• Journal of Dental Rehabilitation and Applied Science
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• v.37 no.3
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• pp.171-176
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• 2021

Pneumomediastinum is a very rare and potentially catastrophic complication of dental procedures. Its common causes are tooth extraction, endodontic treatment, and subgingival curettage using handpieces and high-pressure air/water syringes. We present a case of massive pneumomediastinum with subcutaneous emphysema in a 61-year-old female who underwent bone grafting into the maxilla for pretreatment of dental implantation using a syringe. The patient suffered from abrupt severe odynophagia and loss of consciousness. The patient transferred to emergency department and images work-up revealed a pneumomediastinum and subcutaneous emphysema on the entire face and neck. We performed conservative treatments including prophylactic antibiotics, oxygen inhalation, and fasting meals, and then discharge after 7 days uneventfully. The patient's syncope might be resulting from hypotension and pain shock induced by pneumomediastinum with a sudden chest compression. The pneumomediastinum could be resulting from concurrent perforation and massive air infiltration into the maxillary sinus during bone grafting. We suggest that pneumomediastinum needs prompt diagnosis and management because of the risk of airway obstruction when a patient present syncope in the dental room.

• The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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• v.34 no.1
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• pp.112-135
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• 2021

Objectives : To report a case of drug-induced xerostomia treated with Integrative Korean Medicine Visiting Care Service of a Public Health Center. Methods : Home visit treatment and telemedicine were provided by public health doctor(Korean medicine doctor) for person with physical disability who were diagnosed with Behcet's Disease. Palmul-tang(PMT) soft extract was provided steadily 3 times a day for 6 months, and acupuncture, electro-acupuncture, and electro-moxibustion were provided irregularly 6 times for 6 months. Yin-deficiency questionnaire(YDQ), oral health impact profile-14(OHIP-14), oral pain visual analogue scale(VAS), and xerostomia inventory(XI) were used 3 times(baseline, intermediate and termination) to evaluate the changes. Results : YDQ decreased from 620 to 375, OHIP-14 decreased from 34 to 6, VAS decreased from 70 to 40, and XI decreased from 44 to 34. Four scales all gradually decreased. Conclusions : Integrative Korean Medicine Treatments in health insurance including PMT soft extract through home visit treatment can improve drug-induced xerostomia and Quality of life(QoL) of person with disabilities.

• Journal of Korean Neurosurgical Society
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• v.65 no.4
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• pp.549-557
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• 2022

Objective : This study analyzed the risk factors in patients who developed distal junctional kyphosis (DJK) after posterior cervical fusion. Methods : We retrospectively analyzed the clinical and radiographic outcomes of 64 patients, aged ≥18 years (51 and 13 male and female patients, respectively), who underwent single-staged multilevel (3-6 levels) posterior cervical fusion surgery due to multiple cervical spondylotic myelopathy. The surgeries were performed by a single spinal surgeon between January 2012 and December 2017. Demographic data, clinical outcomes, and radiological results were collected. We divided the patients into a DJK group and a non-DJK group according to the presence of DJK and investigated the risk factors by comparing the differences between the two groups. Results : Of the 64 patients, 13 developed DJK. No significant differences in clinical results were observed between the two groups before and immediately after the surgery. At the final follow-up, a higher visual analog score for neck pain was observed in the DJK group compared to the non-DJK group (p<0.01). The DJK group had a significantly lower T1 slope and a significantly higher C2-7 sagittal vertical axis (SVA) before surgery compared to the non-DJK group (p=0.03 and p<0.01, respectively). Immediately after surgery, the difference between the two groups decreased and no significant difference was observed. However, at the last follow-up, a significantly higher C2-7 SVA was observed in the DJK group (p<0.01). At the last follow up, there is no discrepancy in T1S-CL. In multiple logistic regression analysis, preoperative higher C2-7 SVA and preoperative lower T1 slope were identified as independent risk factors (p=0.03 and p<0.01, respectively). As a result, it was confirmed that DJK occurred along the process of returning to preoperative values. Conclusion : DJK can be considered to be caused by cervical misalignment due to excessive change in the surgical site in patients with low T1 slope and high C2-7 SVA before surgery. This also affects the clinical outcome after surgery. It is recommended to refrain from excessive segmental lordosis changes during multilevel cervical post fusion surgery, especially in patients with a small preoperative T1 slope and a large SVA value.

• The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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• v.35 no.1
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• pp.38-47
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• 2022

Objectives : The purpose of this study is to analyze the characteristics of tinnitus patients according to the presence of headache. Methods : The medical records of 110 tinnitus patients who visited oo Korean Medicine Clinic from June 2019 to June 2021 were retrospectively reviewed. Clinical characteristics including gender, age, onset, cause, tinnitus site, severity of tinnitus and accompanied symptoms were analyzed. Results : Among all patients, 40s and 50s and chronic tinnitus over 1 year was the most frequent group. After an average of 2 months of treatment, 61 patients(55.5%) showed improvement, and there were prescribed more frequently 50s and 60s and with tinnitus grade mild to moderate group. The proportions of female(65%, p=0.012) and herbal dialectics which 'tonify and replenish' and 'tranquilize'(32.5%, p=0.043) were prescribed more frequently in patients with headache than those without headache. Dizziness, ear pain, heart symptoms, fatigue, and neck stiffness were more frequent in patients with headache(p<0.05). In patients with improvement in tinnitus, tinnitus grade improved significantly in patients with improvement in headache compared to those with no improvement in headache(1.83±0.79 vs 0.80±0.84, p=0.018). Conclusions : In tinnitus patients treated with Korean medicine, there was no significant difference in the improvement of tinnitus according to the presence or improvement of headache, but the patients with improvement of both tinnitus and headache showed significantly more degree of improvement in tinnitus severity than patients with only tinnitus improved. Based on these findings, further study is needed regarding the correlation headache and tinnitus in clinical setting.

• Journal of Oral Medicine and Pain
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• v.30 no.3
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• pp.337-344
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• 2005

A tactile sensor employs a piezoelectric element to detect contact frequency shifts and thereby measure the stiffness or softness of material such as tissue, which allows the sensor to be used in many fields of research for urology, cardiology, gynecology, sports medicine and caner detection and especially for cosmetics and skin care. In this study, reliability of the tactile sensor system was investigated with its manual application to the muscles susceptible to temporomandibular disorders. Stiffness and elasticity of anterior temporalis, masseter and trapezius muscles were calibrated bilaterally from 5 healthy men with an average of 24.5$\pm$0.94 years. The tactile sensor used in this study had a computer-controlled and motor-driven sensor unit which automatically pressed down on the skin surface over the muscles being measured and retracted, thereby providing the hysteresis curve. The slope of the tangent of the hysteresis curve (${\Delta}f/{\Delta}x$) is defined as stiffness of the muscle being measured and the distance between the two parts of the curve as its elasticity. To determine inter-examiner reliability, all the measurements were performed by the two examiners A and B, respectively and the same examination were repeated with an interval of 2 days for intra-examiner reliability. The results from this study demonstrated high reliability in measuring stiffness and elasticity of anterior temporalis, masseter and upper trapezius muscles using a tactile sensor system. It is suggested that the tactile sensor system can be a highly reproducible and effective instrument for quantitative evaluation of the muscle in head and neck region.

• Journal of Oral Medicine and Pain
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• v.30 no.3
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• pp.287-300
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• 2005

Squamous cell carcinoma (SCC) in head and neck show a variability in the response to chemotherapy, even when it present with similar histological tumor type, grade, and clinical stage. The purpose of present study it to identify predictive bio-marker for the sensitivity or resistance to conventional chemotherapeutic agents, 5-fluorouracil (5-FU) and Cisplatin Oral cancer cell lines were used in present study. MTT assay was performed to evaluate the sensitivity and/or resistance to 5-FU and Cisplatin. And RT-PCR was carried out for evaluation of the mRNA expressions of various genes associated with mutation, inflammation (COX pathway), cell cycle, senescence and extracellular matrix (ECM). The molecules which are correlated with the sensitivity to 5-FU are XPA, XPC, OGG, APEX, COX-2, PPAR, Cyclin E, Cyclin B1, CDC2, hTERT, hTR, TIMP-3, TIMP-4 and HSP47. And the molecules are correlated with the sensitivity to Cisplatin are COX-1, iNOS, eNOS, PCNA, collagen 1 and MMP-9. Taken together, when choosing the appropriate chemotherpeutic agents for patients, considering the molecules which are correlated or reversely correlated is helpful to choose the resonable agents for cancer patients.

• Journal of Hospice and Palliative Care
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• v.12 no.4
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• pp.228-233
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• 2009

Purpose: The purpose of this study was to retrospectively examine the factors and characteristics of cancer patients who visited the emergency room, as well as to offer some educational materials for to manage acute symptoms. Methods: Data for this study were selected from the period of January to December, 2006. A total of 564 patients were examined using the tool which we developed by ourselves for the study. The collected data were analyzed using the SAS program for frequencies and percentage. Results: As for disease-related characteristics of the subjects, 28.9% of them had gastric and colorectal cancer; 66.9% were in stage 4; 51.6% had been in chemotherapy prior to visiting the emergency room; and 82.5% had their anticancer drug administrated average 1~5 times. As for the characteristics in regard to visit the emergency room, 62.9% were admitted to hospital within 2 weeks of being treated. As for chief complaints for visiting the emergency room, the worst symptom was pain, followed by symptoms such as gastro-intestinal symptoms, respiratory symptoms, high fever, and weakness. As for the disease-related symptoms, the worst symptom that gastric, colorectal, pancreatic, liver and gallbladder cancer patients complained of was pain, high fever for lymphoma patients was respiratory symptoms for lung cancer patients, and gastrointestinal symptoms for head and neck cancer and other patients. Conclusion: Therefore, according to their need and background, an individualized consultation and teaching program should be provided to cancer patients.

• Tuberculosis and Respiratory Diseases
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• v.65 no.4
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• pp.277-284
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• 2008

Background: In principle, cervical tuberculous lymphadenitis (CTBL) is a medical disease that may require surgical treatment, particularly in young women who complain of psychosocial and cosmetic problems. We encountered 13 cases of aggravated CTBL treated surgically despite the appropriate course of antituberculous chemotherapy. We report the clinical characteristis of these cases. Methods: The clinical data of 13 patients with aggravated CTBL requiring surgical treatment from January 2000 to December 2006 at the Department of Chest Medicine, Internal Medicine and Plastic Surgery, National Medical Center was reviewed retrospectively. Results: Twelve of the 13 cases (92%) were female. The most common age was 21~30 years (69%). Multiple nodes were palpated in 11 cases (85%). The supraclavicular lymph nodes were sites the most commonly involved (54%). The other involved sites in the order of decreasing frequency were the jugular chain, posterior cervical, submandibular and infraauricular lymph nodes. A palpable mass was the most commonsymptom. Neck pain was reported in 3 cases (23%). General symptoms such as weight loss, fatigue, anorexia and night sweats were noted in 5 cases (38%). Respiratory symptoms such as cough, sputum, hemoptysis, dyspnea and chest pain were observed in 4 cases (31%). Pulmonary tuberculosis was noted in 11 cases (85%). Other extrapulmonary tuberculosis coexisted in 4 cases (31%). This suggests that surgical CTBLs may be manifestations of a systemic disease and might be difficult to treat. Most cases (92%) were stages 2 and 3 at the initial diagnostic period but all cases fell into stage 4 and 5 when reassesed before surgery. The average duration of anti-TB chemotherapy before and after surgery was 10.2 and 15.2 months, respectively. The 13 patients were followed up until June. 2008. Among them, 2 cases had newly developed CTBL and the other 11cases showed no recurrence. Conclusion: In principle, CTBL is the medical disease. However, despite the appropriate course of anti-TB chemotherapy, CTBL can progress to a more advanced stages and grow rapidly to a large-sized or fistulous mass with a persistent abscess. Surgical treatment may be inevitable for patients with psychosocial and cosmetic problems caused by these masses, particularly in young women.

• The Journal of Pediatrics of Korean Medicine
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• v.32 no.1
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• pp.83-91
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• 2018

Objectives This study aims to build the baseline data for promoting school health care program by identifying satisfaction level and improvement point through the satisfaction survey after Korean medicine doctor's student health and wellness program in 2016. Methods An association of Korean medicine doctor in Seongnam city conducted Korean medicine doctor's student health and wellness program for 12 middle schools, 6 high schools and 1 special-need school in Seongnam city in 2016. The participating Korean medicine doctor visited each school for 8 times and conducted health consultations, health education classes and Korean medicine treatment for the school students and the school employees. Teachers and administrators from the participating schools answered the self-reported satisfaction questionnaires and the results were analyzed by SPSS 22.0. Results 35 people responded the program satisfaction questionnaires, the overall satisfaction average was $9.40{\pm}0.88$ (out of 10). In the course of the program, satisfaction average regarding the student's health check-ups was $9.05{\pm}0.88$, satisfaction average regarding the informatory brochures for the parents was $9.08{\pm}1.09$, satisfaction average regarding the participation enrollment process was $9.06{\pm}1.16$, and the satisfaction average regarding the questionnaire statistics and the result reports was $8.86{\pm}1.93$. The satisfaction average of the program was as follows: health consultation ($9.20{\pm}1.08$), treatment ($9.31{\pm}0.90$), and health education classes ($8.78{\pm}1.68$). Some of the good things about program were 'Telling students about their physical condition' (57.1%), 'Curing the sick student quickly' (48.6%), 'Providing students with useful information about the health' (48.6%), 'Teaching students how to manage their health and how to manage symptoms' (42.9%). Average satisfaction about sustainability and needs of the program was $9.15{\pm}0.91$, and the participant teachers wanted to learn more about how to manage internet addiction (22.9%), stress (45.7%), atopy (28.6%), neck pain (42.9%), allergic rhinitis (37.1%), and low back pain (34.3%) from the future wellness programs. Conclusions Student health care is one of the most important issue in national health policies. We have designed a bridge model that a local community, school, and doctors can work together to develop. After the implementation of the program, the results of the satisfaction survey showed a very high satisfaction level. This study can be the basis for further improvement of the bridge program as well as the expansion of the program in other settings.

• Journal of Oral Medicine and Pain
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• v.32 no.3
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• pp.283-292
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• 2007

In several treatment modalities for snoring and obstructive sleep apnea (OSA), oral appliances mainly including mandibular advancement appliance (MAA) and tongue retaining device (TRD) are recognized as a non-invasive, reversible alternative with favorable results. Tongue bulb is a major component of TRD which prevents the tongue from approaching the posterior wall of the pharynx and can be combined with MAA. Determination of tongue bulb size for the patient is important for therapeutic effect, but frequently needs time-consuming work. For effective fabrication and standardization of tongue bulbs, this study aimed to categorize tongue bulb size for healthy young men and to examine its relation with maximum retention force and with physical parameters including tongue-related variables. 36 non-snoring, asymptomatic young men with normal occlusion were voluntarily participated in this study (mean age: $24.47{\pm}2.58$ years). Experimental procedures consisted of prefabrication of tongue bulb set (20 types with a width of 27-36mm and thickness of 8 and 10 mm), determination of tongue bulb size and the maximum retention force for each subject, and measurement of physical parameters including body mass index (BMI), neck circumference and width, thickness and length of tongue. This study showed that there was significant difference of retention force among the bulb size-related groups both in upright and supine position (p<0.05) and that retention force increased with bulb size. Correlation of tongue bulb size with physical parameters was not clearly verified and there was no significant difference in retention force between upright and supine positions. Based on our results, it can be suggested that retention force relates with tongue bulb size, ultimately with tongue volume. A further study needs to be performed in the patients with snoring and OSA.