsal displacement of the dome, lateral rotation of medial crura, buckling of the alar cartilage, and underdevelopment of the pyriform aperture. Since Dr. Millard first presented his method for repair of the unilateral cleft lip and nasal deformity in 1955, no other technique has gained as much popularity as the rotation-advancement principle. Principles established more than 50 years ago and techniques are evolving continuously. Unlike earlier procedures, this repair gives the surgeon the opportunity to manipulate the individual cleft elements through various modifications while maintaining Millard's original surgical and anatomical goals. Although this strategy is applied worldwide, successful execution is variable and highly operator dependent. Millard and many other surgeons have made technical variations to adjust the procedure to each specific patient, to address some of its faults, and to gain new advantages. We will review the Mulliken's modifications that Dr. Millard made to his original rotation-advancement principle and inform cases applied modifying the rotation-advancement principle.

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Semi-Automatic Registration of Brain M Images Based On Talairach Reference System (Talairach 좌표계를 이용한 뇌자기공명영상의 반자동 정합법)

  • Han Yeji;Park Hyun Wook
    • Journal of the Institute of Electronics Engineers of Korea SC
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    • v.41 no.1
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    • pp.55-62
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    • 2004
  • A semi-automatic registration process of determining specified points is presented, which is required to register brain MR images based on Talairach atlas. Generally, ten specified points that define Talairach coordinates are anterior commissure(AC), posterior commissure (PC), anterior feint (AP), posterior point (PP), superior point (SP), inferior point (IP), left point (LP), right point (RP) and two points for the midline of the brain. The suggested method reduces user interaction for S points, and finds the necessary points for registration in a more stable manner by finding AC and PC using two-level shape matching of the corpus callosum (CC) in an edge-enhanced brain M image. Remaining points are found using the intensity information of cutview.

The Improvement and Completion of Outcome index: A new assessment system for quality of orthodontic treatment

  • Hong, Mihee;Kook, Yoon-Ah;Kim, Myeng-Ki;Lee, Jae-Il;Kim, Hong-Gee;Baek, Seung-Hak
    • The korean journal of orthodontics
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    • v.46 no.4
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    • pp.199-211
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    • 2016
  • Objective: Given the considerable disagreement between the Peer Assessment Rating (PAR) index and the American Board of Orthodontics Cast-Radiograph Evaluation, we aimed to develop a novel assessment system-the Improvement and Completion of Outcome (ICO) index-to evaluate the outcome of orthodontic treatment. Methods: Sixteen criteria from 4 major categories were established to represent the pretreatment malocclusion status, as well as the degree of improvement and level of completion of outcome during/after treatment: dental relationship (arch length discrepancy, irregularity, U1-SN, and IMPA); anteroposterior relationship (overjet, right and left molar position, ANB); vertical relationship (anterior overbite, anterior open-bite, lateral open-bite, SN-MP); and transverse relationship (dental midline discrepancy, chin point deviation, posterior cross-bite, occlusal plane cant). The score for each criterion was defined from 0 or -1 (worst) to 5 (ideal value or normal occlusion) in gradations of 1. The sum of the scores in each category indicates the area and extent of the problems. Improvement and completion percentages were estimated based on the pre- and post-treatment total scores and the maximum total score. If the completion percentage exceeded 80%, treatment outcome was considered successful. Results: Two cases, Class I malocclusion and skeletal Class III malocclusion, are presented to represent the assessment procedure using the ICO index. The difference in the level of improvement and completion of treatment outcome can be clearly explained by using 2 percentage values. Conclusions: Thus, the ICO index enables the evaluation of the quality of orthodontic treatment objectively and consecutively throughout the entire treatment process.

Validity of Three-dimensional Superimposition of Whole Face according to Different Registration Areas

  • Oh, Min-Hee;Jung, Chaeyong;Jeon, Sang-Woon;Cho, Jin-Hyoung
    • Journal of Korean Dental Science
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    • v.12 no.2
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    • pp.39-47
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    • 2019
  • Purpose: This study was aimed to evaluate whether the size of the changed area included in the registration area affects the validity of superimposition in three-dimensional (3D) images. Materials and Methods: Ten mannequin heads which were sectioned to simulate maxillary and mandibular setback surgery were used. A total of 30 images, including 10 initial images, 10 images after moving both middle and lower faces, and 10 images after moving only lower face, were obtained. The 9 landmarks which consisted of the bilateral and midline landmarks of the upper, middle, and lower faces respectively were used. Each 3D image obtained after simulation was superimposed 3 times according to the different 3 registration areas. The one-way ANOVA and posthoc analysis were performed. Result: In the case of moving middle and lower faces, there was no significant difference in all markers when superimposition was performed based on no changed area and forehead area. However, in the case of superimposition by the whole face, all measurements showed a significant difference (P<0.05) except for Pn (P>0.05). In the case of moving only lower face, all measurements did not show a significant difference regardless of the registration area. Conclusion: The validity of 3D superimposition in 3D images could be affected by the size of changed areas included in the registration area. In the postoperative evaluation of mandibular surgery, the registration area does not affect the accuracy of the 3D superposition. However, after the maxilla-mandibular surgery, the registration area should be set except for the changed soft tissue.

Distribution, side involvement, phenotype and associated anomalies of Korean patients with craniofacial clefts from single university hospital-based data obtained during 1998-2018

  • Chung, Jee Hyeok;Yim, Sunjin;Cho, Il-Sik;Lim, Seung-Weon;Yang, Il-Hyung;Ha, Jeong Hyun;Kim, Sukwha;Baek, Seung-Hak
    • The korean journal of orthodontics
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    • v.50 no.6
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    • pp.383-390
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    • 2020
  • Objective: To investigate the distribution, side involvement, phenotype, and associated anomalies of Korean patients with craniofacial clefts (CFC). Methods: The samples consisted of 38 CFC patients, who were treated at Seoul National University Dental Hospital during 1998-2018. The Tessier cleft type, sex, side involvement, phenotype, and associated anomalies were investigated using non-parametric statistical analysis. Results: The three most common types were #7 cleft, followed by #0 cleft and #14 cleft. There was no difference between the frequency of male and female. Patients with #0 cleft exhibited nasal deformity, bony defect, and missing teeth in the premaxilla, midline cleft lip, and eye problems. A patient with #3 cleft (unilateral type) exhibited bilateral cleft lip and alveolus. All patients with #4 cleft were the bilateral type, including a combination of #3 and #4 clefts, and had multiple missing teeth. A patient with #5 cleft (unilateral type) had a posterior openbite. In patients with #7 cleft, the unilateral type was more prevalent than the bilateral type (87.0% vs. 13.0%, p < 0.001). Sixteen patients showed hemifacial microsomia (HFM), Goldenhar syndrome, and unilateral cleft lip and palate (UCLP). There was a significant match in the side involvement of #7 cleft and HFM (87.5%, p < 0.01). Patients with #14 cleft had plagiocephaly, UCLP, or hyperterorbitism. A patient with #30 cleft exhibited tongue tie and missing tooth. Conclusions: Due to the diverse associated craniofacial anomalies in patients with CFC, a multidisciplinary approach involving a well-experienced cooperative team is mandatory for these patients.

Absorbed and effective dose from spiral and computed tomography for the dental implant planning (치과 임프란트 치료 계획을 위한 나선형 일반 단층촬영과 전산화 단층촬영시 흡수선량 및 유효선량 평가)

  • Hong Beong-Hee;Han Won-Jeong;Kim Eun-Kyung
    • Imaging Science in Dentistry
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    • v.31 no.3
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    • pp.165-173
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    • 2001
  • Objectives : To evaluate the absorbed and effective doses of spiral and computed tomography for the dental implant planning. Materials and Methods: For radiographic projection, TLD chips were placed in 22 sites of humanoid phantom to record the exposure to skin and the mean absorbed dose to bone marrow, thyroid, pituitary, parotid and submandibular glands and nesophagus. Effective dose was calculated, using the method suggested by Frederiksen et al.. Patient situations of a single tooth gap in upper and lower midline region, edentulous maxilla and mandible were simulated for spiral tomography. 35 axial slices (maxilla) and 40 axial slices (mandible) with low and standard dose setting were used for computed tomography. All the radiographic procedures were repeated three times. Results: The mean effective dose in case of maxilla was 0.865 mSv, 0.452 mSv, 0.136 mSv and 0.025 mSv, in spiral tomography of complete edentulous maxilla, computed tomography with standard mAs, computed tomography with low mAs and spiral tomography of a single tooth gap (p<0.05). That in case of mandible was 0.614 mSv, 0.448 mSv, 0.137 mSv and 0.036 mSv, in spiral tomography of complete edentulous mandible, computed tomography with standard mAs, computed tomography with low mAs and spiral tomography of a single tooth gap (p<0.05). Conclusions: Based on these results, it can be concluded that low mAs computed tomography is recommended instead of spiral tomography for the complete edentulous maxilla and mandible dental implant treatment planning.

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Extranodal NK/T cell Lymphoma, nasal type: clinical, radiological, histological features for early diagnosis (원발성 비성 NK/T 세포 림프종: 조기 진단을 위한 임상적, 방사선학적, 조직학적 특징)

  • Park, Kyung-Ran;Han, Seon-Hee;Kim, Hyun-Sil;Lee, Seung-Jun;Cha, In-Ho;Kim, Hyung-Jun
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.36 no.6
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    • pp.497-501
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    • 2010
  • Primary nasal type natural killer (NK)/T cell (NKTC) lymphoma, a specific form of malignant lymphoma, has a higher geographic incidence in Oriental, Mexican, and South American populations than the Western population. In Koreans, it comprises 9-12% of all cases of non-Hodgkin's lymphoma. This type of lymphoma has also been named as angiocentic lymphoma and lethal midline granuloma because the most common site is the upper airway area and its clinical aggressiveness presents with a necrotic and destructive pattern. NKTC lymphoma can also be detected in different organs (testis, spleen, parotid gland, skin, gastroinstinal tract, central nervous system, lungs, bone marrow, etc.) other than the upper airway including the oral cavity. The lymphoma detected in the oral cavity shows various destructive and inflammatory changes, similar to the signs of inflammation and infection from periodontitis and pulpal disease, making a diagnosis difficult with just the clinical signs. For early detection, clinical, radiological, and pathological examinations are required. This report describes the clinical, radiological and histological characteristics with a case report for the early detection of NKTC lymphoma in the oral cavity.

Comparison of marginal bone loss and patient satisfaction in single and double-implant assisted mandibular overdenture by immediate loading

  • Tavakolizadeh, Sara;Vafaee, Fariborz;Khoshhal, Masume;Ebrahimzadeh, Zahra
    • The Journal of Advanced Prosthodontics
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    • v.7 no.3
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    • pp.191-198
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    • 2015
  • PURPOSE. The purpose of this study was to compare the coronal bone level and patient satisfaction in 1-implant and 2-implant assisted mandibular overdentures. MATERIALS AND METHODS. Twenty patients who had maladaptive mandibular dentures were treated in this study. Patients were randomly divided into two groups. The first group received 1 implant (Simple line II, Implantium, South Korea) in their mandibular midline and the second group received 2 implants in their B and D regions (according to Misch's category). If the primary stability of each implant was at least 60 ISQ, ball attachment was placed and denture relined with soft liner. After 6 weeks, retentive cap incorporated with hard acrylic resin. In the 6 and 12 months recalls, periapical digital radiograph were made and visual analogue scale questionnaires were used to record patient satisfaction. The Friedman test was done for comparing the presurgical and postsurgical parameters in each group and the U-Mann Whitney test (P<.05) was done for comparison of post-treatment results between the two groups. RESULTS. All implants achieved sufficient primary stability to be immediately loaded. Patient satisfaction was high, and there were no significant differences between two groups (P>.05). In addition, mean marginal bone loss was $0.6{\pm}0.67$ mm in the first group and $0.6{\pm}0.51$ mm in the second group, after 12 month. Mean marginal bone loss showed no significant differences between two groups. CONCLUSION. This preliminary one-year result indicated that mandibular overdentures anchored to a single implant can be a safe and cost-effective method as a starting step for implant-overdenture treatment.