• The Korean Journal of Pain
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• 제28권2호
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• pp.105-108
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• 2015

Background: The most definitive diagnosis of neck pain caused by facet joints can be obtained through cervical medial branch blocks (CMBBs). However, intravascular injections need to be carefully monitored, as they can increase the risk of false-negative blocks when diagnosing cervical facet joint syndrome. In addition, intravascular injections can cause neurologic deficits such as spinal infarction or cerebral infarction. Digital subtraction angiography (DSA) is a radiological technique that can be used to clearly visualize the blood vessels from surrounding bones or dense soft tissues. The purpose of this study was to compare the rate of detection of intravascular injections during CMBBs using DSA and static images obtained through conventional fluoroscopy. Methods: Seventy-two patients were included, and a total of 178 CMBBs were performed. The respective incidences of intravascular injections during CMBBs using DSA and static images from conventional fluoroscopy were measured. Results: A total of 178 CMBBs were performed on 72 patients. All cases of intravascular injections evidenced by the static images were detected by the DSAs. The detection rate of intravascular injections was higher from DSA images than from static images (10.7% vs. 1.7%, P < 0.001). Conclusions: According to these findings, the use of DSA can improve the detection rate of intravascular injections during CMBBs. The use of DSA may therefore lead to an increase in the diagnostic and therapeutic value of CMBBs. In addition, it can decrease the incidence of potential side effects during CMBBs.

• 대한두개안면성형외과학회지
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• 제16권3호
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• pp.131-135
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• 2015

Background: Variable methods have been introduced for reduction of the zygomatic fractures. The Dingman elevator is used widely to reduce these fractures but is inappropriate in certain types of fractures which require atypical traction vectors. We introduce and examine an alternate method of reducing zygomatic fractures using wire and hook traction. Methods: A retrospective study was performed for all zygomatic fracture patients admitted between 2008 and 2014. Medially rotated fractures were reduced by using a wire looped through an intermaxillary screw secured on the medial side of the zygoma. Laterally rotated fractures were reduced using a hook introduced through an infrazygomatic skin incision. Results: No accidental bleeding or incomplete reduction was observed in any of the cases. Postoperative imaging demonstrated proper reduction immediately after the operation. Follow-up computed tomography study at 1 month after operation also demonstrated proper reduction and healthy union across the previous site of fracture. Conclusion: The hook and wire method allowed precise application of traction forces across zygomatic fractures. The fractured bone fragment could be pulled in the direction precisely opposite to the vector of impact at the time of trauma. Soft tissue damage due to dissection was minimized. In particular, this method was effective in reducing rotated bone fragments and can be an alternative option to using the zygoma elevator.

• Archives of Plastic Surgery
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• 제43권2호
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• pp.189-196
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• 2016

Background Several techniques have been designed to treat fifth metacarpal fractures reported to be effective. However, these methods cannot be easily applied to the fourth metacarpal due to its central anatomical position. In this study, we sought to analyze the functional outcomes of patients who underwent transverse pinning for a fourth metacarpal bone fracture. Methods A total of 21 patients were selected and their charts were retrospectively reviewed. After fracture reduction, two transverse Kirchner wires were first inserted from the fifth metacarpal to the third metacarpal transversely at the distal part of the fractured bone, and then another two wires were inserted at the proximal part of the fractured bone. The splint was removed approximately one week postoperatively and the Kirchner wires were removed four to five weeks postoperatively. Patients started active and passive exercise one week after the operation. Pain visual analog scores, total active and passive motion, and the active and passive range of motion of the metacarpophalangeal joint and grip strength were evaluated. Results Dorsal angulation improved from a preoperative value of $44.2^{\circ}$ to a postoperative value of $5.9^{\circ}$. Six weeks after surgery, functional recovery parameters, such as range of motion and grip strength, had improved to 98% of the function of the normal side. No major complication was observed. Conclusions We suggest that the transverse pinning of fourth metacarpal bone fractures is an effective treatment option that is less invasive than other procedures, easy to perform, requires no secondary surgery, minimizes joint and soft tissue injury, and allows early mobilization.

• Journal of Periodontal and Implant Science
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• 제46권4호
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• pp.234-243
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• 2016

Purpose: Immediate loading of dental implants has been proved to be feasible in partially edentulous jaws. The purpose of this retrospective investigation was to assess the feasibility of immediately loading dental implants in fully edentulous jaws. Methods: A total of 24 patients aged between 53 and 89 years received a total of 154 implants in their edentulous maxillae or mandibles. Among the implants, 45 were set in fresh extracted sockets and 109 in consolidated alveolar bones. The implants were provisionally managed with chair-side made provisional resin bridges and exposed to immediate loading. Implants were followed up for 1-8 years, including radiographic imaging. Marginal bone levels were evaluated based on radiographic imaging. Results: A total of 148 out of the 154 implants survived over the follow-up period of 1 to 8 years, giving a survival rate of 96%. The time or region of the implantation, the pre-implant augmentation, and the length and diameter of the implants had no statistically significant influence on the survival or the success rate. The marginal bone level remained stable with only minimal loss of 0.3 mm after 60 months of loading. Conclusions: Within the limitations of this study, immediate loading is feasible for dental implants in edentulous jaws.

• Journal of Periodontal and Implant Science
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• 제44권1호
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• pp.33-38
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• 2014

Purpose: Autogenous bones are frequently used because of their lack of antigenicity, but good osteoconductive and osteoinductive properties. This study evaluated the biological behavior of perforated and nonperforated cortical block bone grafts. Methods: Ten nonsmoking patients who required treatment due to severe resorption of the alveolar process and subsequent implant installation were included in the study. The inclusion criteria was loss of one or more teeth; the presence of atrophy of the alveolar process with the indication of reconstruction procedures to allow rehabilitation with dental implants; and the absence of systemic disease, local infection, or inflammation. The patients were randomly divided into two groups based on whether they received a perforated (inner surface) or nonperforated graft. After a 6-month healing period, a biopsy was performed and osseointegrated implants were installed in the same procedure. Results: Fibrous connective tissue was evident at the interface in patients who received nonperforated grafts. However, full union between the graft and host bed was visible in those who had received a perforated graft. Conclusions: We found that cortical inner side perforations at donor sites increased the surface area and opened the medullary cavity. Our results indicate an increased rate of graft incorporation in patients who received such perforated grafts.

• Journal of Hospice and Palliative Care
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• 제17권4호
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• pp.207-215
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• 2014

암의 다발성 뼈 전이는 폐암, 유방암, 전립선암, 신장암 등 다양한 암에서 흔히 관찰된다. 뼈 전이는 뼈에 발생한 이차적인 암으로 통증, 골절, 그리고 체중을 지지하는 뼈의 불안정성을 유발할 수 있어 신체활동과 삶의 질을 저하시킨다. 뼈 전이 치료 시 병리조직소견, 환자의 전신 상태, 침범 부위, 그리고 환자의 신경학적 소견등 다양한 요인을 고려하여 진통제, 수술, 항암화학요법 그리고 방사선 치료 등을 시행하게 된다. 외부 방사선 치료는 전통적으로 국소 뼈 전이로 인한 통증의 치료에 이용되어왔지만 특히 유방암이나 전립선암의 다발성 골형성 뼈 전이의 경우 $^{89}Sr$, $^{186}Re$, $^{188}Re$, $^{153}Sm$ and $^{117m}Sn$ 등의 방사성동위원소를 이용한 치료가 시행되고 있는데, 약제 투여의 간편함, 낮은 부작용, 방사능 피폭위험에서의 안전성, 높은 치료 반응 등 다양한 장점을 가진 치료로 임상에서의 유용성이 점차 증가되고 있다.

• 대한한방내과학회지
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• 제29권3호
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• pp.827-834
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• 2008

Papillary thyroid carcinoma is the most common type of thyroid malignancy. It has better prognosis and rarer incidence of distant metastasis than other types of thyroid malignancy. However, once distant metastasis happens, its result will be bad. They mostly spread to the lungs and bones. and rarely to the brain. We report a patient with a papillary thyroid carcinoma metastasis to the lymph nodes. the ribs. the brain, and the lungs. The patient underwent total thyroidectomy, radioiodine ablation, rib partial resection, and lung wedge resection. However, upon progress of metastasis. the patient insisted on being treated with traditional Korean medical treatment using allergen-removed Rhus Verniciflua Stokes (A-RVS) instead of the conventional treatment including chemotherapy. The size of the tumor partly decreased, and the patient showed no side effects. This case report brings forth the importance of a thorough study in papillary thyroid carcinomas and their metastasis from the traditional Korean medical point of view, along with the long-term effect of allergen-removed Rhus Verniciflua Stokes (A-RVS).

• Imaging Science in Dentistry
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• 제37권3호
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• pp.133-138
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• 2007

Purpose: The purpose of this study was to evaluate the morphologic features of posterior edentulous mandible for Korean patients using cross-sectional CT images. Materials and Methods: Computed tomographic cross-sectional views taken in 2004 and 2005 at Seoul National University Dental Hospital were analyzed by an oral and maxillofacial radiologist. Four indices were measured to meet the purpose of this study: 1) the horizontal distance between the alveolar crest and mandibular canal (Type), 2) the angle of the mandibular long axis (Angle), 3) the bucco-lingual location of mandibular canal, and 4) the depth of the submandibular fossa. The averages and standard deviations of the measurements were compared according to the location (the first and second molar area) and sex of the patients. Results: Statistically significant difference was found in Type, Angle, and submandibular fossa depth between the first and second molar area (p<0.05). However, there was no significant difference between men and women in any of the measured indices. Most of the mandibular canals were located in lingual side of posterior mandible. Conclusion: More care should be taken when an implant is installed on the mandibular second molar area.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제37권1호
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• pp.54-61
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• 2011

Introduction: Bisphosphonates is used widely for the treatment of the Paget's disease, multiple myeloma, bone metastases of malignant tumors with the prevention of pain and their pathological fracture. However, it was recently suggested that bisphosphonates related osteonecrosis of the jaw (BRONJ) is a side effect of bisphosphonate use. Materials and Methods: Twenty-four individuals, who were referred to the Department of Oral and Maxillofacial surgery, Dankook University Dental Hospital, were selected from those who had exposed bone associated with bisphosphonates from January, 2005 to December, 2009 according to the criteria of American Association of Oral and Maxillofacial Surgeons (AAOMS) for BRONJ. The patients group consisted of 7 males and 17 females between the age of 46 to 78 years (average 61.8 years). Each patient had panoramic imaging, computed tomography (CT), whole body bone scanning performed for a diagnosis and biopsy sampling from the necrotizing tissue. C-terminal cross-linking telopeptide of type I collagen (CTX) level of patients who had undergone surgical intervention was measured 7 days before surgery. Results: The main cause of bone exposure was post-extraction (15), chronic periodontitis (4), persistent irritation of the denture (3). Twenty people had undergone BRONJ treatment for two to eight months except for 4 people who had to maintain the bisphosphonates treatment to prevent a metastasis and bone trabecular pain with medical treatment. When the bisphosphonate treatment was suspended at least for 3 months and followed up according to the AAOMS protocols, the exposed necrotizing bones were found to be covered by soft tissue. Conclusion: Prevention therapy, interruption of bisphophonates for at least 3 months and cooperation with the physician for conservative treatment are the essential for treating BRONJ patient with high risk factors. The CTX level of BRONJ patients should be checked before undergoing surgical intervention. Surgical treatments should be delayed in the case of a CTX level <150 pg/mL.

• 대한치과의사협회지
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• 제52권12호
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• pp.783-794
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• 2014

Since the introduction of non-thermal atmospheric pressure plasma in the field of the dentistry, numerous applications have been investigated. Especially with its advantages over existing vacuum plasma in terms of portability, low cost, and non-thermal damage, it can be directly applied in the oral cavity, giving number of potentials for dental application. First, possible application of non-thermal atmospheric pressure plasma in the field of dentistry is relation to dental caries and periodontal diseases. Teeth and alveolar bones are one of the strongest bony structures in our body, but it cannot be regenerated when they are damaged by dental caries or periodontal disease. Hence many studies to prevent such diseases have been carried out, though no perfect solution has been found yet. With recent studies of modifying surfaces through non-thermal atmospheric pressure application that can prevent attachment of bacteria, or studies on bactericidal effects of non-thermal atmospheric pressure plasma can be applied here to prevent oral pathogen and 'biofilm' attachment to the surface of teeth or directly eliminate the dental caries/periodontal disease causing germs. Secondly, non-thermal atmospheric pressure application will be useful on the surface of dental implant. It is well known that the success of dental implant surgery depends on the process known as 'osseointegration' that result from osteoblast attachment, proliferation and differentiation. As the application of non-thermal atmospheric pressure plasma on the surface of dental implant just before its introduction by the chair-side of dental surgery. Despite its long history, the generation of non-thermal atmospheric pressure plasma has been greatly increased with its application in dentistry.