• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제27권2호
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• pp.167-173
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• 2001

Cystic lesion of the jaw are frequently encountered clinically. Although they rarely lead to development of tumors, they can result in resorption of the jaw bone or asymmetry of the face may occur. The purpose of this study is to find the clinical and histopathological pattern of cysts and to help better understanding for the diagnosis and treatment of jaw cysts. The hospital chart, out-patient chart, panorama X-ray, histopathological report and operation report of 246 patients were reviewed who had been diagnosed as cyst. Sex distribution, age distribution, classification, anatomic distribution, clinical sign & symptoms, treatment, post-operation complications, recurrence rate were studied. Then significant difference between the diameter of cyst with bone graft and none-bone graft was calculated with SAS program. The results were as follows. 1. Among the total patient of 246 cases, male were 163 case(67.0%), and female were 83 case(37.0%), male predominated by the ratio of 1.98. 2. By age group, the 20's accounted for the largest proportion of the cases(27.2%) and the 30' accounted for the 2nd largest proportion of the case(19.5%). 3. Radicular cyst and dentigerous cyst were most common cysts, irrespective of 166 case(67.5%) and 62 case(25.2%). 4. Clinical sign & symptoms were swelling(167case), pain(85case), pus discharge(53case), teeth discoloration(28case), indicating that most complaints were related to inflammation and facial asymmetry. 4.9% of the total cases were discovered accidentally. 5. The primary site of cysts were maxillary anterior area(43.9%), the others were, in descending order, mandibular posterior area(25.6%), maxillary posterior area(14.6%). 6. Enucleation with endodontic treatment was a main treatment method(133 case, 54.1%) and 38 cases(15.4%) were enucleation with extraction, and 37 cases(15.0%) were only enucleation, and 21 cases(8.5%) were enucleation with bone graft. 7. The average diameter of cysts with bone graft was significally greater than with non-bone graft(p<0.05). 8. Post-operation complications occurred in 10 case(4.1%), all of this were due to secondary infection.

• 대한한방소아과학회지
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• 제12권1호
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• pp.111-131
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• 1998

1. In oriental medicine, the case of sinusitis can be explained, not only external invasion such as PUNG HAN(wind-cold), PUNG YUL(wind-hot), SHUP YUL(damp-heat), but also functional disorder of internal organ such as spleen(脾), lung(肺), kidney(腎) The western medicine classified the cause of sinusitis as two factors. That is bacterial infection factor-Haemophilus influenza, streptococcus pyogeues, streptococcus pneumonia- and viral infection factor-Rhinovirus, parainfluenza, Echo28, Coxsacki21, Sinusitis is complicated to allergic rhinitis, chronic otitis media purulent, chronic tonsilitis, sinubronchitis. On the condition of nasal septum deformity, turbinates deformity, nasal septum deviation, sinusitis can be developed. the predisposing factors of sinusitis is swimming, air pollution, malnutrition, shortage of immunity.2. According to survey, sinusitis occurred that children from 4 to 12 years old and from 5 to 7 years old occupied 70% 3. From the past history data, they experienced chronic tonsillar hypertropy(20%), otitis media, atopic dermatitis, allergic rhinitis, bronchial asthma, pneumonia, bronchiolitis, chronic sore throat, urticaria, milk allergy in sequence. 4. the symptoms of sinusitis is nasal obstruction, postnasal dripping, purulunt(yellow)or white discharge, cough, nose bleeding in sequence. nasal obstruction take the portion of 95%, postnasal dripping 65%, night time or early morning cough 60%. 5. The suffering period of sinusitis is 6 month minimum, 4 years maximum, most cases are included in a year. The suffering period of children was shorter than adult. 6. Diagnosis depend on inspection of nasal cavity, postnasal dripping, X-ray finding. 75% of patient(15case) showed both maxillary sinusitis, 25%(5cases) showed left or right maxillary sinusitis. 7. Treatment of oriental medicine, consist of Herb-medicine, acupuncture and exposing of Lazer beam. Kamihyunggyeyungyotang(加味荊芥蓮翹湯) is administered mainly as the medical therapy, Kamigwaghyangjeungkisan(加味藿香正氣散) Kimizwakwieum(加味左歸飮), Kamihyangsosan(加味香蘇散) is administered for a additional symptoms which occurred by influenza recurrence. Kamijeonxibackchulsan(加味錢氏白朮散) is administered to treat gastro-intestine trouble patients who have sinusitis. 8. The period of treatment is varied with patient conditions and X-ray finding. The minimal period is 35days, maximal period is 202days. So it took about 86days in average and about 50% of patient(10cases) is recovered in one or two month.

• Clinical and Experimental Pediatrics
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• 제51권7호
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• pp.775-779
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• 2008

후두개 낭종은 신생아 및 영아에서 협착음을 일으킬 수 있는 드문 질환이지만, 이 질환에 이환된 환아는 갑작스런 기도 협착을 일으켜 사망할 수도 있다. 따라서, 협착음을 보이는 환아에서 후두개 낭종을 감별해 냄으로써 갑작스런 기도 협착으로 인한 사망을 방지할 수 있다. 후두개 낭종은 협착음, 쉰목소리, 흉골 함몰, 무호흡, 수유시 청색증 및 성장 장애를 일으킬 수 있는 질환으로 이 질환이 의심되면 굴곡성 후두경으로 진단해야 한다. 이 질환의 치료는 $CO_2$ 레이저를 이용한 후두미세수술이며, 적절한 치료를 통해 재발을 방지할 수 있다. 저자들은 협착음, 쉰목소리, 흉골 함몰, 수유시 청색증 및 성장 장애를 주소로 전원된 1개월 남아에서 굴곡성 후두경을 통해 후두개 낭종을 진단하였고, $CO_2$ 레이저를 통한 후두미세수술 후 증상이 호전된 증례 1예를 경험하였기에 문헌 고찰과 함께 보고하는 바이다.

• Archives of Plastic Surgery
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• 제36권3호
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• pp.283-288
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• 2009

Purpose: Frey's syndrome is a common complication after parotid surgery and characterized by gustatory sweating and flushing in the periauricular area during meals. Although a variety of methods have been proposed to prevent this postoperative problem but they have been unsatisfactory. In this article, therefore, botulinum toxin A was used to treat nine patients with Frey's syndrome and its duration effect after injection was investigated. Methods: Nine patients became the object of study about the effect of botulinum toxins as treatment of Frey's syndrome. Age of patients ranged from 25 to 78 years (mean, 43.7 years). Six of nine patients had both symptoms of gustatory sweating and flushing. And the others had only gustatory sweating symptom. Using Minor starch iodine test, the affected skin area was detected, and it was marked by $1cm^2$ sized grid appearance. After application of EMLA cream on the gustatory sweating area, botulinum toxin A was injected intracutaneously into the affected skin area ($2.5U/cm^2$). Patients were followed up from six to fifteen months (mean, about 12 months) and asked about improvement of their symptoms. Results: The treatement with botulinum toxin A took effective within two days after injection. Six months after injection, gustatory sweating disappeared completely in all patients, and five of six patients who had gustatory flushing improved in their symptom. Last follow-up, no patients complained of recurrent gustatory sweating and flushing except one. One patient, seven months after initial injection, was retreated with botulinum toxin A because of recurrence, and the result was successful. The duration of the effect after botulinum toxin A treatment was ranged from seven to thirteen months. One patient in our series experienced the upper eyelid weakness as adverse effect, but it improved spontaneously. Conclusion: Local injection of botulinum toxin A is an effective, safe and long - lasting method for treatment of Frey's syndrome. Hereafter, however, additional study will be required to evaluate the duration effect of botulinum toxin A according to frequency in use and dosage.

• Journal of Chest Surgery
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• 제29권1호
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• pp.73-78
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• 1996

1989년 6월부터 1994년 5월까지 5년 동안 임상적으로 중증근무력증으로 진단받고 흉선절제술을 시행받은 23례를 대상으로 하였고, 흉선절제술의 효과를 평가하기 위하여 연령 및 성별분포, 수술전 증상의 정도와 유병 기간, 수술후 호전정도 그리고 총선의 병리 소견과 별기에 따른 흉선절제술의 결과를 분석하였다. 수술후 추적기간은 5개월에서 60개월로 평균 15개월이었다. 흉선절제술의 효과를 환자의 수술후 임상증상의 호전정도와 수술후 약물용량으로 분류하여 본 바 a) 완전회복이 5례 (21.7%), b) 임상증상의 현저 한 호전및 얕용량 감소가 11례 (47.8%), c) 약용량은 같으나 임상증상의 현저한 호전이 3례 (13.0%), 4)호전없음이 2례 (8.7%), e)사망이 1례(4.3%), f) 재발이 1례 (4.3%)로서 23례 중 19례 (82.5%)에서 완전회복 및 임상증상의 현저한 호전을 보였다. 수술전 증상의 중증도와 흉선절제술의 효과를 분석한바, Modified Osserman Staging 분류상 제1군 9례중 6례 (66.7%)가 임상적 호전을 보였고, 3례 (33.3%)에서는 호전이 없었다. 흉선절제술의 효과가 이 두 Group (제I기, 제II기)간에서 유의한 차이는 없었다(P>0.05). 수술후 흉선의 병리 \ulcorner흉선절제술의 효과를 분석한바, 정상흉선의 4례는 전례 (100%)에서 모두 호전을 보였고, 과형 성 11례 에서는 10례 (90.9%)에서 호전을, 1례 (9.1%)에서는 변화가 없었다. 총선종이 있었던 8례 에서는 5례 (62.5%)에서 임상적 호전을 보인 반면 3례 (37.5%)에서는 변화가 없었다. 흉선조직의 병리에 따른 흉선절제술의 효과와의 유의한 차이는 보이지 않았다(P>0.05). 흉선절제술을 시행받은 대부분의 환자(82.5%)에서 완전회복 및 임상증상의 현저한 호전을 가져 왔다. 그러나 수술전 예후에 영향을 미치는 인자로 알려진 증상의 중증도나, 흉선의 병리소견과 수술후 근무력증 치료효과간에 통계적 유의성은 없었다(P>0.05).

• Journal of Korean Neurosurgical Society
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• 제51권6호
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• pp.363-366
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• 2012

Objective : Meralgia paresthetica (MP) is a syndrome of pain and/or dysesthesia in the anterolateral thigh that is caused by an entrapment of the lateral femoral cutaneous nerve (LFCN) at its pelvic exit. Despite early accounts of MP, there is still no consensus concerning the effectiveness of neurolysis or transaction treatments in the long-term relief for medically refractory patients with MP. We retrospectively analyzed available long-term results of LFCN neurolysis for medically refractory MP in an effort to clarify this issue. Methods : During the last 7 years, 11 patients who had neurolysis for MP were enrolled in this study. Nerve entrapment was confirmed preoperatively by electrophysiological studies or a positive response to local anesthetic injection. Decompression of the LFCN was performed at the level of the iliac fascia, inguinal ligament, and fascia of the thigh distally. The outcome of surgery was assessed 8 weeks after the procedure followed at regular intervals if symptoms persisted. Results : Twelve decompression procedures were performed in 11 patients over a 7-year period. The average duration of symptoms was 8.5 months (range, 4-15 months). The average follow-up period was 33 months (range, 12-60 months). Complete and partial symptom improvement were noted in nine (81.8%) and two (18.2%) cases, respectively. No recurrence was reported. Conclusion : Neurolysis of the LFCN can provide adequate pain relief with minimal complications for medically refractory MP. To achieve a good outcome in neurolysis for MP, an accurate diagnosis with careful examination and repeated blocks of the LFCN, along with electrodiagnosis seems to be essential. Possible variation in the course of the LFCN and thorough decompression along the course of the LFCN should be kept in mind in planning decompression surgery for MP.

• 대한관절경학회지
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• 제3권2호
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• pp.121-126
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• 1999

색소 융모 결절성 활액막염은 드물게 발생하는 단관절성 병변으로 비특이적 증상 발현으로 인해 진단이 어려운 것으로 알려져 있다. 본 연구는 관절경적 시술로 진단 및 제거술을 시행 받았던 11명의 환자를 대상으로 임상 양상, 진단 및 치료 결과를 조사하였다. 모든 예에서 조직학 소견상 색소 융모 결절성 활액막염에 합당한 소견을 나타내었다. 6명은 남자였고 5명은 여자였으며, 연령층은 15세에서 59세(평균 34.6세) 였다. 증상발현 기간은 2개월에서 3년으로 관찰 되었고 (평균 29.9개월), 11례 모두에서 수술전 슬관절 동통을 호소하였다. 4례에서는 외상의 과거력이, 9례에서는 1개의 종물이 발견되었으나 나머지 2례에서 각각 2개 3개의 종물이 관찰되었다. 11례 중 5례가 내측 반월판 전각 부위의 활액막에서 발견되었으며, 2례는 슬개하 지방 그리고 나머지는 각각 슬개상부, 후내측 구획, 외측 반월 연골의 전방, 내측 구에서 1례씩 관찰되었다. 수술 후 평균 29.9개월의 추시 관찰상 11례 모두 재발의 소견은 관찰되지 않았다. 색소 융모 결절성 활액막염의 치료에 있어서 관절경 수술은 최소한의 이환율을 가지며 진단과 치료가 동시에 가능한 좋은 치료 방법 중 하나로 사료된다.

• Radiation Oncology Journal
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• 제29권3호
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• pp.156-163
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• 2011

Purpose: To evaluate long-term local control rate and toxicity in patients treated with external beam radiotherapy (EBRT) for pituitary adenomas. Materials and Methods: We retrospectively reviewed the medical records of 60 patients treated with EBRT for pituitary adenoma at Korea University Medical Center from 1996 and 2006. Thirty-five patients had hormone secreting tumors, 25 patients had non-secreting tumors. Fifty-seven patients had received postoperative radiotherapy (RT), and 3 had received RT alone. Median total dose was 54 Gy (range, 36 to 61.2 Gy). The definition of tumor progression were as follows: evidence of tumor progression on computed tomography or magnetic resonance imaging, worsening of clinical sign requiring additional operation or others, rising serum hormone level against a previously stable or falling value, and failure of controlling serum hormone level so that the hormone level had been far from optimal range until last follow-up. Age, sex, hormone secretion, tumor extension, tumor size, and radiation dose were analyzed for prognostic significance in tumor control. Results: Median follow-up was 5.7 years (range, 2 to 14.4 years). The 10-year actuarial local control rates for non-secreting and secreting adenomas were 96% and 66%, respectively. In univariate analysis, hormone secretion was significant prognostic factor (p = 0.042) and cavernous sinus extension was marginally significant factor (p = 0.054) for adverse local control. All other factors were not significant. In multivariate analysis, hormone secretion and gender were significant. Fifty-three patients had mass-effect symptoms (headache, dizziness, visual disturbance, hypopituitarism, loss of consciousness, and cranial nerve palsy). A total of 17 of 23 patients with headache and 27 of 34 patients with visual impairment were improved. Twenty-seven patients experienced symptoms of endocrine hypersecretion (galactorrhea, amenorrhea, irregular menstruation, decreased libido, gynecomastia, acromegaly, and Cushing's disease). Amenorrhea was abated in 7 of 10 patients, galactorrhea in 8 of 8 patients, acromegaly in 7 of 11 patients, Cushing's disease in 4 of 4 patients. Long-term complication was observed in 4 patients; 3 patients with cerebrovascular accident, 1 patient developed dementia. Of these patients, 3 of 4 received more than 60 Gy of irradiation. Conclusion: EBRT is highly effective in preventing recurrence and reducing mass effect of non-secreting adenoma. Effort to improve tumor control of secreting adenoma is required. Careful long-term follow-up is required when relatively high dose is applied. Modern radiosurgery or proton RT may be options to decrease late complications.

• Journal of Oral Medicine and Pain
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• 제37권1호
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• pp.27-33
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• 2012

피부와 구강점막에서 발견되는 편평태선은 만성 염증성 질환으로 세포매개성 면역반응이 주로 언급되고 있으나 아직 정확한 원인은 밝혀지지 않았다. 따라서 완전한 치료법은 아직 없으며 증상의 완화를 치료목표로 하고 있다. 본 연구에서는 구강편평태선의 일차적인 치료법으로 사용되는 corticosteroid의 두 가지 가글용액의 효과를 비교하였다. 2002년부터 2010년까지 부산대학교 치과병원 구강내과에서 구강편평태선으로 진단받은 환자들 중 corticosteroid 가글용액을 처방받은 환자들 총 180명의 환자기록을 조사하였다. 사용된 두 종류의 가글용액은 각각 dexamethasone(dexamethasone disodium phosphate, 0.05%)과 prednisolone($solondo^{(R)}$)을 포함하는 용액이었으며 약물 사용 후 증상의 완화 및 재발의 시기를 기록하여 분석하였다. Dexamethasone gargle(dexa gargle) 처방군은 33명(여성 25명, 남성 8명), prednisolone gargle(solon gargle)처방군은 147명(여성 114명, 남성 33명)이었으며 환자군의 평균연령대는 50대였다. 약물투여 후 초기 2주이내에 증상이 호전된 경우는 dexa gargle을 사용한 환자군에서 유의성 있게 나타났으나 증상재발의 경우는 두가지 가글용액의 차이가 나타나지 않았다. 구강편평태선 환자에 대한 도포용 스테로이드 가글을 이용한 치료에서 증상의 빠른 호전을 기대하기 위해서는 solon gargle보다는 dexa gargle을 사용할 수 있으나 재발율에 있어서는 두 약물의 차이가 발견되지 않았다.

• 대한장애인치과학회지
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• 제2권1호
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• pp.39-44
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• 2006

Cerebral palsy(CP) is one of the most common motor disease, due to brain injury during fetal and neonatal development which results in neuromotor paralysis and associated neuromuscular symptoms. Features of CP include motor disability due to the lack of muscle control, often accompanied by sensory disorders, mental retardation, speech disorders, hearing loss, epilepsy, behavior disorders, etc. There are increasing chances of treatment of dental patients with cerebral palsy, as the occurrence of CP is increasing with the decrease in infant mortality and an increase in immature birth and premature birth and also, there is a trend to pursue of higher quality of life. Reports on the relationship between CP and maxillofacial deformity are uncommon, but it is well known that the unbalance and discontrol of the facial muscles, lip, tongue and the jaws leads to malocclusion and temporomandibular joint disorders, and statistics show that class 2 relationship of the jaws and open bite is frequently reported. However, it is difficult to perform maxillofacial deformity treatment, which consists of orthodontic treatment, maxillofacial surgery and muscle adaptation training, due to difficulties in communication and problems of muscle adaptation caused by difficulties in motor control which leads to a high recurrence rate. This case report is to trearment of maxillofacial deformity in CP patient. A 26 year old female patient came to the department with the chief complaint of prognathism of the mandible and facial asymmetry. According to the past medical history, she was diagnosed as cerebral palsy 1 week after birth, classified as GMFC, classII accompanied with left side torticollis. The patient's intelligence was moderate, and there were no serious problems in communication. For two years time, the patient underwent lingual frenectomy, pre-operation orthodontic treatment and then bimaxillary orthognathic surgery to treat mandibular prognathism and facial asymmetry followed by rehabilitatory exercise of facial muscle. After 6 months of follow up, there was a good result. This is to report to the typical signs and symptoms of DFD in CP patient and the limitation of the usual method of the treatment of DFD in CP patient with literature review.