• Journal of The Korean Dental Society of Anesthesiology
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• v.3 no.1 s.4
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• pp.34-37
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• 2003

Postoperative stroke is uncommon even in elderly patients, who have a higher incidence of all types of postoperative complications. The mechanism of postoperative stroke is not certain, but can be explained by intravascular clottings originated from thrombus or embolus or by intracranial hemorrhage. In a 66-year-old male patient with current hypertension medication, who underwent both neck dissection for malignancy metastasis under general anesthesia, the left hemiparesis and delayed emergency were found postoperatively. After transferred to intensive care unit, he got the thrombolytic therapy and then the therapies to decrease the swelling of the brain on the diagnosis of cerebral infarction in the vascular distribution of the middle cerebral artery. A brain MRI definitely showed the midline deviation to the left of the right brain hemisphere due to the progressing edematous changes. As he got worse, the emergency neurosurgical operation was proposed but rejected by his family. He died at postoperative 3 days. In this hypertensive patient. perioperative stroke could be originated from the surgical stimuli on major vessels, which were inevitable in neck dissection during the operation. We report this case of the postoperative stroke, which could be highly possible to be associated with extensive head and neck surgery.

• Parasites, Hosts and Diseases
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• v.45 no.4
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• pp.255-266
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• 2007

The protective effect of the Synadenium carinatum latex lectin (ScLL), and the possibility of using it as an adjuvant in murine model of vaccination against American cutaneous leishmaniasis, were evaluated. BALB/c mice were immunized with the lectin ScLL (10, 50, 100$[\mu}g$/animal) separately or in association with the soluble Leishmania amazonensis antigen (SLA). After a challenge infection with $10^6$ promastigotes, the injury progression was monitored weekly by measuring the footpad swelling for 10 weeks. ScLL appeared to be capable of conferring partial protection to the animals, being most evident when ScLL was used in concentrations of 50 and 100${\mu}g$/animal. Also the parasite load in the interior of macrophages showed significant reduction (61.7%) when compared to the control group. With regard to the cellular response, ScLL 50 and 100 ${\mu}g$/animal stimulated the delayed-type hypersensitivity (DTH) reaction significantly (P < 0.05) higher than SLA or SLA plus ScLL 10 weeks after the challenge infection. The detection of high levels of IgG2a and the expression of mRNA cytokines, such as IFN-$\gamma$, IL-12, and TNF-$\alpha$ (Th1 profiles), corroborated the protective role of this lectin against cutaneous leishmaniasis. This is the first report of the ScLL effect on leishmaniasis and shows a promising role for ScLL to be explored in other experimental models for treatment of leishmaniasis.

• The Journal of the Korean Society for Microbiology
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• v.16 no.1
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• pp.49-55
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• 1981

Recent studies have demonstrated that histamine could have a modulatory influence on the immune response in vitro and in vivo. However, the effect of histamine on immune response in mice has not been extensivley analyzed. In the present study the regulatory effects of cimetidine, a histamine-2-receptor antagonist(H2 blocker) and histamine on the immune response to sheep red blood cells(SRBC) were evaluated in mice. Mice pretreated with daily intraperitoneal injection of varying concentrations of cimetidine for 14 days were immunized intraperitoneally with various concentrations of SRBC($10^6,\;10^7,\;and\;10^8$ cells) and challenged 4 days post immunization. The cellular immune response was determined by measuring the footpad swelling reaction. Footpad swelling reaction of each mouse was measured at 3hr(Arthus) reaction) and 24 or 48 hr(delayed reactions) after challenge. The humoral immune response was determined by measuring hemagglutinins to SRBC. Histamine in varying concentrations($10^{-1},\;10^{-3}\;and\;10^{-5}M$(was added in SRBC suspension at the time of antigen challenge into footpad, and 24-hr delayed type hypersensitivity(DTH) was measured. Cimetidine in varying concentrations(10, 50, 250, 1250 and 6250${\mu}g$) enhanced 24-hr DTH and this enhancement of DTH was more pronounced at 250${\mu}g$ of cimetidine. However, there were no significant differences between the cimetidine-pretreated groups and controls in Arthus reaction and hemagglutinin titers. Histamine suppressed the DTH in the dose-dependent fashion. This suppression was more pronounced at lower concentration of immunizing antigen($10^7\;and\;10^6$ SRBC). However, histamine did not diminish the DTH at higher concentration of antigen($10^8$ SRBC). These results present the evidences which strongly suggest that cimetidine enhances the cell-mediated immune response but not significantlly influences the humoral immune response and that exogenous and endogenous histamine is involved in the modulation of cellular immune response as well as immediate hypersensitivity.

• The Journal of Korea Assosiation for Disability and Oral Health
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• v.8 no.1
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• pp.10-14
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• 2012

Self-injurious behavior (SIB) has been defined as the deliberate destruction or alteration of body tissue without conscious suicidal intent. It occurs in conjunction with a variety of psychiatric disorders as well as various developmental disabilities and some syndromes. The behavior is destructive and causes concern and distress to all involved in the care and treatment of the affected individual. A 13-year-old girl with autism, mental retardation and delayed development was reffered from her pediatrician because of severe and painful lower lip biting. An intraoral examination revealed a diffuse swelling of lower lip. It was covered with necrotic slough and the ulcer and scarring of the lower lip was observed. We chose to use an oral removable prosthesis for Conservative treatment. It was decided to use a soft silicone mouthguard in the maxillary arch. Initially, she could not tolerate the appliance inside her mouth but soon adapted with the appliance. After one month, she lost the mouth guard and started lip biting. So we made mouth guard again. There are no standard methods for preventing self-injurious behavior in a patient who is developmentally disabled. Appropriate preventive methods must be developed for each individual patient based on close observation and clinical findings. Behavior modification techniques, pharmacological treatment, extraction of teeth, orthognathic surgery and intra/extra oral appliances can be performed for adjust self-injurious behavior. A suitable oral guard could be tried initially before employing more invasive approaches.

• Korean Journal Plant Pathology
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• v.13 no.3
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• pp.184-190
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• 1997

Lesion enlargement of ginger rhizome rot was most rapid at 35~40 C, but delayed greatly as temperature decreased. Time needed for a killing a ginger plant, 22~25 cm long, was about 5 days at 35~40 C, but was 15 days at 15 C in a growth chamber test. Higher RH above 90%, higher soil moisture level above 80% of maximum soil moisture capacity, and deeper planting below 4cm enhanced the lesion development on ginger stems and rhizomes. Pythium myriotylum existed in field soil as forms of hyphal portion, hyphal swelling body, or oospore- or zoospore-like bodies, and served as the origin of its colonization. Inocula of P. myriotylum was randomly distributed in soil surface around ginger plants, but its density was decreased as increasing soil depth with the highest density at 0~10 cm soil depth. Population density of P. myriotylum did not vary significantly between the rhizoplane and the rhizosphere soil of a ginger plant, but differed greatly between the disessed and healthy plants with several to several hundreds times higher population in the diseased plants. A positive curvilinear relationship was found between P. myriotylum density and ginger rhizome rot severity.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.38
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• pp.41.1-41.6
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• 2016

Background: The goal of this study was to retrospectively evaluate the prognosis of minimal invasive horizontal ridge augmentation (MIHRA) technique using small incision and subperiosteal tunneling technique. Methods: This study targeted 25 partially edentulous patients (10 males and 15 females, mean age $48.8{\pm19.7years$) who needed bone graft for installation of the implants due to alveolar bone deficiency. The patients took the radiographic exam, panoramic and periapical view at first visit, and had implant fixture installation surgery. All patients received immediate or delayed implant surgery with bone graft using U-shaped incision and tunneling technique. After an average of 2.8 months, the prosthesis was connected and functioned. The clinical prognosis was recorded by observation of the peri-implant tissue at every visit. A year after restoration, the crestal bone loss around the implant was measured by taking the follow-up radiographs. One patient took 3D-CT before bone graft, after bone graft, and 2 years after restoration to compare and analyze change of alveolar bone width. Results: This study included 25 patients and 39 implants. Thirty eight implants (97.4 %) survived. As for postoperative complications, five patients showed minor infection symptoms, like swelling and tenderness after bone graft. The other one had buccal fenestration, and secondary bone graft was done by the same technique. No complications related with bone graft were found except in these patients. The mean crestal bone loss around the implants was 0.03 mm 1 year after restoration, and this was an adequate clinical prognosis. A patient took 3D-CT after bone graft, and the width of alveolar bone increased 4.32 mm added to 4.6 mm of former alveolar bone width. Two years after bone graft, the width of alveolar bone was 8.13 mm, and this suggested that the resorption rate of bone graft material was 18.29 % during 2 years. Conclusions: The bone graft material retained within a pouch formed using U-shaped incision and tunneling technique resulted with a few complications, and the prognosis of the implants placed above the alveolar bone was adequate.

• Journal of Korean Neurosurgical Society
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• v.29 no.8
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• pp.1126-1135
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• 2000

Objectives : The goal of surgical management of cerebral arteriovenous malformation(AVM) is elimination of the lesion without development of new neurological deficits. To improve the management results of cerebral AVMs in the future, this article discusses about surgical complications of the AVM and their management. Material and Methods : During the past 18 years, 116 patients with cerebral AVMs were managed by surgery. Among these cases, 7 cases died, 7 cases developed new neurological deficits, 11 cases residual AVM and 5 cases intracerebral hematoma(ICH) after surgery. The author analyzes the causes of those complications and investigates the methods to minimized those complications based on the review of the literatures. Results : One stage removal of AVM and ICH in the poor neurological state were performed in 5 of 7 death cases. Subtotal removal of ICH followed by delayed AVM surgery after recovery is regard as one method to improve the outcome of patient with large ICH. Postoperative new neurological deficits developed owing to normal perfusion pressure breakthrough(NPPB) in 3, judgement error in 2, preoperative embolization in 1 and cortical injury in 1 case(s). Proper management of NPPB, accurate anatomical knowledge and physiological monitoring during operation, and well trained skill for embolization are regard as methods to minimize those complications. Residual AVMs after surgery were noticed in 11 cases, in which unintended 6 cases due to inaccurate dissection of peripheral margin of AVM, and intended 3 cases due to massive brain swelling during operation, 1 cases due to diffuse type and 1 case due to multiple type of AVM. Accurate dissection of peripheral margin of AVM and mild hypotension during operation may help to avoid this complication. Postoperative hemorrhage occurred in 3 cases due to rupture of the residual AVM and in 2 cases due to oozing from the AVM bed. Complete resection of AVM, complete control of bleeding points at AVM bed and mild hypotension during early postoperative period are the methods to avoid this complication. Conclusion : A precise but flexible therapeutic strategy and refined skill for endovascular, radiosurgical and microsurgical techniques are required to successful treatment of cerebral AVM. Adequate timing of AVM resection, accurate anatomical knowledge, proper management of NPPB and accurate dissection of peripheral margin of AVM are the key points for avoiding complications of the AVM surgery.

• Clinics in Shoulder and Elbow
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• v.11 no.1
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• pp.57-61
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• 2008

Tuberculous arthritis on the sternoclavicular joint is an uncommon disease and a delayed diagnosis can be due to the obscure clinical symptoms. We should suspect tuberculous arthritis in patients with slowly progressive pain, swelling, mild fever and a previous history of tuberculosis. Early diagnosis is important through conducting a thorough physical examination and performing laboratory tests and radiologic study. Tuberculous arthritis on the sternoclavicular joint should be treated with a combination of systemic antituberculous agents and thorough surgical debridement in marked damaged joints. When performing this operation, it is important not only to minimized the injury of the costoclavicular ligament, but also to avoid injury to the surrounding the vital structures such as the mediastinum and pleura after aggressive resection or radical debridement. We describe here 2 cases of the tuberculous arthritis on the sternoclavicular joint: one case had a good result after surgical debridement with using an anti-tuberculous agent, and the other had fatal complications such as mediastinal abscess and pleural effusion after the operation.

• Korean Journal of Clinical Laboratory Science
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• v.36 no.2
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• pp.69-75
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• 2004

Vibrio vulnificus is a halophilic bacterium frequently involved in human infection of seafood-associated primary septicemia and primary wound infection, mostly in men with over 40-years of age with underlying liver disease. The primary septicemia, which is the most common form of V. vulnificus infection in Korea, is defined as a systemic illness presenting fever or hypotension with recovery of V. vulnificus from blood or tissue without the apparent primary focus of infection. V. vulnificus typically do not produce acid from sucrose, but a case of primary septisemia was found in a patient at Chonnam K hospital in 1993 from whose blood a sucrose-fermenting strain was isolated. The patient was a 62-year-old man, heavy drinker, with underlying liver disease. He consumed a raw seafood dish two days before onset of the present illness. His symptoms were tenderness and swelling on the right foot. He rapidly developed septicemia, resulting in sudden death. V. vulnificus was isolated from the venous blood culture of the patient. On subculture, the isolate formed yellow colonies on TCBS and produced acid from sucrose. Because of these characteristics, species identification was not achieved by the API 20E and was delayed. Other characteristics of the isolate were identical to those of typical V. vulnificus. The isolate was common serotype O4A and possession of V. vulnificus-specific cytolysin gene was detected by PCR. The isolate was susceptible to all the antimicrobial agents tested including tetracycline, but was intermediate to colistin. In conclusion, it is important that microbiologists be aware of the presence of sucrose-positive V. vulnificus when he or she identifies gram-negative bacilli, which is isolated from the blood of patients with a recent history of raw seafood dish consumption.

• Journal of Korean Academy of Oral and Maxillofacial Radiology
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• v.25 no.2
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• pp.399-408
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• 1995

The purpose of this study was to obtain information on the clinical and radiographic features of the dentigerous cysts in the jaws. For this study, the authors examined and analysed the clinical records and radiographs of 233 patients who had lesions of dentigerous cyst diagnosed by clinical and radiographic or histopathological examinations. And the obtained results were as follows: 1. Dentigerous cysts occurred the most frequently in the 2nd decade(38.2％) and occurred more frequently in males(67.4％) than in females(32.6％). 2. The most common clinical symptom was swelling of the jaw(33.9％), and the lesions were treated by the method of surgical removal. 3. The type of lesions was mainly observed as central type(72.5％), and size of the lesion was most frequently observed 2 - 2.9cm in the widest length. 4. The lesions were most frequently observed well-defined outline with hyperostotic border(49.8％), and smooth margin(73.4％), and homogeneous lesional radiolucency(79.4％). 5. Cortical thinning and expansion of the lesions(82.0％) were observed, and their direction were most frequently observed toward buccal side(64.0％). 6. The effect on the causative tooth were observed as tooth displacement(41.2％) and delayed root development(l9.3％), and the distance between cemento-enamel junction and lesional wall attachment of the causative tooth was mainly observed as below 2mm(79.6％). 7. The effect on the adjacent tooth were observed as loss of lamina dura(66.8％), root resorption(33.9％), and tooth displacement(31.5％). 8. The effects on the adjacent anatomic structures were observed as displacement of the mandibular canal(46.5％) and maxillary sinus or nasal cavity(72.2％).