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ORTHODONTIC TREATMENT OF THE PALATALLY IMPACTED MAXILLARY CANINE (구개측 매복된 상악 견치의 교정적 치험례)

  • Kam, Dong-Hoon;Kim, Jung-Wook;Hahn, Se-Hyun
    • Journal of the korean academy of Pediatric Dentistry
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    • v.25 no.1
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    • pp.127-133
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    • 1998
  • An impacted tooth is defined pathologically as a tooth that remains under the mucosa of inside bone without eruption of the crown after a specific period of eruption. Clinically, the term includes those teeth, even before eruption period, that are not expected to erupt due to shape, position and alignment of tooth and lack of space. Canine is prone to impaction more than other teeth because it has the longest time to develop and a complex route from the place of formation to the site of eruption. The impaction incidence of maxillary canine is repoted 0.92$\sim$3.3% (Ferguson, 1990). In 1995 Orton reported that the incidence was 0.92$\sim$2.2% and palatal impaction was more frequent than labial impaction(85%:15%). In 1969 Johnston presented it was more common to woman than to man(3:1). The etiology includes systemic disease such as endocrine disorder, cleidocranial dysostosis, irradiation, Crouzon syndrome, ricketts, facial hemihypertrophy and hereditary and local problems such as ectopic position of the tooth, distance of tooth from its place of eruption, malformation of the tooth, presence of supernumerary teeth, trauma of tooth germ, infection of tooth germ, displacement of tooth germ or tooth by a neoplasm, ankylosis, overretention of deciduous predecessor, lack of space for the tooth in the dental arch and mucosal barrier due to gingival fibrosis. The maxillary canine is especially important as it has the longest root, provides guidance for lateral movement of the mandible and masticatory function and assumes an important role esthetically as it is located at mouth angle. If left untreated, it may cause migration and external, internal resorption of adjacent teeth, loss of arch length, formation of dentigerous cyst or tumors, infection and referred pain as well as malposition of the tooth. Therefore, periodic examination of the development and eruption of the maxillary canine is especially important in a growing child. This case study presents the results of treatment of palatally impacted maxillary canine utilizing surgical exposure and orthodontic tooth movement on patients visiting SNUDH dept. of pediatric dentistry.

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The effect of low-dose intravenous bisphosphonate treatment on osteoporosis in children with quadriplegic cerebral palsy

  • Moon, Soon Jeong;An, Young Min;Kim, Soon Ki;Kwon, Young Se;Lee, Ji Eun
    • Clinical and Experimental Pediatrics
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    • v.60 no.12
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    • pp.403-407
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    • 2017
  • Purpose: Quadriplegic children with cerebral palsy are more susceptible to osteoporosis because of various risk factors that interfere with bone metabolism. Pamidronate is effective for pediatric osteoporosis, but there are no guidelines for optimal dosage or duration of treatment in quadriplegic children with osteoporosis. We aimed to evaluate the efficacy of low-dose pamidronate treatment in these patients. Methods: Ten quadriplegic patients on antiepileptic drugs (6 male, 4 female patients; mean age, $10.9{\pm}5.76years$), with osteoporosis and gross motor function classification system level V, were treated with pamidronate (0.5-1.0 mg/kg/day, 2 consecutive days) every 3-4 months in a single institution. The patients received oral supplements of calcium and vitamin D before and during treatment. The lumbar spine bone mineral density (BMD) z score and biochemical markers of bone metabolism were measured regularly during treatment. Results: The main underlying disorder was perinatal hypoxic brain damage (40%, 4 of 10). The mean cumulative dose of pamidronate was $4.49{\pm}2.22mg/kg/yr$, and the mean treatment period was $10.8{\pm}3.32months$. The BMD z score of the lumbar spine showed a significant increase from $-4.22{\pm}1.24$ before treatment to $-2.61{\pm}1.69$ during treatment (P=0.008). Alkaline phosphatase decreased during treatment (P=0.037). Significant adverse drug reactions and new fractures were not reported. Conclusion: Low-dose pamidronate treatment for quadriplegic children with cerebral palsy increased lumbar BMD and reduced the incidence of fracture.

TREATMENT OF COMPOSITE RESIN RESTORATION WITH THE AIR ABRASIVE TECHNIQUE (Air abrasive technique을 이용한 복합레진 수복 증례)

  • Lee, Chang-Woo;Jang, Ki-Taeg;Lee, Sang-Hoon;Hahn, Se-Hyun
    • Journal of the korean academy of Pediatric Dentistry
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    • v.24 no.4
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    • pp.763-770
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    • 1997
  • The air abrasive technique is a non-mechanical method by which teeth are treated before restoration and stains and calculi are removed from tooth surfaces using the kinetic energy of small particles. The air abrasive technique in dentistry was first introduced in the 1950's with as instrument called 'Airdent'. But, as the main restorative materials of the period were amalgam and gold, and the instrument's inability to control the flow of particles caused the particles to be spread throughout the clinics, widespread use was not possible. In the 1990's, as these techincal problems were solved and more interest in new restorative materials rose in an effort to preserve sound tooth structure, new developements took place in instruments related to the air abrasive technique. The air abrasive technique produces less pressure, vibration and heat that might cause patient discomfort and facilitates the preservation of sound tooth structure. It also reduces the need for anesthesia and is less harmful to the pulp. Other advantages include increase in dentin bonding strength of composite resin, lower possibility of saliva contamination and maintenance of a dry field. But there is not direct contact between the nozzle and the tooth, the operator cannot use his or her tactile sense and must rely solely upon visual input. Other disadvantages are: the tooth preparation depends on the operator's ability; alpha-alumina particles, after bouncing off the tooth surface, cause damage to dental mirrors; the equipment is expensive and takes up a certain amount of space in the clinic. The author conducted case report using the air abrasive technique on patient visiting the Department of Pediatric Dentistry at Seoul National University Dental Hospital and arrived at the following conclusions. 1. The tooth preparation capability of different air abrasive devices varied widely among manufacturers. 2. It was more effective in treating early caries lesions and stains compared to lesions where caries had already progressed to produce soft dentin. 3. The cold stream and noise caused by the evacuation system was a major cause of discomfort to pediatric patients. 4. As there is no direct contact with tooth surface when using the air abrasive technique for tooth preparation, considerable experience and skill is required for proper tooth preparation.

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Recognition of Medicinal Efficacy of Pepper as an Introduced Species in Traditional Medicine (전통사회에서 외래종 작물인 고추의 효능 인식 - 한국 전통의서를 중심으로 -)

  • Oh, Jun-Ho;Kwon, Oh-Min;Park, Sang-Young;Ahn, Sang-Woo
    • Journal of the Korean Society of Food Culture
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    • v.27 no.1
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    • pp.12-18
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    • 2012
  • The aim of this study is to look at how pepper was used in traditional medicine. In other words, this study aims to take a look at the process by which the medicinal nature & efficacy of pepper in traditional society was perceived and arranged through the aspects of the use of pepper as an exotic crop for treating diseases. This study investigated cases of using pepper for medical treatments by referring to books on traditional medicine in Korea. The old records about pepper are mainly in empirical medical books from the late Chosun dynasty. Nevertheless, the records about pepper tend to decrease in medical text as time goes by. Such a phenomenon can be attributable to the fact that people began to use pepper for daily food life rather than for medicinal purposes. Pepper was used mostly for digestive trouble such as vomiting, diarrhea, and stomachaches, and it was also applied to mental and aching diseases caused by the sound of body fluids remaining in the stomach. In addition, there were many cases where pepper was used externally for surgical disorders. Such symptoms for treatment are linked to, or in a complementary relationship with, research results in modern times. Boiled pepper was generally taken in the traditional herbal decoction method, and in the case of surgical diseases, it was applied externally. The cases of using old pepper, using pepper with seeds or without seeds, and using pepper mixed with sesame oil belong to a sort of herbal medicine processing, which usually aimed at changing the medicinal nature of pepper. In addition, in relation to the eating habits at that time, pepper was used as seasoning and to make red pepper paste with or without vinegar. There are two words used for pepper in the medical textbooks, 苦椒 (gocho) and 烈棗 (yeoljo). These words are translated into Korean as gochu, so we can identify this word as a nickname for pepper.

Weekly Cisplatin-Based Concurrent Chemoradiotherapy for Treatment of Locally Advanced Head and Neck Cancer: a Single Institution Study

  • Ghosh, Saptarshi;Rao, Pamidimukkala Brahmananda;Kumar, P Ravindra;Manam, Surendra
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.16
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    • pp.7309-7313
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    • 2015
  • Background: The organ preservation approach of choice for the treatment of locally advanced head and neck cancers is concurrent chemoradiation with three weekly high doses of cisplatin. Although this is an efficacious treatment policy, it has high acute systemic and mucosal toxicities, which lead to frequent treatment breaks and increased overall treatment time. Hence, the current study was undertaken to evaluate the efficacy of concurrent chemoradiation using 40 mg/m2 weekly cisplatin. Materials and Methods: This is a single institutional retrospective study including the data of 266 locally advanced head and neck cancer patients who were treated with concurrent chemoradiation using 40 mg/m2 weekly cisplatin from January 2012 to January 2014. A p-value of < 0.05 was taken to be significant statistically for all purposes in the study. Results: The mean age of the study patients was 48.8 years. Some 36.1% of the patients had oral cavity primary tumors. The mean overall treatment time was 57.2 days. With a mean follow up of 15.2 months for all study patients and 17.5 months for survivors, 3 year local control, locoregional control and disease free survival were seen in 62.8%, 42.8% and 42.1% of the study patients. Primary tumor site, nodal stage of disease, AJCC stage of the disease and number of cycles of weekly cisplatin demonstrated statistically significant correlations with 3 year local control, locoregional control and disease free survival. Conclusions: Concurrent chemoradiotherapy with moderate dose weekly cisplatin is an efficacious treatment regime for locally advanced head and neck cancers with tolerable toxicity which can be used in developing countries with limited resources.

Current Status of Fluoroquinolone Use for Treatment of Tuberculosis in a Tertiary Care Hospital in Korea

  • Kang, Bo Hyoung;Jo, Kyung-Wook;Shim, Tae Sun
    • Tuberculosis and Respiratory Diseases
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    • v.80 no.2
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    • pp.143-152
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    • 2017
  • Background: Fluoroquinolones are considered important substitutes for the treatment of tuberculosis. This study investigates the current status of fluoroquinolone for the treatment of tuberculosis. Methods: In 2009, a retrospective analysis was performed at one tertiary referral center for 953 patients diagnosed with tuberculosis. Results: A total of 226 patients (23.6%), who received fluoroquinolone at any time during treatment for tuberculosis, were enrolled in this study. The most common reasons for fluoroquinolone use were adverse events due to other anti-tuberculosis drugs (52.7%), drug resistance (23.5%), and underlying diseases (16.8%). Moxifloxacin (54.0%, 122/226) was the most commonly administered fluoroquinolone, followed by levofloxacin (36.3%, 82/226) and ofloxacin (9.7%, 22/226). The frequency of total adverse events from fluoroquinolone-containing anti-tuberculosis medication was 22.6%, whereas fluoroquinolone-related adverse events were estimated to be 2.2% (5/226). The most common fluoroquinolone-related adverse events were gastrointestinal problems (3.5%, 8/226). There were no significant differences in the treatment success rate between the fluoroquinolone and fluoroquinolone-$na{\ddot{i}}ve$ groups (78.3% vs. 78.4%, respectively). Conclusion: At our institution, fluoroquinolones are commonly used for the treatment of both multidrug-resistant tuberculosis and susceptible tuberculosis, especially as a substitute for adverse event-related drugs. Considering the low adverse event rates and the comparable treatment success rates, fluoroquinolones seem to be an invaluable drug for the treatment of tuberculosis.

Risk Factors Associated with the Need for Operative Treatment of Intussusception in Children (소아에서 발생한 장중첩증에서 수술적 치료의 필요와 관련된 위험인자)

  • Ha, Heontak;Cho, Jayun;Park, Jinyoung
    • Advances in pediatric surgery
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    • v.20 no.1
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    • pp.17-22
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    • 2014
  • The aim of this study was to identify the risk factor related to the need for operative treatment and avoid unnecessary non-operative management for intussusception in children. We retrospectively reviewed medical records of patient treated for intussusception at our institution between January 2006 and January 2013. Clinical features such as gender, age, seasonal variation, symptoms and signs, treatment results were analyzed. Univariate and multivariate analyses including a chi-square test for categorical variables and logistic regression analysis were performed. During the study period, 356 patients were treated for intussusception. 328 (92.1%) was treated successfully by the non-operative pneumoreduction, and 28 (7.9%) required operative management. On univariate analysis, risk factors which were related to the need for operative treatment were age, vomiting, bloody stool, lethargy, and symptoms duration. A logistic regression analysis in order to assess for independent predictors of operative treatment was performed. Age (<6 vs ${\geq}12$ months) (OR 4.713, 95% CI 1.198~18.539, p=0.027) and symptoms duration longer than 48 hours (OR 4.534, 95% CI 1.846~11.137, p=0.001) were significantly associated with a requirement for operative treatment. We conclude that younger age and a longer duration of symptoms (${\geq}48$ hours) are the independent risk factor related to the need for operative treatment for intussusception. Early surgical intervention or transfer to a hospital with pediatric surgical capabilities should be considered for patients with these findings.

Proposed Treatment Protocol for Frostbite: A Retrospective Analysis of 17 Cases Based on a 3-Year Single-Institution Experience

  • Woo, Eun-Kyung;Lee, Jong Wook;Hur, Gi-Yeun;Koh, Jang-Hyu;Seo, Dong-Kook;Choi, Jai-Ku;Jang, Young-Chul
    • Archives of Plastic Surgery
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    • v.40 no.5
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    • pp.510-516
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    • 2013
  • Background This paper discusses the treatment protocol for patients with frostbite. Methods We performed a retrospective analysis of a series of 17 patients with second- and higher-degree frostbite who had been treated at our medical institution between 2010 and 2012. Results Our clinical series of patients (n=17) included 13 men and four women, whose mean age was $42.4{\pm}11.6$ years (range, 22-67 years). The sites of injury include the foot in six patients (35.3%), the hand in six patients (35.3%) and the facial region in five patients (29.4%). Seven patients with second-degree frostbite were completely cured with only conservative treatment during a mean period of $12.7{\pm}3.3$ days (range, 8-16 days). Of the five patients with third-degree frostbite, two underwent skin grafting following debridement, and the remaining three achieved a complete cure with conservative treatment during a mean period of $35{\pm}4.3$ days (range, 29-39 days). Five patients with fourth-degree frostbite were treated with surgical procedures including amputation. Conclusions With the appropriate conservative management in the early stage of onset, surgeons should decide on surgery after waiting for a sufficient period of time until the demarcation of the wound. Continuous management of patients is also needed to achieve functional recovery after a complete cure has been achieved. This should also be accompanied by patient education for the avoidance of re-exposure to cold environments.

Comparing locus of control in orthodontic patients of a university dental hospital with those of a private dental clinic. (치과의원과 대학치과병원 교정환자의 통제소재 특성)

  • Ku, Seung-Jun;Lee, Shin-Jae;Chang, Young-II;Kim, Tae-Woo
    • The korean journal of orthodontics
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    • v.36 no.6
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    • pp.442-450
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    • 2006
  • Objective: Many factors are considered when a patient chooses the type of dental institution they wish to receive treatment from. Numerous studies have been conducted regarding this issue. However, more research is needed in analyzing the patient's psychological aspects when he/she decides to choose the dental institution they wish to receive treatment from. Methods: A locus of control test was utilized to analyze the psychological aspects in orthodontic patients of a university dental hospital and a private dental clinic. The locus of control test is known to be useful in predicting a human being's behavior. Both intrinsic and extrinsic locus of control tests were carried out in 934 orthodontic patients attending Seoul National University Dental Hospital and 1466 orthodontic patients from a private dental clinic. Results: The orthodontic patients at the university dental hospital showed a stronger extrinsic locus of control compared with those from the private dental clinic. Conclusion: The orthodontic patients at the university dental hospital value the doctor as the authority figure and the treatment quality more than those at the private dental clinic.

Efficacy and Safety of Trastuzumab Deruxtecan and Nivolumab as Third- or Later-Line Treatment for HER2-Positive Advanced Gastric Cancer: A Single-Institution Retrospective Study

  • Keitaro Shimozaki;Izuma Nakayama ;Daisuke Takahari;Kengo Nagashima;Koichiro Yoshino ;Koshiro Fukuda;Shota Fukuoka ;Hiroki Osumi ;Mariko Ogura ;Takeru Wakatsuki;Akira Ooki ;Eiji Shinozaki;Keisho Chin ;Kensei Yamaguchi
    • Journal of Gastric Cancer
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    • v.23 no.4
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    • pp.609-621
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    • 2023
  • Purpose: Determination of optimal treatment strategies for HER2-positive advanced gastric cancer (AGC) in randomized trials is necessary despite difficulties in direct comparison between trastuzumab deruxtecan (T-DXd) and nivolumab as third or later-line treatments. Materials and Methods: This single-institution, retrospective study aimed to describe the real-world efficacy and safety of T-DXd and nivolumab as ≥ third line treatments for HER2-positive AGC between March 2016 and May 2022. Overall, 58 patients (median age, 64 years; 69% male) were eligible for the study (T-DXd group, n=20; nivolumab group, n=38). Results: Most patients exhibited a HER2 3+ status (72%) and presented metastatic disease at diagnosis (66%). The response rates of 41 patients with measurable lesions in the T-DXd and nivolumab groups were 50% and 15%, respectively. The T-DXd and nivolumab groups had a median progression-free survival of 4.8 months (95% confidence interval [CI], 3.3, 7.0) and 2.3 months (95% CI, 1.5, 3.5), median overall survival (OS) of 10.8 months (95% CI, 6.9, 23.8) and 11.7 months (95% CI, 7.6, 17.1), and grade 3 or greater adverse event rates of 50% and 2%, respectively. Overall, 64% patients received subsequent treatment. Among 23 patients who received both regimens, the T-DXd-nivolumab and nivolumab-T-DXd groups had a median OS of 14.0 months (95% CI, 5.0, not reached) and 19.3 months (95% CI, 9.5, 25.1), respectively. Conclusions: T-DXd and nivolumab showed distinct efficacy and toxicity profiles as ≥ third line treatments for HER2-positive AGC. Considering the distinct features of each regimen, they may help clinicians personalize optimal treatment approaches for these patients.