• Journal of Korean Neurosurgical Society
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• 제45권3호
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• pp.176-178
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• 2009

Traumatic brainstem hemorrhage after blunt head injury is an uncommon event. The most frequent site of hemorrhage is the midline rostral brainstem. The prognosis of these patients is poor because of its critical location. We experienced a case of traumatic brainstem hemorrhage. A 41-year-old male was presented with drowsy mentality and right hemiparesis after blunt head injury. Plain skull radiographs and brain computerized tomography scans revealed a depressed skull fracture, epidural hematoma, and hemorrhagic contusion in the right parieto-occipital region. But, these findings did not explain the right hemiparesis. T2-weighted magnetic resonance (MR) image of the cervical spine demonstrated a focal hyperintense lesion in the left pontomedullary junction. Brain diffusion-weighted and FLAIR MR images showed a focal hyperintensity in the ventral pontomedullary lesion and it was more prominent in the left side. His mentality and weakness were progressively improved with conservative treatment. We should keep in mind the possibility of brainstem hemorrhage if supratentorial lesions or spinal cord lesions that caused neurological deficits in the head injured patients are unexplainable.

• Journal of Korean Neurosurgical Society
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• 제45권3호
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• pp.143-150
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• 2009

Objective : The purpose of this study was to investigate the reliable factors influencing the surgical outcome of the patients with traumatic acute subdural hematoma (ASDH) and to improve the functional outcome of these patients. Methods : A total of 256 consecutive patients who underwent surgical intervention for traumatic ASDH between March 1998 and March 2008 were reviewed. We evaluated the influence of perioperative variables on functional recovery and mortality using multivariate logistic regression analysis. Results : Functional recovery was achieved in 42.2% of patients and the overall mortality was 39.8%. Age (OR=4.91, p=0.002), mechanism of injury (OR=3.66, p=0.003), pupillary abnormality (OR=3.73, p=0.003), GCS score on admission (OR=5.64, p=0.000), and intraoperative acute brain swelling (ABS) (OR=3.71, p=0.009) were independent predictors for functional recovery. And preoperative pupillary abnormality (OR=2.60, p=0.023), GCS score (OR=4.66, p=0.000), and intraoperative ABS (OR=4.16, p=0.001) were independent predictors for mortality. Midline shift, thickness and volume of hematoma, type of surgery, and time to surgery showed no independent association with functional recovery, although these variables were correlated with functional recovery in univariate analyses. Conclusion : Functional recovery was more likely to be achieved in patients who were under 40 years of age, victims of motor vehicle collision and having preoperative reactive pupils, higher GCS score and the absence of ABS during surgery. These results would be helpful for neurosurgeon to improve outcomes from traumatic acute subdural hematomas.

• 대한치과교정학회지
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• 제4권1호
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• pp.57-61
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• 1974

The patient, a girl of 19 years in good health, had a class I malocclusion. The maxillary left centra1 incisors and both lateral incisors had already erupted. But the space for the right central incisor was partially closed by the mesial drifting of the neighboring teeth. The caused a shift in the midline and a cross-bite relation on the incisors. X-ray examination revealed the presence of the right central incisor in the alveolar bone and odontoma just above the crown of the right central incisor. After enough space for the impacted incisor was created in the dental arch with a open-coil spring the rectangular incision was made. Removing the odontoma uncovered the flat surface of the labial aspect of the incisor. During the tooth had erupted of its own accord, any unnecessary force had been imposed on the tooth. When it was decided that the tooth should be brought out by the mechanical device, the gold cast onlay with hook was used and run a light elastic between this hook and the main arch wire. Finally the tooth was brought down to the arch level. The result was excellent. Fortunately the esthetic problem and any detrimental effects on the psychological make-up could be avoided.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제35권5호
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• pp.324-328
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• 2009

Submentovertex(SMV) projection shows the base of skull, positions of mandibular condyle and zygomatic arches. We would like to investigate how to use SMV and evaluate its availability for the construction of the plan for orthognathic surgery of mandible prognathism and asymmetry. Preoperative Surgical Treatment Objective(STO) using SMV was performed to 12 patients, who visited to Seoul National University Bundang Hospital with chief complaints like mandible prognathism or asymmetry from Dec 2007 to Feb 2009. Surgical splint was made of stone model repositioned according to STO using SMV. We estimate the change in skeletal midline and the stability of occlusion through superposition between preoperative and postoperative SMV. It was effective on the amount of mandible movement and the correction of mandibular asymmetry, while the facial asymmetry involved with maxilla was excluded. It was concluded that STO using SMV is available and predictable method for not only the setback of prognathic mandible but also the correction of mandible asymmetry accurately.

• 대한치과교정학회지
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• 제44권6호
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• pp.330-341
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• 2014

A 19-year-old woman presented to our dental clinic with anterior crossbite and mandibular prognathism. She had a concave profile, long face, and Angle Class III molar relationship. She showed disharmony in the crowding of the maxillomandibular dentition and midline deviation. The diagnosis and treatment plan were established by a three-dimensional (3D) virtual setup and 3D surgical simulation, and a surgical wafer was produced using the stereolithography technique. No presurgical orthodontic treatment was performed. Using the surgery-first approach, Le Fort I maxillary osteotomy and mandibular bilateral intraoral vertical ramus osteotomy setback were carried out. Treatment was completed with postorthodontic treatment. Thus, symmetrical and balanced facial soft tissue and facial form as well as stabilized and well-balanced occlusion were achieved.

• 대한심미치과학회지
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• 제22권1호
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• pp.67-73
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• 2013

치아의 3가지 기능인 저작, 발음, 심미 중 하나인 Aesthetic 이란 단어는 단순히 예쁘다는 뜻은 아니다. Harmony가 빠진 심미는 심미라 할 수 없다. 주변치아와의 조화, 입술, 정중선, 안모 등등 주위 환경과의 조화가 이루어 질 때 그것이 진정한 심미라 할 수 있다. 조화로운 보철물 제작을 위해 많은 정보가 기공사에게 전달이 되어야 하며, 기공사 또한 진료실에 필요한 정보를 요구하여야 한다. 신선하지 않은 재료로 맛있는 음식을 만들 수 없다. 신선한 재료를 공급한다 해도 요리사의 실력이 없다면 역시 맛있는 음식을 만들 수 없다. 실력 있는 요리사가 신선한 재료를 갖고 요리에 최선을 다할 수 있는 조건을 갖춘 상황 아래서 일류 요리가 만들어 진다. 본 연구에서는 조화로운 심미보철을 위해 공유해야 할 진료팀과 기공팀의 팀워크에 대한 내용에 대해 알아보고자 한다.

• 치과방사선
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• 제18권1호
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• pp.167-176
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• 1988

This study was designed to evaluate the morphology of the temporomandibular joint components and dentofacial characteristics of patients with clicking and painful temporomadibular joint. The materials consisted of 80 conventional pantomographs in normal an symptomatic individuals aged 18-23 and divided into 2 groups by symptom of temporomandibular joint. The results were as follows; 1. In morphologic analysis of condylar head, type Ⅰ (anterior, posterior smooth curve) was most dominant in both group(58.75%, 55.0%) and asymmetrical condylar shape was predominant in symptomatic group (18 cases, 45%). 2. In symptomatic group, the condylar width were slightly lesser and the ratio of condylar height to height of condyle-ramus were larger than those of normal group. 3. Vertical overlap of central incisor of symptomatic group was slightly larger than that of normal group. There was significant differences between each group in mandibular midline deviation. 4. The symptomatic group tended to steep mandibular plane angle and the degree of condylar path and condylar axis of normal group were larger than those of symptomatic group. 5. The condylar width was inversely correlated with inclination of condylar path and inclination of condylar path was correlated with condylar axis in both groups.

• Advances in pediatric surgery
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• 제7권2호
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• pp.137-141
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• 2001

Thyroglossal duct cyst is ectodermal remnant, which may develop along the line of descent of the thyroid gland from the foramen cecum of the tongue to the pyramidal lobe of the thyroid gland. Meticulous dissection of the cyst and duct, along with the body of the hyoid bone is necessary to avoid recurrence. Eighty-one patients with thyroglossal duct cyst treated at Hanyang University Hospital between January 1980 and December 2000 were reviewed to determine the incidence and to analyze the result of management. The male-to-female ratio was 1.4:1(47:34) with a male preponderance. They are most commonly present at 3-8years(54.2 %) of age, but rarely present at infancy. The most common symptom was a painless midline neck mass(76.5 %, 62cases). Eighty-one patients underwent modified Sistrunk operation without evidence of recurrence. Eight-nine percent(72 cases) of these lesions were located between thyroid substance and hyoid bone, and 11 %(9 cases) were above the hyoid bone. There were 22 infected cysts(27.2 %). The Sistrunk operation is a gold standard for treating the thyroglossal duct cysts. For best results in thyroglossal duct cyst surgery, one should make every effort to remove the cyst intact in continuity with the body of the hyoid bone. In our institute, Sistrunk operation modified by the authors showed a good result.

• Clinical and Experimental Pediatrics
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• 제57권6호
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• pp.292-296
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• 2014

The deletion of the distal long arm of chromosome 1 is associated with a characteristic facial appearance and a pattern of associated malformations. Characteristic manifestations include a round face with prominent 'cupid's bow' and downturned corners of the mouth, thin vermilion borders of lips, a long upper lip with a smooth philtrum, a short and broad nose, epicanthal folds, apparently low-set ears, micrognathia, microcephaly, abnormal hands and feet, variable cardiac or genital anomalies, moderate to severe mental retardation, and growth retardation. Using fluorescent in situ hybridization (FISH) analysis to map precisely the deletion, we present a case of chromosome 1q44 deletion with craniofacial characteristics, multiple congenital anomalies, and growth and psychomotor retardation. In comparison with other reported cases of 1q43-44 deletion, the subject does not show hydrocephalus, seizure, syn- or polydactyly of hands, and a urogenital anomaly. However, an arachnoid cyst, pinpoint dimple on the midline of the forehead, a right-sided supernumerary nipple and auricular pit, polydactyly of the right foot, adducted thumb, and flexion restriction of the proximal interphalangeal joint with a simian line in both hands were observed additionally.

• Investigative Magnetic Resonance Imaging
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• 제18권2호
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• pp.167-170
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• 2014

내측세로다발은 조화로운 눈운동의 핵심적인 역할을 하는 유수 합성로이며 수도관주위회색질의 배쪽의 중간선 근처에 놓여있다. 내측세로다발의 병변은 신경핵사이 눈근육마비로 불리는 동측의 내전 결손과 반대측 외전 안진을 야기한다. 중뇌와 교뇌에서 인접한 백질과 섞여있는 신경로는 전산화단층촬영술과 자기공명영상과 같은 뇌영상에서 구별하기 어렵다. 지금까지 우리가 알기로는 내측세로다발은 실제 자기공명영상에서 구체적으로 묘사되지 않았다. 우리는 염증성 탈수초성 질환에서 자기공명영상에 내측세로다발의 전체 연결 과정을 보이는 증례를 보고한다.