• Journal of Dental Anesthesia and Pain Medicine
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• 제23권5호
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• pp.257-264
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• 2023

Background: Accessory infraorbital foramen (AIOF) can change the normal course of emerging branches of the infraorbital nerve and blood vessels exiting the infraorbital foramen (IOF). This study aimed to examine the AIOF, number of foramina, and their position in relation to IOF using cone-beam computed tomography (CBCT). Methods: We performed a retrospective CBCT assessment of hospital records between January 2018 and August 2022. The CBCT of 507 patients were examined to extract information on the prevalence, number, position, linear distance from the IOF, and diameter of AIOF in relation to demographic factors. Descriptive statistics were used to evaluate the prevalence of AIOF. Mean and standard deviation were used to calculate the linear distance and diameter of the AIOF, respectively. The AIOFs, its distribution, and number were compared between sexes and sides using the chi-square test. The independent t-test and Mann-Mann-Whitney test were used to compare the mean difference between the sexes and sides. Statistical significance was set at P < 0.05. Results: In this current study, the prevalence of AIOF was 7.1% (36 of the 507 patients). Additionally, the current study examined the number of foramina using a single foramen on each side and double foramina located bilaterally at a distance from the AIOF to the IOF. The mean AIOF diameter was also studied, and the AIOF position with respect to the IOF on CBCT was superomedial or inferomedial. There were no statistically significant associations between any of the parameters assessed in this study when comparing sex and sides. Conclusions: A greater number of patients with AIOF presented with a single foramen and unilateral occurrence, without a statistically significant difference. The AIOF was most commonly located superomedial to the IOF.

• 대한두개안면성형외과학회지
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• 제25권1호
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• pp.22-26
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• 2024

Background: This study analyzed the demographic characteristics of patients with facial palsy who were treated using either dynamic or static procedures. This study aimed to compare the frequency of procedure implementation and age distribution between the two groups. Methods: This study retrospectively analyzed the medical records of patients treated for facial palsy at a single institution from 2014 to 2022. Among cases included in our study, dynamic procedures involved cross-facial nerve graft and latissimus dorsi or gracilis muscle flap transfer. Static procedures included gold weight insertion, canthopexy, browlift, and thread lift/static slings. Results: Among the 31 patients included in our study, eight (25.8%) incorporated dynamic techniques, and the average age of patients was 44.75 years (range, 24-68 years) with a male to female ratio of 1:4. The remaining 23 patients (74.2%) underwent a static procedure, of which the average age was 59.17 years (range, 23-81 years) which was statistically significantly higher than the average age of 44.75 of dynamic patients (p= 0.013). Regarding the timing of treatment after diagnosis, no patient underwent dynamic procedures more than 20 years after initial diagnosis. A greater diversity in the timing of treatment was observed in the static group. All patients who underwent dynamic procedures were treated using static procedures during the study period. Conclusion: Because aesthetics-based static techniques are typically quick outpatient procedures that can be performed under local anesthesia, our study shows that these are often preferred treatments for all age groups, especially for debilitated or older patients. Further research is required to investigate the long-term functional outcomes of these surgical techniques in a wider population of patients.

• 대한영상의학회지
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• 제83권6호
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• pp.1273-1285
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• 2022

목적 자기공명신경조영술은 말초신경을 시각화하는 데 최적화된 영상 기법이다. 본 주제 범위 문 헌고찰에서는 요천추신경총에서 자기공명신경조영술의 프로토콜을 조사하고, 요추신경총 질환 환자에서 자기공명신경조영술의 임상적 이득에 대해 고찰하고자 한다. 대상과 방법 두 개의 의료 데이터베이스에서 2021년 9월까지 영문으로 출판된 논문에 대해 체계적 문헌검색을 수행하였다. 'Magnetic resonance Imaging', 'lumbosacral plexus', 'neurologic disease'를 포함하는 55편의 논문을 분석하였다. 결과 요천추신경총의 자기공명신경조영술은 말초 신경 질환의 분포 확인, 신경 주변 주사시 유도, 좌골신경통 환자에서는 척추외 원인 평가에 유용하였다. 혈관억제 기법이 적용된 3차원 단시간 반전회복 고속 스핀에코 영상이 주된 자기공명신경조영술 기법이었다. 결론 향후 요천추신경총의 자기공명신경조영술에 대한 기술적 성숙과 임상적 유용성에 대한 검증이 필요하다.

• The Korean Journal of Pain
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• 제1권2호
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• pp.214-222
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• 1988

With the arm in hyperabduction, we have carried out 525 procedures of supraclavicular brachial plexus block from Aug. 1976 to June 1980, whereas block with the arm in adduction has been customarily performed by other authors. The anesthetic procedure is as follows: 1) The patient lies in the dorsal recumbent position without a pillow under his head or shoulder. His arm is hyperabducted more than a 90 degree angle from his side, and his head is turned to the side opposite from that to be blocked. 2) An "X" is marked at a point 1 cm above the mid clavicle, immediately lateral to the edge of the anterior scalene muscle, and on the palpable portion of the subclavian artery. The area is aseptically prepared and draped. 3) A 22 gauge 3.5cm needle attached to a syringe filled with 2% lidocaine (7~8mg/kg of body weight) and epineprine(1 : 200,000) is inserted caudally toward the second portion of the artery where it crosses the first rib and parallel with the lateral border of the muscle until a paresthesia is obtained. 4) Paresthesia is usually elicited while inserting the needle tip about 1~2 em in depth. If so, the local anesthetic solution is injected after careful aspiration. 5) If no paresthesia is elicited, the needle is withdrawn and redirected in an attempt to elicit paresthesia. 6) If, after several attempts, no paresthesia is obtained, the local anesthetic solution is injected into the perivascular sheath after confirming that the artery is not punctured. 7) Immediately after starting surgery, Valium is injected for sedation by the intravenous route in almost all cases. The age distribution of the cases was from 11 to 80 years. Sex distribution was 476 males and 49 females (Table 1). Operative procedures consisted of 103 open reductions, 114 skin grafts combined with spinal anesthesia in 14, 87 debridements, 75 repairs, i.e. tendon (41), nerve(32), and artery (2), 58 corrections of abnormalities, 27 amputations above the elbow (5), below the elbow (3) and fingers (17), 20 primary closures, 18 incisions and curettages, 2 replantations of cut fingers. respectively (Table 2). Paresthesia was obtained in all cases. Onset of analgesia occured within 5 minutes, starting in the deltoid region in almost all cases. Complete anesthesia of the entire arm appeared within 10 minutes but was delayed 15 to 20 minutes in 5 cases and failed in one case. Thus, our success rate was nearly 100%. The duration of anesthesia after a single injection ranged from $3\frac{1}{2}$ to $4\frac{1}{2}$, hours in 94% of the cases. The operative time ranged from 0.5 to 4 hours in 92.4% of the cases(Table 3). Repeat blocks were carried out in 33 cases when operative times which were more than 4 hours in 22 cases and the others were completed within 4 hours (Table 4). Two patients of the 33 cases, who received microvasular surgery were injected twice with 2% lidocaine 20 ml for a total of $13\frac{1}{2}$ hours. The 157 patients who received surgery on the forearms or hands had pneumatic tourniquets (250 torrs) applied without tourniquet pain. There was no pneumothorax, hematoma or phrenic nerve paralysis in any of the unilateral and 27 bilateral blocks, but there was hoarseness in two, Horner's syndrome in 11 and shivering in 7 cases. No general seizures or other side effects were observed. By 20ml of 60% urcgratin study, we confirm ed the position of the needle tip to be in a safer position when the arm is in hyperabduction than when it is in adduction. And also that the humoral head caused some obstraction of the distal flow of the dye, indicating that less local anesthetic solution would be needed for satisfactory anesthesia. (Fig. 3,4).

• Archives of Reconstructive Microsurgery
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• 제5권1호
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• pp.35-45
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• 1996

After transplantation of groin free flap was sucessed by the Daniel and Taylor in 1973, the reconstruction of plastic surgery was extensive and universal due to rapidly developement of anatomic study of the donor site and technique of microvascular surgery. The free tissue transfers is possible to be early activity and rehabilitation by one stage operation. It currently available allow transfer of specific tissue quality as bone, muscle, nerve to achieve a functional and cosmetic result as well as the most favorable secondary defect. But free flaps require critical, skillful technique and lengthy operating time. Also it has disadvantage of donor site morbity at the large tissue transfer. Authors were transferred with 107 cases in 103 patients from May 1987 to June 1996, and then we analysed free tissue transfer to acquire more increased sucess rate, satisfactory functional and cosmetic results. The sexual distribution was male prominent in 79 cases(76.7%), female in 24(23.3%) and age was variable distribution from 3 to 76 years old. The cause of defects was most prevalent in trauma of traffic and industrial accident in 51 cases(49%). The common recipient site were lower extremities in 47 cases(43.9%), upper extremities in 28 cases(26.5%), head and neck in 25 cases(23.4%), and trunk in 7 cases(6.5%). The type of transfer were free skin flaps in 46 cases(43%), free muscle or musculocutaneous flaps in 31 cases(29%), free vasculized or osteocutaneous flaps in 10 cases(9.3%), and specilized free flaps in 20 cases(18.7%). The anastomosis of artery was end to end anastomosis in 94 cases(87.9%), end to side anastomosis in 13 cases(12.1%) and all vein was end to end anastomosis. The number of anastomosed vessels were one artery one vein in 62 cases(57.9%), one artery two vein in 45 cases(42.1%) and vein graft was performed only one case. The postoperative mornitoring were used with temperature, color of flap, capillary refilling time, ultrasonogram, bone scan, doppler, and endoscopy. The reexploration was performed in 9 cases(8.4%), and then flap was loss in 3 cases(2.8%). Accordingly overall success rate was 97.2%. The postoperative complication was early vascular occlusion, hematoma, partial necrosis and late bulkiness, scarring, color dismatch etc. Therefore, free tissue transfer is the preferred method of treatment, even through conventional local and distant flaps are available.

• 한국수산과학회지
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• 제28권4호
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• pp.383-391
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• 1995

출산 전후의 황점볼락 및 조피볼락 어미의 뇌 조직에서 GtH 분비를 자극하는 신경호르몬으로 알려진 NPY를 검출하기 위해, 면역조직화학을 실시하고 뇌하수체내 GtH 분비세포의 활성을 서로 비교하였다. 두 어종 모두에서 뇌 조직중 NPY 양성반응을 나타내는 세포는 후각망울, 종뇌 및 중뇌에서, 신경섬유는 후각망울, 종뇌, 시각신경, 시상하부, 중뇌 및 시각엽에서 각각 관찰되었다. 뇌하수체내에서 NPY 양성반응을 나타내는 신경섬유는 성숙에 관계없이 두 어종 모두 앞원위부분의 AF 음성세포에 인접한 신경엽에 분포하였고, 성장 및 성숙기의 난모세포를 가진 어체에서는 앞원위부분의 신경엽과 중간원위부분의 GtH 분비세포에 인접한 신경엽에서 관찰되었다. 뇌하수체내의 GtH 분비세포는 출산전의 황점볼락 및 성숙기의 조피볼락 개체에서는 AF 염색성이 약했으나, 출산후 황점볼락 및 조피볼락의 GtH 분비세포는 출산전 및 성숙기에 비해 AF 염색성이 증가하였다. 두 어종에서 출산전 난소를 가진 개체들의 GtH 분비세포와 핵경의 크기는 출산후(황점볼락)이거나 출산 이후 휴지기의 난소를 가진 개체(조피볼락) 보다 유의하게 컸다(P<0.01).

• 대한수의학회지
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• 제26권1호
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• pp.1-9
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• 1986

This study was carried out to investigate the branch and distribution of Nervus facialis of the Korean native goat. The observation was made by dissection of embalmed cadavers of ten Korean native goats. The results were as follows; 1. N. facialis arose from the ventrolateral surface of the medulla oblongata. 2. In the facial canal, N. facialis gave off N. petrosus major, N. stapedius and Chorda tympani. 1) N. petrosus major arose from Ganglion geniculi, passed through the pterygoid canal and terminated in Ganglion pterygopalatinum. 2) Chorda tympani joined N. lingualis at the lateral surface of the internal pterygoid muscle. 3. At the exit of the stylomastoid foramen, N. facialis gave off N. caudalis auricularis, Ramus auricularis internus, Ramus stylohyoideus and Ramus digastricus. 1) N. caudalis auricularis arose by two branches in 6 cases and by a single branch in 4 cases. N. caudalis auricularis gave off branches to the caudoauricuIar muscles and the internal surface of the conchal cavity. 2) Ramus auricularis internus arose by a single branch except in 2 cases in which it arose in common with N. caudalis auricularis. It penetrated the caudolateral surface of the tragus and distributed in the skin of the scapha. 3) Ramus stylohyoideus and Ramus digastricus arose separately from N. facialis. 4. In the deep surface of the parotid gland, N. facialis divided into N. auriculopalpebralis, Ramus buccalis dorsalis and Ramus buccalis ventralis. In 6 cases, N. facialis gave off Ramus buccalis ventralis and then divided into N. auriculopalpebralis and Ramus buccalis dorsalis. In 3 cases, N. facialis trifurcated into Ramus buccalis ventralis, Ramus buccalis dorsalis and N. auriculopalpebralis. In one case, N. facialis gave off N. auriculopalpebralis and then divided into Ramus buccalis dorsalis and Ramus buccalis ventralis. 1) Ramus buccalis ventralis ran along the ventral border of the masseter muscle and distributed to the buccinator and depressor labii inferioris muscles. Ramus buccalis ventralis communicated with a branch of Ramus buccalis dorsalis and N. buccalis. In 2 cases, it also communicated with N. mylohyoideus. 2) Ramus buccalis dorsalis communicated with Ramus transverses faciei, N. buccalis, N. infraorbitalis and a branch of Ramus buccalis ventralis. Ramus buccalis dorsalis distributed to the orbicularis oris, caninus, depressor labii inferioris, levator labii superioris, buccinator, malaris, nasolabialis and zygomaticus muscles. 3) N. auriculopalpebralis gave off Rami auriculares rostrales, which supplied the zygomaticoauricularis muscle, the frontoscutularis muscle and the skin of the base of the ear. N. auriculopalpebralis then continued as Ramus zygomaticus, which innervated the frontal muscle, the lateral surface of the base of the horn, the orbicularis oculi muscle and the adjacent skin of the orbit. N. auriculopalpebralis communicated with Nn. auriculares rostrales and Ramus zygomaticotemporalis. In 7 cases, it also communicated with N. infratrochlearis.

• Journal of Acupuncture Research
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• 제17권1호
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• pp.55-66
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• 2000

The following results have been obtaind after examing 72patients with facial paralysis who were hospitalzed and treated through the time period of December 1st, 1996 to November 30th, 1999 at the Department of Acupuncture and Moxibustion of Seoul Oriental Medicine, Kyungwon University. During the examination, those 72 patients were divided into two groups, and One group was treated by oriental-western treatment, the other group was treated by oriental treatment. Oriental treatments were acupuncture and moxibustion, herb medicine, physical treatment and hygienic treatment. The one of main western treatments is steroid therapy. The results were obtained as follows : 1. In regard to signs at the first medical examination, lacrimation was showed highest number and facial paralysis, dysgeusia, hyperacusis were showed in numerical order. 2. In regard to prescription of oriental herb medicine, Kamissangbotang(加味雙補湯) was prescribed in greatest numbers and Boyangwhanotang(補陽還五湯), Kamiboiktang(加味補益湯), Ligigepungtang(理氣祛風湯) were prescribed in numerical order. 3. In regard to treatment number, 10~19 times for treatment was showed highest number and 1~9 times, 20~29 times, 40~49 times were showed in numerical order . 4. In regard to mean treatment times about injury region and main sign, the effect of oriental-western treatment was showed as follows: lacrimal gland disorder, hyperacusis, dysgeusia, facial paralysis were treated for 15.1, 27, 13.2 and 21.4 times, repectively. The effect of oriental treatment was showed as follows: lacrimal gland disorder, hyperacusis, dysgeusia, facial paralysis were treated for 34.8, 22.1, 33.8 and 16.3 times, respectively. 5. In regard ta the effect of treatment about injury region and main sign, oriental-western treatment was showed as follows: cases of lacrimal gland disorder were showed 1 of excellent case, 1 of fair case, 5 of good cases. In hyperacusis patients, there was showed 1 of fair case. In dysgeusia patients, there was showed 1 of excellent case, 3 of fair cases, 1 of good case. In facial paralysis, there were showed 5 of fair cases. Oriental treatment was showed as follows: In lacrimal gland disorder, the excellent were 4 cases, the fair were 10 cases, the good were 3 cases and the poor were 4 cases, In hyperacusis, the fair were 5 cases, the poor 2 cases. In dysgeusia, the excellent were 4 cases, the fair were 1 case, the good were 1 case and the poor was 1 case, In facial paralysis, the excellent were 9 cases, the fair were 4 cases, the good 3 cases and the poor were 3 cases. 6. The effect of total treatment was as follows: 30 cases were showed fair effect, 19 cases were showed excellent effect, 13 cases were showed good effect and 10 cases were showed poor effect. 7. In regard to attack factor, overlabour was showed highest number and wind-cold, mental stress, trauma, ear disease, common cold, dental diseae, reason unknwon were showed in numerical order. 8. In regard to premonitory symptoms, non significant symptoms were in 38 cases, the pain of peri-stylomastoid region were in 38 cases and headache, dysaesthesia of periorbit, dysgeusia, stomatitis, eyelid tic were showed in numerical order. 9. In regard to sex, male were 33 cases and female were 39 cases. The distribution of age was disclosed that thirty, forty, fifty, seventy, sixty, twenty and below twenty years were revealed in turn. Sex and paralytic side were showed as follows: male-left were 15 cases, male-right were 18 cases, female-left were 19 cases and female-right were 19 cases. In regard to attack frequence in month, March was showed highest number and January, April, May, August, October, etc were showed in numerical order. In regard to attack frequence in season, spring was showed highest number and winter, summer, fall were showed in numerical order, but attack frequence between four seasons wasn't showed significant difference.

• 대한소아치과학회지
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• 제29권4호
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• pp.539-554
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• 2002

우리나라의 소아치과학과 큰 연관성을 가진 일본과 미국, 두 나라의 최근 소아치과학적 연구동향을 살펴보기 위하여 일본 소아치과학회지 (이하 JJPD)와 미국 소아치과학회지 (이하 PD)를 대상으로 1991년부터 2000년까지 양 학술지에 게재된 논문의 서지학적인 정보를 수집하여 시대별, 주제별 분포 및 각 연구주제에 있어서의 변화양상을 비교, 분석하여 다음과 같은 결과를 얻었다: 1. JJPD에는 총 869편, PD에는 672편으로, JJPD에 약 30% 정도 더 많은 논문이 게재되었다. 2. JJPD와 PD 모두 증례보고가 원저에 비하여 1/4 정도의 비율을 보였다. 3. 전신질환 관련 연구는 JJPD와 PD 모두에서 가장 높은 비율을 보였으며, 치아우식증, 수복재 연구 또한 양자 모두에서 비교적 높은 비율을 보였다. 4. 약물진정과 생화학적 행동연구는 PD에서 높은 비율을 보인 반면, JJPD에서는 상당히 낮은 비율을 보였다. 행동연구 및 행동조절은 JJPD의 게재 논문수가 PD보다 2배 정도 더 많았다. 5. 치아우식증, 치아우식증의 예방 지역치과의료 조사, 수복 치료, 수복재 연구, 치수치료, 부정교합의 원인과 치료, 국소 마취 및 신경조직 연구, 구강병리와 소수술, 외상성 손상은 양자 간의 논문 수에 있어서 유의한 차이가 없었다. 6. JJPD의 경우 치과용 장비가, PD의 경우 수복재 연구가 유의한 증가추세를 보였다. 7. JJPD의 경우에는 국소마취 및 신경조직 연구, 치아우식증의 예방, PD의 경우 수복치료가 유의한 감소추세를 보였다.

• Journal of Oral Medicine and Pain
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• 제34권2호
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• pp.207-216
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• 2009

2003년부터 2008년까지 경북대학교병원 구강내과를 내원한 삼차신경통 환자 90명의 임상 소견 및 약물 치료에 대한 결과를 분석하여 다음과 같은 결론을 얻었다. 1. 삼차신경통 환자는 40대 이상이 94.4%를 차지하였고 남녀비가 1:2.1로 여성에서 거의 2배 정도 호발하였다. 2. 삼차신경의 상악분지에 단독으로 이환된 경우가 51.1%로 가장 많았고 좌우비가 1:2.9로 우측에 더 자주 발생하였다. 3. 85명(94.4%)의 환자가 경북대학교병원 구강내과에 내원하기 전 삼차신경통을 치료하기 위해 다른 의료기관을 내원한 경험이 있었다. 3. 40명(44.4%)의 환자가 현재 치료 중인 전신질환을 가지고 있었다. 4. Carbamazepine 단독 투여로 69명(76.7%)의 환자가 효과를 나타내었으며 이 때 사용된 Carbamazepine의 일일 용량은 평균 402.9mg이었다. 반면에 16명(17.8%)의 환자는 Carbamazepine과 다른 약물을 복합 투여하여 효과를 나타내었고 사용된 Carbamazepine 일일 용량은 평균 618.8mg이었으며 가장 많이 사용된 병용 약물은 Baclofen이었다. 나머지 5명(5.6%)의 환자는 Carbamazepine으로 효과를 얻지 못했다. 5. Carbamazepine 단독 투여에 효과가 있었던 69명 중 39명은 내원 기간 동안 지속적인 효과를 나타내었으나 30명은 Carbamazepine에 대한 효과가 감소하였거나 부작용으로 인해 복합 투약을 시행하였거나 다른 약물로 교체 또는 신경외과로 의뢰하였다. 6. 54명(60%)의 환자에서 Carbamazepine 투여 후 현기증, 졸음, 오심, 혈구 감소, 피부 발진 등의 부작용이 발생하였으나 대부분 그 정도가 미약하거나 일시적이었고 11명의 환자가 부작용으로 인해 Carbaamzepien 투약을 중단하였다.