• Maxillofacial Plastic and Reconstructive Surgery
• /
• 제23권4호
• /
• pp.338-347
• /
• 2001

Purpose: This is to review the cases of posterior maxillary segmental osteotomies to regain the interarch spaces for dental implants in the posterior mandible. Materials & Methods: Seven patients who presented with alveolar extrusion of upper posterior molars underwent segmental osteotomies by single-stage Kufner's buccal approach under the intravenous sedation and local anesthesia. The posterior maxillary cento-alveolar segments were repositioned upward using pre-fabricated palato-occlusal resin splints and immobilized with osteosynthesis microplates and screws. Dental implants were installated simultaneously. The regained spaces, tooth vitality, periodontal healing, relapse, tenderness on function, and complications including maxillary sinus involvements were evaluated periodically for over one year after the surgeries. Results: The single-tage procedures were completed within 80 minutes without any surgical complications. The posterior maxillary segments were repositioned upward to regain the interarch spaces ranging from 2.5 to 5.5mm. All teeth involved in the procedures keep their vitalities. The repositioned segments were maintained showing neither evidence of periodontal break-down nor tenderness to function. One patient whose segments had not been immobilized by osteosynthesis plate resulted in 2mm down-ward relapse in post-operative 8 months. A case of postoperative nasal bleeding from the posterior-lateral wall resulted in oroantral fistula and chronic maxillary sinusitis later. Conclusion: The extruded dento-alveolar segments of the posterior maxilla were repositioned properly by Kufner's one-stage segmental osteotomies. One microplate can be of help to keep the position until the osseous healing enough to support the masticatory force.

• 대한두개안면성형외과학회지
• /
• 제9권2호
• /
• pp.93-96
• /
• 2008

Purpose: Sudoriferous cyst usually occurs on the face, and especially on the ear and scalp as a solitary cystic mass. It is derived from the sweat glands of Moll and results from the obstruction of excretory ducts with the retention of fluid. In the eyelid, it is usually seen as small and firm vesicle arising at the eyelid margin. If it rarely occurs on the orbit, it develops from orbital ectopic epithelial cells predetermined to form glands of Moll. We experienced a case of sudoriferous cyst on eyelid which was adhered to levator aponeurosis and it disappeared when patient closed eyes. Methods: A 55-year-old women suffered palpable mass on left upper eyelid without pain that had been present for 25 years. Orbital computed tomographic finding showed a oval mass($2.1{\times}0.6{\times}0.6cm$ size) inside upper eyelid and it invaded the orbit. The mass was completely excised under general anesthesia and histopathological examination was followed. Results: Cystic mass was purple color and it was located in superiorly to tarsal plate. The mass was adhered to levator aponeurosis and levator palpabrae superioris muscle between the fat layer of post-orbital septum and the Whitnall ligament. The mass was completely excised without injury of aponeurosis and muscle. Microscopically, the lesion was a solitary cyst lined by two layers of cuboidal epithelial cells and innermost cells displaying eosinophilic cytoplasm with apical expansions. Conclusion: Sudoriferous cyst usually occurs on eyelid margin. But in this case, cystic mass occurred on upper eyelid and disappeared when patient closed the eyes because it was partially adhered to levator aponeurosis and levator palpebrae superioris muscle. Therefore, if sudoriferous cyst occurs on eyelid, it is necessary to excised the mass carefully.

• 대한치과교정학회지
• /
• 제14권1호
• /
• pp.53-65
• /
• 1984

The purpose of this study was to investigate the histopathological change and adaptation process of the mandibular joint of the rat by muscle alteration. For this study, one hundred and twenty eight rats of 25 - and 60 - day old of age were used. Unilateral and bilateral detachment, with anterior positioning of the Masseter muscle, was performed under anesthesia. The animal was sacrified 10, 20, 50, 80 days postoperatively. This alteration in muscle function led to change in neuromuscular activity and demonstrated the adaptive nature of the condyle cartilage to functional demand. The results were as follows : 1. In the right muscle detached group, operated at 25 days of age, marked decrease on the chondroblastic zone was found in the condyle head on the right side of animals examined 10 days postoperatively. Comparing with the control group, no difference was found on the chondroblastic zone in the condylar head of animals examined 20, 50 and 80 days postoperatively. 2. In the bilateral muscle detached group, operated at 25 days of age, the chondroblastic zone was slightly decreased in the anterior parts of condylar head of animals examined 10 days postoperatively. 3. In the unilateral and bilateral muscle detached group, operated at 60 days of age, no significant change was found in the mandibular joint regardless of the post operative experimental periods. 4. Under Toluidine blue staining, slightly decreased metachromasia was found in the condyle head on the right side of unilateral experimental animals, operated at 25 days of age and examined 10 days postoperatively. 5. Under Masson's trichrome staining, increased metachromasia was found in the condyle head on the right side of unilateral experimental animals, operated at 25 days of age and examined 10 days postoperatively. In summary, the condyle of the rat could respond to changes in neuromuscular activity depend on the level of maturation of the tissue, because the endochondral bone formation of the condyle of the rat was almost ended within 3 months.

• Biomolecules & Therapeutics
• /
• 제24권5호
• /
• pp.489-494
• /
• 2016

Neuropathic pain (NPP) is the main culprit among chronic pains affecting the normal life of patients. Procaine is a frequently-used local anesthesia with multiple efficacies in various diseases. However, its role in modulating NPP has not been reported yet. This study aims at uncovering the role of procaine in NPP. Rats were pretreated with procaine by intrathecal injection. Then NPP rat model was induced by sciatic nerve chronic compression injury (CCI) and behavior tests were performed to analyze the pain behaviors upon mechanical, thermal and cold stimulations. Spinal expression of Janus kinase 2 (JAK2) and signal transducer and activator of transcription 3 (STAT3) was detected by qRT-PCR and western blot. JAK2 was also overexpressed in procaine treated model rats for behavior tests. Results showed that procaine pretreatment improved the pain behaviors of model rats upon mechanical, thermal and cold stimulations, with the best effect occurring on the $15^{th}$ day post model construction (p<0.05). Procaine also inhibited JAK2 and STAT3 expression in both mRNA (p<0.05) and protein levels. Overexpression of JAK2 increased STAT3 level and reversed the improvement effects of procaine in pain behaviors (p<0.01). These findings indicate that procaine is capable of attenuating NPP, suggesting procaine is a potential therapeutic strategy for treating NPP. Its role may be associated with the inhibition on JAK2/STAT3 signaling.

• Asian Pacific Journal of Cancer Prevention
• /
• 제17권6호
• /
• pp.2853-2856
• /
• 2016

Background: Many studies have pointed to strategies to cope with patient anxiety in colposcopy. Evidence shows that patients experienced considerable distress with the large loop excision of transformation zone (LLETZ) procedure and suitable interventions should be introduced to reduce anxiety. This study aimed to investigate the effects of music therapy in patients undergoing LLETZ. Materials and Methods: A randomized controlled trial was conducted with patients undergoing LLETZ performed under local anesthesia in an out patient setting at Ramathibodi Hospital, Bangkok, Thailand, from February 2015 to January 2016. After informed consent and demographic data were obtained, we assessed the anxiety level using State Anxiety Inventory pre and post procedures. Music group patients listened to classical songs through headphones, while the control group received the standard care. Pain score was evaluated with a visual analog scale (VAS). Statistical analysis was conducted using Pearson Chi-square, Fisher's Exact test and T-Test and p-values less than 0.05 were considered statistically significant. Results: A total of 73 patients were enrolled and randomized, resulting in 36 women in the music group and 37 women in the non-music control group. The preoperative mean anxiety score was higher in the music group (46.8 VS 45.8 points). The postoperative mean anxiety scores in the music and the non-music groups were 38.7 and 41.3 points, respectively. VAS was lower in music group (2.55 VS 3.33). The percent change of anxiety was greater in the music group, although there was no significant difference between two groups. Conclusions: Music therapy did not significantly reduce anxiety in patients undergoing the LLETZ procedure. However, different interventions should be developed to ease the patients' apprehension during this procedure.

• Journal of Korean Neurosurgical Society
• /
• 제37권2호
• /
• pp.116-123
• /
• 2005

Objective: Percutaneous kyphoplasty using a balloon-catheter is an widely accepted method which achieves the restoration of vertebral height and the correction of kyphotic deformity with little complication in osteoporotic vertebral compression fractures. The authors assess the results of 59 patients who underwent kyphoplasty, and analyze the factors that could affect the prognosis. Methods: From December 2001 to May 2003, fifty-nine patients underwent kyphoplasty. The patients included 49 women and 10 men aged 52-85 years. Average t-score on bone marrow density was -3.58. About 7cc of polymethylmethacrylate(PMMA) was injected into the fractured vertebral body using $Kyphon^{(R)}$ under local anesthesia. The vertical height of all fractured vertebrae was measured both before and after surgery. Outcome data were obtained by comparing pre- and post-operative VAS score and by assessing postoperative satisfaction, drug dependency and activity. Various clinical factors were analyzed to assess the relationship with the outcome. Results: The VAS score improved significantly, and the mean percentage of restored vertebral height was 53%. The mean improvement in kyphosis was $3.6^{\circ}$. Eighty-nine percent of the patients gained excellent or good results. Any of the clinical factors including the interval between fracture and operation, the degree of height loss, the degree of the vertebral height restoration or the correction rate of kyphosis did not affect the clinical results. Conclusion: Kyphoplasty is associated with a statistically significant improvement in pain and function with little complication. The clinical results are not affected by any clinical parameters. Further follow-up study is needed to determine whether the restoration affects the long-term clinical results.

• The Korean Journal of Pain
• /
• 제9권1호
• /
• pp.166-171
• /
• 1996

The purpose of this study is to compare the postoperative analgesic effect of morphine and meperidine, employing intravenous patient controlled analgesia after cesarean section. Among fifty nine parturients undergoing cesarean section with general anesthesia, 32 were administered morphine designated as 'morphine group', and 27 parturient administered meperidine as 'meperidine' group, during 48 hours after commencement of PCA. Doses administered, based on potency for this setting, were equivalent to 1 mg morphine or 10 mg meperidine. Loading dose was administered when parturient first complained of pain after cesarean section. This was followed with bolus dose, 1 mg for morphine group and 10 mg for meperidine group, with a lockout interval of 8 minutes between doses wherever parturient requested additional analgesia. Visual analog scale(VAS) pain scores during rest were significantly lower at only 1 and 2 hour for the meperidine group, than morphine group. Loading dose and cumulative dose at 1, 2 and 3 hours were significantly lower for meperidine group than the morphine group. There were no significant difference in total dose and hourly dose for 48 hours and cumulative dose at 6, 12, 24, and 48 hours between both groups. More than 90% of the parturients from both groups were satisfied with the analgesic effects of pain relief. Morphine group experienced side effects such as: pruritus, sedation and dizziness. Meperidine group had sedation, dizziness, nausea and local irritation. Neither group required any specific treatment for any of the above side effects. We conclude that meperidine had greater analgesic effect at early stage of post-operative period.

• 대한후두음성언어의학회지
• /
• 제8권2호
• /
• pp.199-203
• /
• 1997

In the treatment of spasmodic dysphonia, local injection of botulinum toxin A has been reported to be successful. The treatment of adductor type spasmodic dysphonia with botulinum toxin type A injection using a flexible nasopharyngoscope was conducted in 29 patients and using a telearyngoscope in 31 patients. These patients were given toxins in the vocal fold(s), unilaterally or bilaterally, under flexible nasopharyngoscopic guidance with sclerosing needle or telelaryngoscopic guidance with 23 gauge scalp needle attached by laryngeal forceps. Before the above procedure, laryngeal anesthesia was done with 2% pontocain instillation. Among the 60 patients, 59 patients were given the toxin successfully. Telephone interview were made at 2weeks and then at 4 weeks post injection. Among 29 patients using a flexible nasopharyngoscope, 75.8% and among 31 patients using a telelaryngoscope, 90.0% reported that the patients' symptom was improved. The functional status of the patient's disorder was classified into four grades. The mean pre-injection grade fir the patients using flexible nasopharyngoscope and telelaryngoscope was 1.6 and 2.1 respectively. And it was lowered to 0.7 and 1.1 respectively after the injection. The result was similar(p<0.05). As a self assessment method, the patients were asked to rate their voice on a scale of 100. In this study, the mean pre-injection score was 44 and 40 respectively. And it was improved to 77.7 and 69.8 respectively after the injection. The result was similar(p<0.05). In conclusion, botulinum toxin injection using a flexible nasopharyngoscope is also an effective method for the treatment of adductor type spasmodic dysphonia as using a telelaryngoscope.

• 대한후두음성언어의학회지
• /
• 제19권2호
• /
• pp.117-122
• /
• 2008

Background and Objectives: $Radiesse^{(R)}$ is a gell-formed material of calcium hydroxylapatite (CaHA) and carboxymethylcellulose (CMC) used for vocal fold injections. The authors aimed to study injection laryngoplasty with $Radiesse^{(R)}$, and determine the efficacy of $Radiesse^{(R)}$ for unilateral vocal cord palsy using objective and subjective measures. Materials and Method: Nine patients with unilateral vocal cord palsy received injection laryngoplasty with $Radiesse^{(R)}$ under general anesthesia from Jul. 2007 to Jan. 2008. $Radiesse^{(R)}$ was injected with 25gauze long needle perorally or percutaneously. The Acoustic, aerodynamic, stroboscopic analysis and pre-injection/post-injection perceptual assessment were evaluated in all patients. Results: Postoperative jitter and shimmer scores tended to diminish compared to preoperative scores, and maximum phonation time increased with statistical significantly. Stroboscopic findings demonstrated improvement postoperatively. The degree of hoarseness, which is a part of perceptual assessment, decreased after the procedure. Conclusion: $Radiesse^{(R)}$ may be an altemative material for injection laryngoplasty. We suggest long-term follow up with more cases.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
• /
• 제27권5호
• /
• pp.435-441
• /
• 2001

Orthognathic surgery for the correction of dentofacial deformities is a common elective procedure. That has proven over the years to be a safe operation with minimal long-term morbidity. But, there are many surgical complication including mal-union of the bone, TMJ problem, excessive bleeding, and permanent damage of inferior alveolar nerve. Among them excessive bleeding which focus is not clear is one of the serious complication because that is fatal and so a transfusion is performing for the prevention and management of that. Until the end of the 1980's, homologous blood transfusions were routinely necessary because of the large amounts of blood lost during surgery. Recently several blood-saving measures can be undertaken for orthognathic surgery patients before, during, and after the operation. We made a comparative study of an amount of blood loss, hematologic change and transfusion requirements based on a series of 40 consecutive patients undergoing single-jaw and double-jaw surgery. The purpose of this investigation was to make a comparative analysis of an amount of blood loss, post-operative hematologic change and duration of the procedure under induced hypotensive anesthesia in healthy orthognathic patients.