• 한국임상수의학회지
• /
• 제30권4호
• /
• pp.288-291
• /
• 2013

The purpose of the retrospectivestudy was to describe the clinical findings and treatment of intracorneal hemorrhage (ICH) in canine small breeds. The medical records of 6 dogs with ICH (January 2007 to November 2011) were examined to obtain the breed, age, gender, affected eye, cornea area, treatment, and follow-up. A total of 12 corneal areas in 8 eyes were identified in 6 dogs (4 Yorkshire terriers, 1 Poodle, and 1 Maltese). The mean age ${\pm}SD$ at the first presentation was $12.3{\pm}2.8$years, and 5 of 6 dogs were over 12 years old. ICH caused by corneal neovascularization was the most common in the nasal area of cornea (nasal 6/12, superior 4/12, and inferior 2/12) and recurred in different area of same or other cornea in 3 dogs. There were no concomitant corneal diseases at the initial presentation. All dogs affected were treated with combination of topical antibiotics and steroids and subconjuctival injection of steroids. The results showed that ICH can be treated with long-term medical therapies. In addition, further study would be needed to identify specific causes for the intracorneal hemorrhage.

• 대한치과교정학회지
• /
• 제50권1호
• /
• pp.3-12
• /
• 2020

Objective: This study compared three prominent midsagittal planes (MSPs) to identify the MSP that best approximates the true symmetrical MSP. Methods: Forty-three patients (mean age, 23.0 ± 8.20 years) were grouped as follows: group 1 consisted of 10 patients with skeletal Class I and a menton (Me) deviation of < 2 mm; group 2, 11 patients with skeletal Class III and a Me deviation < 2 mm; group 3, nine patients with skeletal Class III and a Me deviation of 2 to less than 4 mm; and group 4, 13 patients with skeletal Class III and an Me deviation ≥ 4 mm. The candidate MSPs were established by three-dimensional (3D) cone beam computed tomography (CBCT) reorientation methods (RMs): (1) the MSP perpendicular to the Frankfort horizontal (FH) plane while passing through the crista galli and basion; (2) the MSP including the nasion, incisive foramen, and basion; (3) the MSP including the nasion, anterior nasal spine, and posterior nasal spine. The mean absolute distances (MADs) to the MSPs were calculated from the coordinates of 1,548 points on 129 CBCT images. The differences in the values of the 3D coordinates among RMs were compared. Results: The MADs of the three RMs showed significant differences (p < 0.05). Most of the differences in values of the coordinates were not significant among RMs. Conclusions: Although the differences in distance among the three MSPs were minor, the MSP perpendicular to the FH plane while passing through the crista galli and basion best approximated the true symmetrical MSP.

• 대한두개안면성형외과학회지
• /
• 제16권3호
• /
• pp.119-124
• /
• 2015

Background: The Kirschner wire (K-wire) technique allows stable fixation of bone fragments without periosteal dissection, which often lead to bone segment scattering and loss. The authors used the K-wire fixation to simplify the treatment of laborious comminuted zygomatic bone fracture and report outcomes following the operation. Methods: A single-institution retrospective review was performed for all patients with comminuted zygomatic bone fractures between January 2010 and December 2013. In each patient, the zygoma was reduced and fixed with K-wire, which was drilled from the cheek bone and into the contralateral nasal cavity. For severely displaced fractures, the zygomaticofrontal suture was first fixated with a microplate and the K-wire was used to increase the stability of fixation. Each wire was removed approximately 4 weeks after surgery. Surgical outcomes were evaluated for malar eminence, cheek symmetry, K-wire site scar, and complications (based on a 4-point scale from 0 to 3, where 0 point is 'poor' and 3 points is 'excellent'). Results: The review identified 25 patients meeting inclusion criteria (21 men and 4 women). The mean age was 52 years (range, 15-73 years). The mean follow up duration was 6.2 months. The mean operation time was 21 minutes for K-wire alone (n=7) and 52 minutes for K-wire and plate fixation (n=18). Patients who had received K-wire only fixation had severe underlying diseases or accompanying injuries. The mean postoperative evaluation scores were 2.8 for malar contour and 2.7 for K-wire site scars. The mean patient satisfaction was 2.7. There was one case of inflammation due to the K-wire. Conclusion: The use of K-wire technique was associated with high patient satisfaction in our review. K-wire fixation technique is useful in patient who require reduction of zygomatic bone fractures in a short operating time.

• Maxillofacial Plastic and Reconstructive Surgery
• /
• 제29권4호
• /
• pp.321-328
• /
• 2007

If there are problems for us to sleep, we are faced with fatigue and dizziness in the day. Snoring and OSAS (obstructive sleep apnea syndrome) during sleeping are the main cause of sleep disorder. Treatments through surgical method and sleep splint can be performed to treat snoring and OSAS. Relapse of snoring and OSAS is common after treatment by surgical method. But, Recently sleep splint is frequently applied to treat snoring and OSAS with surgical treatment, because it is convenient and conservative. Sleep splint treat snoring and OSAS by ensuring airway through nose. As first step of fabrication occlusal bite is gained at a point that patient get feeling of increased nasal breathing in supined position, and next, the bite is transfered to sleep splint. This study surveyed the effect of sleep splint by questionnaire to the out-patients (the Dept. of Oral and Maxillofacial Surgery, Chonbuk National University Hospital) weared sleep splint and their partners, secondarily measured airflow through nose by aerophone II after wearing sleep splint and finally evaluated the effect of treatment of snoring and OSAS by sleep splint. The obtained result were as follows; 1. Though 'sleep splint' couldn't eliminate fundamental problems of snoring, it could improve the symptoms when patients were selected could using the 'Nakagawa's respiration method'. 2. Patients who used the sleep splint could breathe stably when patients are sleeping stably. Wearing a 'sleep splint' improved airflow by expanding the upper airway. 3. Even though sleep splint can be made with variable materials, the patients expressed the most satisfaction on the splint with '0.75mm hard shell'. 4. The 'Herbst' may allows the mandible to move the TMJ to relax. Nevertheless, some patients experienced a discomfort or irritation. 5. In Snoring and OSAS cases, it is recommended that patients should first explore non-surgical options prior to choosing a surgical treatment.

• Maxillofacial Plastic and Reconstructive Surgery
• /
• 제41권
• /
• pp.19.1-19.6
• /
• 2019

Background: The submucous cleft palate (SMCP) is a type of cleft palate that may result in velopharyngeal insufficiency (VPI). Palate muscles completely separate oral and nasal cavities by closing off the velopharynx during functional processes such as speech or swallow. Also, hypernasality may arise from anatomical or neurological abnormalities in these functions. Treatments of this issue involve a combination of surgical intervention, speech aid, and speech therapy. This case report demonstrates successfully treated VPI resulted from SMCP without any surgical intervention but solely with speech aid appliance and speech therapy. Case presentation: A 13-year-old female patient with a speech disorder from velopharyngeal insufficiency that was caused by a submucous cleft palate visited to our OMFS clinic. In the intraoral examination, the patient had a short soft palate and bifid uvula. And the muscles in the palate did not contract properly during oral speech. She had no surgical history such as primary palatoplasty or pharyngoplasty except for tonsillectomy. And there were no other medical histories. Objective speech assessment using nasometer was performed. We diagnosed that the patient had a SMCP. The patient has shown a decrease in speech intelligibility, which resulted from hypernasality. We decided to treat the patient with speech aid (palatal lift) along with speech therapy. During the 7-month treatment, hypernasality measured by a nasometer decreased and speech intelligibility became normal. Conclusions: Surgery remains the first treatment option for patients with velopharyngeal insufficiencies from submucous cleft palates. However, there were few reports about objective speech evaluation pre- or post-operation. Moreover, there has been no report of non-surgical treatment in the recent studies. From this perspective, this report of objective improvement of speech intelligibility of VPI patient with SMCP by non-surgical treatment has a significant meaning. Speech aid can be considered as one of treatment options for management of SMCP.

• 대한구순구개열학회지
• /
• 제8권1호
• /
• pp.1-9
• /
• 2005

1. Introduction : 개방형 비성형술은 직접적인 비소주에 대한 접근으로 진단과 기술상의 장점으로 인하여 과거 수년간 의심의 여지 없이 사용되었으며 또한 비익 연골을 쉽게 사용할 수 있어서 대부분의 경우에 사용되어져 왔다. 그러나 비개방형에 비해 개방형 비성형술의 경우 콧구멍과 비첨부의 비대칭 및 비익부의 길어짐 등의 불만을 호소하는 경우가 많았다. 그러나 개방형 비성형술의 경우 아직도 접근의 용이성 및 대칭성으로 많이 사용되고 있다. 2. Material & Methods : 이에 서울대학교 구강악안면외과에서 1999년부터 2001년까지 개방형 성형술을 시행 받은 환자를 대상으로 술후에 비익과 비첨부의 대칭 및 비공의 크기 정도를 평가해보고 개방형 비성형술의 좋은 결과에 대해 논해보고자 하였다. 3. Resulo : 술 후 환자의 만족도는 높은 편이었으나 양측의 대칭 정도에서는 조금씩 차이를 보여 비첨은 대개 이환측으로 변위되어 있었으며 비공의 크기에서도조금씩 차이를 나타내었다. 4. Conclusion : 지금까지는 주로 비순부의 평균치나 성장 방향을 연구하는데 주로 계측치들이 이용되었던 반면, 수술 후 일어날 수 있는 비부의 변화앙상을 나타내는 데에는 부족한 점이 많았고 특히 구순 구개열 환자에서 연령, 성별에 따른 표준자료의 부족으로 형태학적인 비교 연구 및 표준자료가 부족하였다. 따라서 이번 연구에서는 구순 구개열 환자의 술 전 및 술 후 의 변화 양상을 파악하는데 도움이 될 만한 차트를 만들었고 변화양상을 연구하는데 도움이 될만한 자료를 제시하는 바이다.

• Archives of Plastic Surgery
• /
• 제35권1호
• /
• pp.36-41
• /
• 2008

Purpose: For facial reconstruction, skin color match is crucial to achieve great aesthetic result. Forehead flap and full thickness skin graft have been used for many years to reconstruct facial defect. Their results are aesthetically valuable with remarkable resemblance and harmony of the skin color between donor and recipient sites. The purpose of this study is to evaluate and compare the aesthetic outcome of the two methods as the analysis of skin color match. Methods: From January 1995 to December 2005, ten forehead flaps and ten full thickness skin grafts were performed. The reconstructed areas of forehead flaps were five noses and five eyelids. Recipient sites of full thickness skin grafts were seven eyelids, two noses and one forehead. In order to obtain the objective validity, the skin color of flap(or graft) and the recipient sites were measured by chromameter. The skin colors were quantified according to a three-dimensional coordinate system used in chromameter, L*(brightness), a*(redness), and b*(yellowness).Results: There was no significant color difference between forehead flap site and adjacent skin in all color values. On the other hand, the L* and b* values of graft sites were significantly lower than those of the adjacent skins. The a* values of graft sites were higher than those of the adjacent skins. Conclusion: This study reveals that skin color match of forehead flap is greater than that of full thickness skin graft. As forehead flap has adequate volume and great color match, it can be useful to reconstruct deep facial defect such as nasal defect. On the other hand, full thickness skin graft can be used for superficial defect like partial eyelid defect.

• 대한두경부종양학회지
• /
• 제13권1호
• /
• pp.9-15
• /
• 1997

서론 : 혈구탐식증후근은 고열, 범혈구감소증, 간비장종대, 림프절비대 및 혈액응고장애 등을 동반하는 전신적 질환으로 대부분 면역억제 상태에서 바이러스 및 각종 병원체의 감염에 의해서 유발되고 예후가 불량하다. 조직학적으로 림프세망기관의 조직구의 증가와 혈관탐식현상이 빈번히 관찰되고 이와 같은 현상을 보이는 악성조직구증식증과의 감별이 어렵다. 코의 혈관중심위 림프종은 거의 일정한 Epstein-Barr 바이러스(EBV)양성을 보인다고 보고되고 있고 병의 경과중 혈관탐식증추군이 빈번하게 발생되는데 이는 EBV감염에 의해서 유발된다고 보아지고 있다. 재료 및 방법 : 1985년 1월부터 1995년 12까지 강남성모병원과 성바오로병원에서 코의 혈관중심위 림프종으로 진단 받았던 환자 42명 중 혈구탐식증후근을 동반한 10명을 대상으로 임상양상을 관찰하고, 조직표본에 면역조직화학염색법과 교잡반응을 사용하여 악성세포의 표현형을 살펴보고 EBV와의 관련성을 관찰하였다. 결과 : 10명의 환자 중 5명은 혈관중심위 림프종 진단당시, 3명은 재발시기, 2명은 관해 시기에 혈구탐식증후군을 동반하였다. 모든 환자에서 실시된 치료방법에 상관없이 치명적인 경과를 보였으며 중앙생존기간은 18일(2-44일)이었다. 대상 모두에서 T형세포 표현형과 교잡반응상 EBV양성을 보였으며, EBV는 주로 악성림프종세포에 분포양상을 보였다. 결론 : 혈구탐식증추군은 코의 혈관중심위 림프종의 흔한 합병증으로 불량한 예후를 보인다. 임상적 양상 및 조직학적 검사상 악성 조직구증가증과 유사한 소견을 보여 감별이 어렵고, 치명적 결과를 초래하므로 치료에 어려움을 주고 있다. 코의 혈관중심위 림프종과 밀접한 관계를 보이는 EBV에 의해서 유발된다고 보아지고 있으며 치료의 개선을 위하여 앞으로 병인적연구가 필요하다고 생각된다.

• 대한시과학회지
• /
• 제20권4호
• /
• pp.421-429
• /
• 2018

목적 : 굴절이상별 세 그룹으로 분류한 우리나라 아동들의 안축장과 빛간섭단층촬영(OCT)로 측정한 황반두께, 망막신경섬유층두께 사이의 상관성을 알아보고자 하였다. 방법 : 안질환이 없고 안과관련 수술 경험이 없는 아동 67명(134안)을 대상으로 원시, 정시, 근시 그룹으로 분류하였다. 황반부와 망막신경섬유층두께는 Cirrus HD-OCT를 이용하여 측정하였고, 안축장은 IOL Master를 이용하여 측정하였다. 결과 : 안축장은 근시, 정시, 원시그룹 순서로 길게 측정되었다(p<0.05). 중심부황반의 두께는 근시, 정시, 원시그룹 순서로 두껍게 측정되었다(p<0.05). 주변부황반부는위쪽, 코쪽, 아래쪽부분에서 근시그룹이 가장 얇았다(p<0.05).황반의 중심부 두께는 안축장과 양의 상관관계가 있었다(r=0.283, p<0.05). 주변부 황반의 두께는 모두 안축장과 음의 상관관계를 보였다. 귀쪽망막신경섬유층두께(Temporal RNFL Thickness)는 근시그룹이 가장 두꺼운 결과를 보였고,안축장과통계적으로 유의한 양의상관성이 나타났다(r=0.39, p<0.05). 위쪽과 코쪽, 아래쪽의 망막신경섬유층 두께는 안축장과 모두 음의 상관성을 나타냈다. 코쪽 부분의 두께는 통계적으로 유의하게 나타났다(r=-0.23, p<0.05). 결론 : 본 연구를 통해 우리나라 소아들의 OCT로 측정한 망막의 황반부의 두께, 망막신경섬유층의 두께와 안축장은 근시의 정도가 높을수록 안축장의 길이가 더 길게 측정되었으며, 굴절이상별 세 그룹에서 나타나는 차이점을 확인하였다.

• 대한치과교정학회지
• /
• 제50권6호
• /
• pp.383-390
• /
• 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.