• Sleep Medicine and Psychophysiology
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• v.27 no.2
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• pp.77-81
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• 2020

Obstructive sleep apnea (OSA) is a sleep-related breathing disorder in which narrowing and obstruction of the upper airway lead to frequent arousal and decreased arterial oxygenation during sleep. OSA is more common in children with genetic disorders like achondroplasia compared to children without genetic disorders. Achondroplasia is genetic disorder characterized by hypoplasia of the facial bone and skull base with foramen magnum stenosis, resulting in exceedingly high frequency of OSA. The authors present a case of a patient with achondroplasia diagnosed with severe OSA through polysomnography after adenectomy showed little therapeutic effect and who was treated with continuous positive airway pressure.

• Imaging Science in Dentistry
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• v.51 no.1
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• pp.63-71
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• 2021

Purpose: The aim of this study was to assess the artefacts of 12 fixed orthodontic appliances in magnetic resonance images obtained using 1.5-T and 3-T scanners, and to evaluate different imaging sequences designed to suppress metal artefacts. Materials and Methods: In vitro, study casts of 1 adult with normal occlusion were used. Twelve orthodontic appliances were attached to the study casts and scanned. Turbo spin echo (TSE), TSE with high readout bandwidth, and TSE with view angle tilting and slice encoding for metal artefact correction were used to suppress metal artefacts. Artefacts were measured. In vivo, 6 appliances were scanned: 1) conventional stainless-steel brackets; 2) nickelfree brackets; 3) titanium brackets; 4) a Herbst appliance; 5) a fixed retainer; and 6) a rapid maxillary expander. The maxilla, mandible, nasopharynx, tongue, temporomandibular joints, and cranial base/eye globes were assessed. Scores of 0, 1, 2, and 3 indicated no artefacts and minor, moderate, and major artefacts, respectively. Results: In vitro, titanium brackets and the fixed retainer created minor artefacts. In vivo, titanium brackets caused minor artefacts. Conventional stainless-steel and nickel free brackets, the fixed retainer, and the rapid maxillary expander caused major artefacts in the maxilla and mandible. Conventional stainless-steel and nickel-free brackets caused major artefacts in the eye globe (3-T). TSE with high readout bandwidth reduced image artefacts in both scanners. Conclusion: Titanium brackets, the Herbst appliance, and the fixed retainer caused minor artefacts in images of neurocranial structures(1.5-T and 3-T) when using TSE with high readout bandwidth.

• Archives of Plastic Surgery
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• v.49 no.3
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• pp.397-404
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• 2022

Background Excessive use of corticosteroids therapy along with gross immunocompromised conditions in the novel coronavirus disease 2019 (COVID-19) pandemic has raised the risks of contracting opportunistic fungal infections. Here, we describe our experience with the implementation of a surgical protocol to treat and reconstruct rhino-orbital-cerebral mucormycosis. Methods A retrospective review of our prospectively maintained database was conducted on consecutive patients diagnosed with mucormycosis undergoing immediate reconstruction utilizing our "Mucormycosis Management Protocol." All patients included in this study underwent reconstruction after recovering from COVID-19. Wide local excision was performed in all cases removing all suspected and edematous tissue. Reconstruction was done primarily after clear margins were achieved on clinical assessment under a cover of injectable liposomal amphotericin B. Results Fourteen patients were included. The average age was 43.6 years and follow-up was 24.3 days. Thirteen patients had been admitted for inpatient care of COVID-19. Steroid therapy was implemented for 2 weeks in 11 patients and for 3 weeks in 3 patients. Eight patients (57.1%) had a maxillectomy and mucosal lining resection with/without skin excision, and six patients (42.8%) underwent maxillectomy and wide tissue excision (maxillectomy and partial zygomatic resection, orbital exenteration, orbital floor resection, nose debridement, or skull base debridement). Anterolateral thigh (ALT) flaps were used to cover defects in all patients. All flaps survived. No major or minor complications occurred. No recurrence of mucormycosis was noted. Conclusion The approach presented in this study indicates that immediate reconstruction is safe and reliable in cases when appropriate tissue resection is accomplished. Further studies are required to verify the external validity of these findings.

• Journal of Korean Neurosurgical Society
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• v.30 no.9
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• pp.1079-1085
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• 2001

Objective : We analysed various surgical approaches and surgical results of 28 middle cranial base tumors for the purpose of selecting optimal surgical approach to the middle cranial base tumor. Methods : In this retrospective review, 28 patients, including 16 meningioma, 6 trigeminal neurinoma, 2 pituitary adenoma, 2 craniopharyngioma, 1 facial neurinoma, and 1 metastatic tumor, underwent surgical treatment using skull base technique. Of theses, 16 tumors were mainly confined to middle cranial fossae, 5 tumors with extension into both anterior and middle fossa, and 7 tumors with extension into both middle and posterior fossa. Tumors that confined to the middle cranial fossa or extended into the anterior cranial fossa were operated with modified pterional, orbitozygomatic or Dolen'c approach, and tumors that extended into the posterior cranial fossa were operated with anterior, posterior or combined transpetrosal approach. Completeness of tumor resection, surgical outcome, postoperative complication, and follow up result were studied. Results : Total tumor removal was achieved in 9 tumors of 10 tumors that did not extended to the cavernous sinus, and was achieved in 7 tumors of 8 tumors that extended to the lateral wall of the cavernous sinus. Of 10 tumors that extended to the venous channel of the cavernous sinus, only 2 were removed totally. Surgical outcome was excellent in 14 patients, good in 10, fair in 2 and poor in 2. There were no death in this series. Dumbell type tumor which extended into both middle and posterior fossae showed tendency of poor prognosis as compared with tumors that confined middle cranial fossa and extended into both anterior and middle cranial fossa. Postoperative dysfunctions were trieminal hypesthesia in 3, oculomotor nerve palsy in 2, abducens nerve palsy in 2, hemiparesis in 2, cerebellar sign in 1, facial palsy in 1 and hearing impairment in 1. Conclusion : Based on our findings and a review of the literature, we conclude that, when selecting the surgical approach to the middle cranial fossa tumors, the most important factors to be considered were exact location of the tumor mass and existence of the cavernous sinus invasion by tumor mass. We recommend modified pterional or orbitozygomatic approach in cases with tumors located anterior and middle cranial base, without cavernous sinus invasion. In cases with tumors invading into cavernous sinus, we recommend Dolen'c or orbitozygomatic approach. And in lateral wall mass and the cavernous sinus, it is preferred to approach the tumor extradurally. For the tumor involing with middle fossa and posterior fossa(dumbell type) a combined petrosal approach is necessary. In cases with cavernous sinus invasion and internal carotid artery encasement, we recommend subtotal resection of the tumor and radiation therapy to prevent permanent postoperative sequele.

• The Journal of the Korean bone and joint tumor society
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• v.10 no.2
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• pp.142-146
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• 2004

Bizzare parosteal osteochondromatous proliferation is a rare lesion, tends to frequently recur. It was first described in 1983, when Nora and his colleagues reported 35 examples of a proliferative lesion involving small bones of the hand and the feet. It was regarded as occurring only in the small bones of the hand and the feet initially, but from then on, other authors have been reported cases including those involving long bones, skull and maxilla. We experienced a case of bizzare parosteal osteochondromatous proliferation which affects the humeral shaft in a 14-year-old male patient. Radiographs showed calcified mass measuring $4{\times}3$ cm in size and attached to the underlying cortex, which had a broad stalk base. Histologically, it showed hypercellular cartilage maturation to the trabecular bone and plump amount of fibrous stroma in the spaces around the bony trabeculae. Bizzare parosteal osteochondromatous proliferation is a relatively rare lesion, but has a recurrent behavior and histologically tends to be mistaken for malignancy. It can be treated by excision.

• Journal of Korean Neurosurgical Society
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• v.61 no.1
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• pp.51-59
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• 2018

Objective : The feasibility and usefulness of transradial catheterization for coronary and neuro-intervention are well known. However, the anatomical change in the catheterized radial artery (RA) is not well understood. Herein, we present the results of ultrasonographic observation of the RA after routine transradial cerebral angiography (TRCA). Methods : Patients who underwent routine TRCA with pre- and post-procedure Doppler ultrasonography (DUS) of the catheterized RA were enrolled. We then recorded and retrospectively reviewed the diameter and any complicated features of the RA observed on DUS, and the factors associated with the diameter and complications were analyzed. Results : A total of 223 TRCAs across 181 patients were enrolled in the current study. The mean RA diameter was 2.48 mm and was positively correlated with male gender (p<0.001) and hypertension (p<0.002). The median change in diameter after TRCA was less than 0.1 mm (range, -1.3 to 1.2 mm) and 90% of changes were between -0.8 and +0.7 mm. Across 228 procedures, there were 12 cases (5.3%) of intimal hyperplasia and 22 cases (9.6%) of asymptomatic local vascular complications found on DUS. Patients with abnormal findings on the first procedure had a smaller pre-procedural RA diameter than that of patients without findings (2.26 vs. 2.53 mm, p=0.0028). There was no significant difference in the incidence of abnormal findings for the first versus subsequent procedures (p=0.68). Conclusion : DUS identified the pre- and post-procedural diameter and local complications of RA. Routine TRCA seems to be acceptable with regard to identifying local complications and changes in RA diameter.

• Journal of Chest Surgery
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• v.38 no.11 s.256
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• pp.799-802
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• 2005

Langerhans cell histiocytosis (LCH) involves disorders previously referred as 'histiocytosis X' (including eosinophilic granuloma, Letterer-Siwe, and Hand-Schuller syndrome). Its clinical patterns are various and it is a basically benign tumoral condition but with a strong tendency toward dissemination and destruction. Its natural history is unpredictable. But, in solitary bone lesion, wide resection with tumor-free margin is required in order to provide the best chance for a cure. In the majority of patients LCH is a osteolytic lesion with a predilection for calvarium and is rarely seen in the skull base and the femur. LCM of rib, especially if solitary, is relatively rare. We report two rare cases of solitary LCH developed in the rib, which were successfully treated by surgical resection.

• Korean Journal of Ichthyology
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• v.27 no.3
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• pp.189-198
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• 2015

This research has been launched in order to observe the osteological development of sevenband grouper, Epinephelus septemfasciatus larvae and juveniles and will be used for the basic data of phylogenetically systematics research. We got some samples of larvae and juveniles from a adult fish which belongs to the sea cage in Geomun-do, Yeosu-si, Jeolla-namdo province, and we have watched them. The average of breeding water temperature was $21.5{\sim}24.5^{\circ}C$ (average $23.0{\pm}1.5^{\circ}C$). In yolk-sac larvae just after hatching, ossification was not observed at all, and when the average total length reached 2.66 mm, the premaxillary and maxillary forming the upper jaw, dentary forming the lower jaw, and parasphenoid forming the skull base were ossified. In addition, the preopercle and opercle forming the opercular region began to be ossified. The caudal skeleton supporting the caudal fin is built with the caudal complex consisting of the malleus and incus. Until the average total length reached 2.59 mm, ossification did not occur at all and the urostyle bent at 45-degree angle. As to the ossification of the pterygiophore, when the average total length was 6.12 mm, the first interhemal spine began to be ossified in articulation with two spines of the anal fin, and the synapse also began to be ossified in articulation with two spines of the dorsal fin. When the average total length was 21.9 mm, individuals with completed ossification of the interhemal spines and synaptic clefts began to appear.

• Radiation Oncology Journal
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• v.31 no.3
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• pp.118-124
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• 2013

Purpose: The optimal treatment of advanced maxillary sinus cancer has been challenging for several decades. Intra-arterial chemotherapy (IAC) for head and neck cancer has been controversial. We have analyzed the long-term outcome of neoadjuvant IAC followed by radiation therapy (RT) and surgery. Materials and Methods: Twenty-seven patients with advanced maxillary sinus cancer were treated between 1989 and 2002. Five-fluorouracil (5-FU, $500mg/m^2$) was infused intra-arterially, and followed by RT (total 50.4 Gy/28 fractions). A planned surgery was performed 3 to 4 weeks after completion of IAC and RT. Results: At a median follow-up of 77 months (range, 12 to 169 months), the 5-year rates of overall survival in all patients were 63%. The 5-year rates of overall survival of stage T3/T4 patients were 70.0% and 58.8%, respectively. Seven of fourteen patients with disease recurrence had a local recurrence alone. The 5-year actuarial local control rates in patients with stage T3/T4, and in all patients were 20.0%, 32.3%, and 27.4%, respectively. Overall response rate after the completion of IAC and RT was 70.3%. During the follow-up, seven patients (25.9%) showed mild to moderate late complications. The tumor extent (i.e., the involvement of either orbit and/or base of skull) appeared to be related with local recurrence. Conclusion: Neoadjuvant IAC with 5-FU followed by RT and surgery may be effective to improve local tumor control in the patients with advanced maxillary sinus cancer. However, local failure was still the major cause of death. Further investigations are required to determine the optimal treatment schedule, radiotherapy techniques and chemotherapy regimens.

• Journal of the Korean Society of Radiology
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• v.12 no.2
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• pp.149-157
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• 2018

One of the purposes of radiation protection is to minimize stochastic effects. PCXMC 2.0 is a Monte Carlo Simulation based program and makes it possible to predict effective dose and the probability of cancer development through entrance surface dose. Therefore, it is especially important to measure entrance surface dose through dosimeter. The purpose of this study is to measure entrance surface dose through semiconductor dosimeter, general dosimeter, glass dosimeter, and to compare and analyze the effective dose and probability of disease of critical organs. As an experimental method, the entrance surface dose of skull, chest, abdomen was measured per dosimeter and the effective dose and the probability of cancer development of critical organs per area was evaluated by PCXMC 2.0. As a result, the entrance surface dose per area was different in the order of a general dosimeter, a semiconductor dosimeter, and a glass dosimeter even under the same condition. Base on this analysis, the effective dose and probability of developing cancer of critical organs were also different in the order of a general dosimeter, a semiconductor dosimeter, and a glass dosimeter. In conclusion, it was found that the effective dose and the risk of diseases differ according to the dosimeter used, even under the same conditions, and through this study it was found that it is important to present an accurate entrance surface dose model according to each dosimeter.