• Progress in Medical Physics
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• v.12 no.2
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• pp.177-184
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• 2001

The goal of radiation treatment is to deliver a prescribed radiation dose to the target volume accurately while minimizing dose to normal tissues. Due to inaccurate placement of field and shielding block and patient's movement, there could be displacement errors between the planed and treatment regions. In order to verify the location of radiation treatment, we in this study developed the registration algorithm of the x-ray simulator images and portal images and quantified the inaccuracy in terms of shift, scale and rotation. The algorithm for registration of pairs of radiation fields consists of the alignment of pairs of radiation images by points matching and field displacement analysis by field boundary matching. In the first step, paired surface landmarks are matched to calculate the transformation parameters (scale, rotation and shift) using the corresponding line pairs which are created by connecting two landmarks of each image. In the next step, portal field boundary is extracted and then the two field boundaries are matched by the $\rho$-$\theta$ technique. Applying the phantom portal images, detection errors were calculated to be less than 2mm in translation, 1$^{\circ}$ in rotation and 1% in scale. In conclusion, we quantitatively analyzed the displacement error of x-ray simulator images and portal images. The present results could contribute to the study of the radiation treatment verification.

• Journal of Korean Neurosurgical Society
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• v.47 no.1
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• pp.11-16
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• 2010

Objective: Abnormalities of the bone are frequently encountered in patients with meningioma, and hyperostosis and endostosis are common bone alterations in these tumors. Extensive bony destruction is very unusual in patients with meningioma. We report six cases of intracranial meningioma associated with an osteolytic lesion of the skull and discuss the underlying mechanisms that may be responsible for bone destruction in patients with meningioma. Methods: Six patients were classified into three groups, severe, moderate and mild, according to the degree of osteolytic bony destruction. The tumor was classified as intracranial or extracranial, depending on its location. We investigated the potential role of matrix metalloproteinase (MMP) in meningioma-associated osteolysis. The levels of MMP expression were determined by gelatin zymography, reverse transcription-quantitative PCR analysis (RT-PCR) and immunohistochemical analysis. Results: Complete surgical removal of the lesion was performed in each patient. Histological examination revealed benign meningioma in four cases, and two cases of atypical meningioma. Patients did not have a poor prognosis except one case of recurred atypical meningioma. Gelatin zymography and RT-PCR detected high levels of MMP-2 in almost all extracranial masses in comparison with the intracranial masses and MMP9 in two. There was no difference in the severity of bone destruction. Immunohistochemical analysis revealed MMP-2 expression in the vicinity of the bone destruction, and a few MMP-9-positive stainings were observed. Conclusion: Osteolysis of the skull in patients with meningiomas might not be indicative of malignant pathological features and poor prognosis. Invasion to the extracranial portion and osteolysis might be associated with MMP-2 expression in meningioma.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.34 no.6
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• pp.398-403
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• 2012

Purpose: Mandible resection and discontinuity defect created lead to aesthetic and functional problems. The iliac crest bone graft exhibits relative ease for bone harvesting, possibility of two team approach, ability to close the wound primarily, large amount of corticocancellous bone and relatively few complications. Whereas the use of free vascularized flaps has donor site morbidity and worse-fitting bone contour, the use of nonvascularized iliac bone graft has advantages in the operation time and patients' recovery time. So, nonvascularized iliac bone graft could be an attractive option. Methods: Twenty-one patients (M:F=1:1.1) underwent iliac crest bone harvesting for reconstruction of mandibular discontinuity defect (mean length : $61.6{\pm}17.8$ mm), from May 2005 to October 2011 at the Department of Oral and Maxillofacial Surgery in Kyungpook National University. The average age was $44.1{\pm}16.4$ years and the mean follow up periods was $28.2{\pm}22.7$ months. Bone resorption rate, according to age, sex, primary lesion, location and distance of defect, type of fixation plate, time of graft and pre-operative radiation therapy, were measured in each patient. Results: The mean bone resorption rate was $16.1{\pm}9.0%$. Bone resorption rate was significantly increased in mandibular defect that is over 6 cm in size (P=0.015, P<0.05) and the cases treated pre-operative radiation therapy (P=0.017, P<0.05). All was successfully fixed and maintained for the long-term follow-up. There were a few donor site complications and almost all patients were shown favorable outcome without severe bone resorption in this study. Conclusion: The nonvascularized iliac bone graft seems to be a reasonably reliable treatment option for reconstruction of mandibular discontinuity defects.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.29 no.6
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• pp.509-512
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• 2007

Purpose: The Le Fort I osteotomy is a commonly performed maxillary procedure for dentofacial deformity. One of the risks of this procedure is major hemorrhage resulting from injury to the descending palatine artery. So it is very important to know the exact position of the descending platine artery. An increased understanding of the position of this artery can minimize the intra-operative bleeding while allowing extension of the bone cuts to achieve exact positioning maxilla. The aim of this investigation was to study the position of the descending palatine artery as it relates to the Le Fort I osteotomy. Methods and patients: Total 40 patients who underwent Le Fort I osteotomy in SNUDH OMFS were studied in this study. We measured the distance from the pyriform aperture to the descending palatine artery (DPA distance) using a ruler. We investigated the relationship between DPA distance, the distance from A point to the McNamara line on lateral cephalography and the patient's body height. Results: The average distances from the pyriform rim to the descending palatine artery were 35.3 mm on the right (range: $30{\sim}40mm$) and 33.7mm (range: $30{\sim}41mm$) on the left in males. Those in females were 33.4 mm on the right (range: $28{\sim}40mm)$ and 32.8mm (range: $27{\sim}38mm$) on the left. The significances between the distance the DPA distance, the body height and the distance from A point to McNamara line were not found. Conclusion: Injury to the descending palatine artery during Le Fort I osteotomy can be minimized by not extending the osteotomy more than 30 mm posterior to the pyriform aperture in mal, and 27 mm in female.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.16 no.2
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• pp.171-178
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• 1994

Cystic hygroma remains a complex entity in terms of its development and management. Most recently, cystic hygroma has been categorized as part of a larger spectrum that include lymphangioma. The majorities of lymhangioma occur in the head and neck as cystic hygromas with the posterior cervical region as the most common site. Cystic hygromas usually present in infancy or early childhood as compressible masses that may rapidly and intermittently enlarge. While they may arise in any anatomic location, hygromas of the head and neck are especially difficult and speech pathology. Since as airway obstruction, feeding difficulties, and speech pathology. Since its original description, there have been many attepmts at treatment modalities : surgical excision remains the treatment of choice. Complete extirpation of these lesions is often impossible, and recurrence rates are accordingly high. This is report of a case bout 5-year-old female patient with cystic hygroma, resulted in facial asymmetry and swallowing difficulty, in left submandibular area. We obtained the successful functional and esthetic results by simple surgical excision of tumor mass. Therefore, we represents the case with literatural reviews.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.33 no.5
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• pp.535-542
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• 2007

Ameloblastoma, a benign tumor of odontogenic type, represents 10% of all tumors of the jaw. It is localized in the mandible(80%) and in the maxilla(20%). In every case, the selection of the surgical treatment must consider some fundamental elements, including the age and general state of health the clinicopathological variant, and the localization and extent of the tumor. This study was invested the clinicopathological findings of 23 patients with ameloblastoma which had been diagnosed by biopsy during the period of 1987 to 2005 at Chonnam National University Hospital. And it contained the statistical analysis according to the treatment methods and the clinicopathological findings such as sex, age, location, chief complaints, duration, radiographic findings, histologic findings, treatment methods. The results obtained are were follows. The age of patient ranged from 10 to 91 years(means, 35.9 years) at biopsy. Thirteen(57%) of the 23 subjects were males, and 10(43%) were females. Twenty(87%) of the 23 ameloblastomas were located in the mandible. Swelling was the most common symptom and was experienced by 20(87%) patients. Radiographically, 11(48%) of the 23 tumors were unilocular with a well-demarcated border and 12(52%) were multilocular. The most common histologic pattern was plexiform and acanthomatous rather then follicular. Conservative treatment was performed 7 cases(30%), radical treatment 11 cases(48%), and combined treatment 5 cases(22%). Follow-up period ranged from 2.1 years to 22 years(mean 5.1 years). Based on the above results, surgical excision after marsupialization was found to be useful as a preliminary treatment of the large cystic ameloblastoma in children and adolescents. On the contrary, the lesion with a soap bubble appearance, the one with ineffective marsupialization was subjected to extensive excision of the tumor with a wide margin of normal bone.

• Tuberculosis and Respiratory Diseases
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• v.52 no.1
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• pp.86-91
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• 2002

A bronchial artery aneurysm(BAA) is rare, and has an unclear etiology. However, it may be caused by congenital abnormalities and acquired diseases like as bronchiectasis, tuberculosis, and other infections. The pathogenesis of a bronchial artery dilatation and the formation of an aneurysm results in an increase in the systemic blood flow to the chronic inflammatory pathologic lungs such as bronchiectasis or tuberculosis. It can be divided into the mediastinal and intrapulmonary BAA according to their location. The most common symptom is hemoptysis. Chest computed tomography and bronchial artery angiography may be used for a diagnosis. Treatment is mainly by a surgical resection of the aneurysmal artery. However, when patient is unstable due to massive hemoptysis or recurrent hemoptysis, bronchial artery embolization is useful. Here, we experienced a case of a bronchial artery aneurysm presenting as a massive hemoptysis.

• Journal of Periodontal and Implant Science
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• v.35 no.3
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• pp.563-575
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• 2005

The aim of present study is to evaluate the influence of adjacent tooth to the microbiology of clinically healthy implant. Control group included patients who had clinically healthy implant and tooth with healthy $periodontium(PD{\leq}3mm)$, test group was composed of patients who had clinically healthy implant and tooth with periodontal pocket(PD>3mm). The criteria of clinically health implant are no pain or discomfort, the restorative suprastructure provide satisfactory fit and function, and the tissue around the fixtures were firm and probing with standard periodontal probe with a rounded tip 0.5mm in diameter resulted in penetration of no more than 5mm when using a force of 0.5N at any location. 38 patients, partially edentulous subjects with endosseous root-form implants were selected. All subjects were medically healthy and had not taken systemic antibiotics and professional plaque control 3 months before sampling. Number of control group is 25(mean age $52{\pm}13$, 26 teeth, 34 implants) and test group is 13(mean age $60{\pm}13$, 13 teeth, 17 implants). All teeth and implants of each patient were examined probing depth(PD), bleeding on probing(BOP), and plaque index(PI), and samples of subgingival plaque were obtained at each site with sterile curet or fine paper points, then the plaque transferred to PBS. Obtained samples were examined for the presence of P. gingivalis, T. forsythensis, and T. denticola by the polymerase chain reaction(PCR). The relationship among clinical parameters and the colonizations by the 3 bacterial species from natural teeth and implants region were analyzed by student t-test. The results of this study were as follows: 1. PD was different in teeth between 2 groups(p<0.05), but the other parameters were not. 2. Statistically significant difference was not found in clinical parameters of implants between 2 groups. 3. All bacterial prevalences of teeth were higher in test group than in control group, and prevalence of T. forsythensis had statistically significant difference between 2 groups(p<0.05). 4. Prevalences of P. gingivalis and T. forsythensis are higher in test group than control group, and that of T. denticola is higher in control group than in test group. But there were no statistically significant differences between 2 groups. In conclusion, there is no statistically significant difference in prevalence of implant microbiology between 2 groups. But if the number of samples increased, it will be possible to find out statistical significance in prevalence of P. gingivalis. It seems that pocket of adjacent tooth influences prevalence of P. gingivalis. These results mean that improvement of the periodontal condition before implantation is very important.

• Journal of Periodontal and Implant Science
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• v.39 no.1
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• pp.59-70
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• 2009

Purpose: The purpose of this study was to investigate the degree of compliance with supportive periodontal therapy(SPT), to determine if any significant differences existed in the characteristics of compliant, erratically compliant and non-compliant patients and to identify reasons for poor compliance. Materials and methods: Four hundred five patients who initially visited between July 2003 and December 2004 and were treated until June 2005 were retrospectively evaluated for their compliance with SPT in terms of attendance for a recommended schedule of visits. Patients' compliance was classified as complete compliance(attended more than 80% of the recommended appointments), erratic compliance(attended less than 80% of the recommended appointments or discontinued) and non-compliance(did not return for SPT). Analysis was made for each group to correlate the degree of compliance with gender, age, smoking, distance between their houses and the hospital, disease severity, type of therapy, implant, plaque control instruction and systemic diseases. Tele research of erratically compliant and non-compliant patients was carried out to identify reasons for their poor compliance. Results: Only 24.7% of the patients were in complete compliance. The highest drop-out rate(32.4%) occurred in the first year. A significantly greater percentage of non-smokers and patients who finished plaque control instruction were in complete compliance. A significantly greater percentage of patients without implant and patients who had been treated by only scaling and root planing were in non-compliance. More males were found to be compliant with SPT, although this was marginally significant. There were no significant differences between compliant, erratically compliant and non-compliant patients with regard to age, distance, disease severity and systemic disease. The survey revealed that the main reasons for poor compliance with SPT were inconvenient location and insufficient time. Conclusion: Patients' compliance with SPT was poor and the highest drop-out rate(32.4%) occurred in the first year. Significant relationships were found between the degree of compliance and smoking, type of therapy, implant, plaque control instruction and gender.

• Journal of the Korean Society of Radiology
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• v.4 no.2
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• pp.13-20
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• 2010

True lateral scapula image was very important to diagnosis the scapula fracture and dislocation induced by traumatic injury. The aim of this study was to know the patient rotation angle to be showing the scapula true lateral in korean. d Materials Thirty patients(22men, 8 women, mean ages 53.4)with scapular pain, had supine Anteroposterior projection taken with $30^{\circ}$, $40^{\circ}$, $45^{\circ}$ trunk rotation angle changing the manual angulation material. Radiographs were evaluated independently by 5 experienced observers(1 orthopedics surgery specialist, 1 diagnostic radiology specialist, 3 radiological technologist) They assessed overlap of vertebral border and axillary border of scapula as follows; Totally overlapping of vertebral border and axillary border is 4, partially overlapping is 3, not overlapping is 2 and oblique location with two borders is 1. All observers scored using by PACS monitor.$30^{\circ}$ trunk rotation was scored $1.53{\pm}0.39$, $40^{\circ}$ trunk rotation was scored $3.83{\pm}0.15$ and $45^{\circ}$ trunk rotation was scored $2.17{\pm}0.43$. There was no difference(p<0.05) between group of more than 100cm of the girth of the chest and group of less than 100cm. Similarly, men and women group showed no difference(p<0.05) with trunk rotation statistically. There was no result of trunk rotation angle to radiograph the true scapula lateral image up to date. This studies were summarized as follows; Adaptation of $40^{\circ}$ trunk rotation was the best to show the true scapula lateral image in korean. Our results were very useful to get the true scapula lateral images in clinic.