• Restorative Dentistry and Endodontics
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• 제18권1호
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• pp.197-204
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• 1993

This study was conducted to evaluate and compare the apical leakage in the following retrofilling techniques after apical resection; No apical cavity preparation and no retrofilling(control group), Amalgam(group I) or silver glass ionomer cement(group II) retrofilling after apical cavity preparation with mini contra-angle and bur, Amalgam(group III) or silver glass ionomer cement(group N) retrofilling after apical cavity preparation with ultrasonic micro endo tip. Extracted ninety upper anterior and lower canine teeth were fixed in skull simulators and root canals were prepared with step-back method and obturated with gutta-percha and zinc oxide eugenol sealer. Obturated roots were resected 2mm from apical ends and apical cavities of 1mm width and 2mm depth were prepared and retrofilled by above mentioned methods. After application of nail varnish on all surface except resected surface, apical 1/3 of the roots were placed in 1% methylene blue solution for 3 days. After longutudinal sectioning to expose central parts of filled materials, depths of penetrated dye were measured by measuring microscope and were analyzed statistically. The results were as follows. 1. Having no relation with instruments used in apical cavity preparation, amalgam retrofilling groups(group I and II) showed less apical leakage which was not significant statistically than no retrofilling group(control group) (P<0.05), but silver glass ionomer cement retrofilling gruoups(group II and IV) showed significantly less apical leakage than no retrofilling group(control group) (P<0.01). 2. In the groups retrofilled with the same material, the apical leakage in cavities prepared with ultrasonic micro endo tip (group III and IV) was less than that in cavities prepared with mini contra-angle and bur(group I and II), but not significant statistically(P>0.05). 3. When apical cavities were prepared with same instrument. the egroups retrofilled with silver glass ionomer cement(group II and IV) showed significantly less apical leakage than the groups retrofilled with amalgam(group I and III)(<0.01).

• Archives of Plastic Surgery
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• 제37권4호
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• pp.477-480
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• 2010

Purpose: Ganglioneuromas are well-differentiated tumors derived from neuroectodermal neural crest cells. Although these tumors can occur anywhere along the sympathetic chain from the base of the skull to the pelvic cavity, they usually develop in the posterior mediastinum and retroperitoneum these tumors are rarely found in the cervical region. Method: We report the case of a 16-year-old male patient with neurofibromatosis type 1 who was admitted because of a palpable mass centrally located on the left side of the neck. A preoperative contrast-enhanced neck computed tomography image showed a low-density homogeneous mass on the parapharyngeal space along with marked displacement of the trachea and carotid vessels. Round and soft masses were also detected on both axillae. Results: The patient subsequently underwent complete excision of the neck mass via the transcervical approach. The mass was smooth and well encapsulated between the sternocleidomastoid muscle and the trachea. Further, the mass appeared to arise from the cervical sympathetic chain, which was preserved during surgery. Both the axillary masses were also excised. The histopathological findings were ganglioneuroma for the neck mass and neurofibroma for both the axillary masses. Conclusion: Cervical ganglioneuromas are rare tumors that present as enlarging parapharyngeal cervical masses in the oropharynx or neck. To our knowledge, a case of cervical ganglioneuroma associated with neurofibromatosis type 1 has never been reported. In patients with neurofibromatosis, multiple tumors may develop, and therefore periodic clinical and radiological follow-up is recommended. Further, repeated imaging analysis should be performed if the presence of another tumor is suspected.

• 대한두경부종양학회지
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• 제32권2호
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• pp.91-94
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• 2016

A 37 year-old male presented with sudden right proptosis and bilateral nasal obstruction. A huge tumor was noted in bilateral nasal cavities, ethmoid sinuses and central frontal sinus on magnetic resonance imaging. Right posterior frontal sinus wall and bilateral medial orbital wall was destructed by the tumor. Complete resection of the tumor was performed via minimal invasive craniofacial resection. Histopaghologic examination revealed sinonasal undifferentiated carcinoma (SNUC). Cerebrospinal fluid leakage was developed after 2 days of the surgery. On the 5th day, anterior skull base was reconstructed with forearm free flap (FFF). The patient got 6000cGy of radiotherapy and survived in 27 months of follow up.

• 패션비즈니스
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• 제12권5호
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• pp.77-93
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• 2008

The purpose of the study was to examine make-up expression elements of horror characters as an evil spirit, a vampire, a zombie, a monster and a psycho murderer through make-up, focused on horror movies of the United States after1960s. First, an evil spirit was expressed that the pupil grew dim without a focus and the skin was torn by going bad and rot completely. Also, it was expressed that its teeth was changed to pointed canine teeth as a wild beast and its pale and bloodless face showed blood vessels clearly. To express its bloodless and pale skin, air brush was swept into the skin over several times. Its canine tooth was made acryl powder into its shape and was harden to make its shape smooth. Also, it was colored to show people like the real thing. Second, a vampire was expressed by make-up elements as long nails, a sharp canine tooth, a pale skin with a blood vessel and dead eyes. Its rough skin and long nails were manufactured with latex foam, which was colored like the skin. Third, a monster image as a werewolf was expressed by make-up elements as fur, sharp teeth, changed nails and toenails, a rough skin and a face changed to a wolf. Rubber mask and rubber body suit were manufactured as a make-up of special character and so all its body was changed. Fourth, a psycho murderer and body-deformed man were expressed by make-up elements as a distorted mask, swelled-up and deformed skull and face form, terribly deformed body, discolored and hang down skin and teeth with an indeterminate form. Its body and face were manufactured by the foam latex technology according to make-up design as a make-up of special character.

• Journal of Korean Neurosurgical Society
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• 제39권3호
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• pp.198-203
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• 2006

Objective : To evaluate the natural histories and growth rates of meningiomas, the authors perform this retrospective observational study and attempt to identify those factors predicting tumor growth. Methods : Between 1993 and 2004, a total of 83 patients were diagnosed by computed tomography[CT] scans or magnetic resonance[MR] imaging as having an intracranial meningioma, and were treated by observation only using regular clinical and radiological examinations. Twenty-six of these 83 patients, with available data were included in this study. Follow up periods ranged from 9 to 137 months [mean, 55.6 mo.; median, 60 mo.]. The tumor volumes, absolute growth rates, and tumor doubling times were calculated. Results : Patient age and sex distributions were comparable to those of other studies, but exceptionally 16 meningiomas [62%] were located at the skull base in the present study. During follow-up monitoring, the majority of meningiomas grew, though 77% showed low absolute annual growth rates [$<1cm^3/yr$]. The tumor doubling times ranged from 2.87 to 201.72 years [mean, 42.91 yr]. Based on Imaging analysis, peritumoral edema and the absence of calcification were probable factors predicting tumor growth. Tumor-related symptoms seemed to be slightly related to tumor growth. Other factors, e.g., gender, age, tumor location, and T2-weighted signal Intensities on MR imaging, were not significantly related to tumor growth. Conclusion : This study shows that the majority of meningiomas are slow growing. However, variations in tumor growth are unexplained, thus individualized optimal treatment strategies should be provided in each meningioma.

• Journal of Korean Neurosurgical Society
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• 제30권sup1호
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• pp.51-54
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• 2001

Objective : Authors analyzed clinical outcomes of cranioplasty according to the materials used for covering defects of the skulls. Methods : From January 1997 to February 2000, there were forty one patients undergone cranioplasty at our institution. We used refrigerated autogenous bone flaps in 19 cases(group A) and methyl methacrylate(MMA) in 22 cases(group B). The medical records and plain skull radiographs of the patient were reviewed. Results : There were thirty men and eleven women. Mean follow up period was 12 months(From operation to last Outpatient department follow up). The mean operative time of the group A($136.8{\pm}3$ minutes) was shorter than the group B($172.7{\pm}2$ minutes, Mann-Whitney test, p=0.001). In group A, the degree of satisfaction was good in 8 cases, fair in 10, and poor in 1. In the group B, there were fair in 13 and poor in 9. So the cosmetic result was superior in the group A(Chi-square test, p=0.00). The complications were occured in one case of flap infection in the group A and 6 in the group B(one stitch abscess, 4 infected flaps, one subgaleal hematoma). Conclusion : Cranioplasty using refrigerated autogenous bone flap showed shorter operative time, better cosmetic results, and less complication rate than those using MMA.

• Journal of Korean Neurosurgical Society
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• 제30권sup1호
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• pp.128-132
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• 2001

뇌기저동맥 체간부에 존재하는 동맥류는 매우 희귀하며 그 수술적 치료는 복잡한 해부학적 구조와 근접해있는 중요한 신경혈관 구조때문에 수술적 접근이 매우 어려운 부위이다. 산화 단층촬영과 자기공명영상의 발달은 두개저 병변을 정확히 진단할 수 있게 하였고 두개저 부위의 수술적 접근에 많은 발전을 가져오게 하였다. 뇌기저동맥 체간부에 존재하는 동맥류의 수술 방법중의 하나로 저자들은 소뇌와 측두엽의 견인이 적어 소뇌 부종을 극소화 할 수 있고 와우, 미로, 안면신경등의 구조물을 보존하여 청력손실, 안면신경마비등의 합병증이 없고 횡정맥동, S상정맥동의 보존뿐만 아니라 Labbe's 정맥을 보존할 수 있으며 수술시야가 비교적 좋은 장점들이 있는 후미로 전S상정맥동 경천막을 통한 추체로접근법을 이용하여 뇌기저동맥 체간부에 발생한 동맥류의 직접 결찰수술을 시행하여 좋은 결과를 얻었기에 문헌고찰과 함께 보고하는 바이다.

• 대한두개안면성형외과학회지
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• 제12권1호
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• pp.63-66
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• 2011

Purpose: Cranial fasciitis is a rare type of benign tumor that occurs mostly in children younger than 6 years. It arises from the deep fascia, periosteum, or fibromembranous layer that covers fontanelles. The etiology is unknown, although prior trauma has been postulated to be an underlying cause. There is a 2:1 male predominance. Despite its rapid growth, this tumor has a benign clinical course and can be cured by total excision. Methods: A 16-year-old male presented with a 3 cm-sized palpable mass in the left lateral eyebrow region that he first noticed 4 months before presentation. The mass had grown rapidly since it was first noticed. Preoperative brain computed tomography showed a well-demarcated mass approximately 3 cm in size extending from the subcutaneous layer to the periosteum. Preoperatively, the presumed diagnosis was a dermoid cyst. An operation was performed with the patient under general anesthesia. The subcutaneous mass was completely excised by periosteal dissection. Results: Histological diagnosis revealed the presence of cranial fasciitis. After 20 months of follow-up, there have been neither complications nor evidence of local recurrence besed on clinical examination. Conclusion: Although cranial fasciitis is quite rare, it should be considered in the differential diagnosis for lytic skull lesions in patient whose clinical presentation suggests this possibility. This condition could be occasionally mistaken for malignant or locally aggressive lesions. To prevent local recurrence, curettage of the underlying bone is recommended for patients with bone involvement.

• Journal of Interdisciplinary Genomics
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• 제1권2호
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• pp.19-22
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• 2019

CATCH 22 syndrome is rare genetic disease that has various manifestations. Cervical vertebral anomaly, such as Klippel-Feil anomaly, is frequently observed in the patients with CATCH22 syndrome. We present the case of an 11-year-old female patient with CATCH22 syndrome and Klippel-Feil anomaly who had been treated torticollis using the customized soft neck collar. During the patient's first visit to our clinic, she presented with low ear set, skull deformity, intellectual disability, and tilting of the head to the left by approximately 25 degrees. Imaging studies revealed multisegmental fusion and C3 hemivertebrae of the cervical spine and left thoracic scoliosis at T4 with 50 degrees of Cobb's angle. We instructed passive stretching and applied the customized soft neck collar we invented. The ipsilateral aspect of the neck collar is designed to provide vertical support between the clavicle and mandibular angle and is adjustable in height. The Velcro was attached to the neck collar at the point of contact with the ipsilesional mandibular angle, which provides negative sensory feedback, inducing her to tilt neck to the contralesional side. We applied the neck collar for 2 hours a day. After 1 year of treatment, her neck inclination angle improved from 25 to 10 degrees. Providing negative sensory feedback using the customized soft neck collar can be one of the treatment options of postural management in patients with torticollis in cases of CATCH 22 syndrome combined with Klippel-Feil anomaly.

• 대한기관식도과학회지
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• 제4권1호
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• pp.52-58
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• 1998

BACKGROUND： Aspiration is defined as the laryngeal penetration of secretions below the level of the true vocal cords. Aspiration can result in life-threatening complications, such as bronchospasm, airway obstruction, pneumonia, pulmonary abscess, sepsis, and death. The patient with high vagal palsy had significant aspiration and dysphagia OBJECTIVE： To formulate a step-by-step management paradign for the patients with high vagal palsy MATERIALS AND METHODS : The medical records of 23 patients who were diagnosed as high vagal palsy from September, 1995 to April, 1998 in Seoul National University Hospital were reviewed retrospectively. Eleven patients were managed conservatively and 12 patients were operated to treat chronic aspiration. RESULTS : The main etiologies of high vagal palsy were mass lesions of the skull base such as neurogenic tumor, pseudotumor, meningioma or nasopharyngeal carcinoma. Aspiration and dysphagia improved in 7 out of 11 patients who were managed conservatively after 2.2 months on the average. The patients who were refractory to the conservative management underwent surgery and showed improvement in 10 out of 12 patients. The employed surgical modalities were vocal cord medialization combined with cricopharyngeal myotomy in 7 patients, laryngotracheal separation in 3 patients and arytenoid adduction only in 2 patients. Two patients still had gastrostomy tube due to the persistent symptoms. Two patients had improved after surgery, but died of underlying disease. CONCLUSION : The patients with high vagal palsy are recommended to be managed conservatively for the first 2 months. If aspiration and dysphagia are persisting after conservative management, vocal cord medialization combined with or without cricopharyngeal myotomy should be considered. If failed, laryngotracheal separation or gastrostomy will be the next option based on the control of the oropharyngeal secretion.