• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.41 no.6
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• pp.299-305
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• 2015

Objectives: This article describes our experience with neck dissection in 10 patients with oral squamous cell carcinoma. Materials and Methods: Between January 2007 and October 2009, 10 patients underwent primary surgery for the treatment of squamous cell carcinoma of the oral cavity. For patients with $N_0$ disease on clinical exam, selective neck dissection (SND [I-III]) was performed. In patients with palpable cervical metastases (N+), modified radical neck dissections were performed, except in one patient in whom SND (I-III) was performed. The histopathologic reports were reviewed to assess the surgical margins, the presence of extra-capsular spread, perineural invasion, and lymphatic invasion. Results: On histopathologic examination, positive soft tissue margins were found in three patients, and regional lymph node metastases were present in five of the ten patients. Perineural invasion was noted in five patients, and extra nodal spread was found in four patients. Regional recurrence was seen in two patients and loco-regional recurrence plus distant metastasis to the tibia was observed in one patient. During the study period, three patients died. Seven patients remain free of disease to date. Conclusion: Histopathological evaluation provides important and reliable information for disease staging, treatment planning, and prognosis. The philosophy of neck dissection is evolving rapidly with regard to the selectivity with which at-risk lymph node groups are removed. The sample size in the present study is small, thus, caution should be employed when interpreting these results.

• The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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• v.15 no.2
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• pp.93-97
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• 2009

Anatomy: Facet joint syndrome most often affects the lower back and neck and refers to pain that occurs in the facet joints, which are the connections between the vertebrae in the spine that enable the spine to bend and twist. Many physicians have believed that the usual lesion of facet syndrome was an anatomical impairments of facet joint itself.. Facet joint injection using local anesthetics is a reliable method for the diagnosis and treatment for facet syndrome. Etiology: One of many possible causes is imbalances that can occur in stress levels, hormone levels, and nutritional levels. These imbalances can adversely affect posture, which can lead to neck and back pain. The common disorder called facet syndrome exhibits lower back pain, with or without, radiating pain to buttock and thigh due to facet joint arthropathy. Pain in the facet joint is supposedly the secondary effect of narrowing of joint space by sustained muscle contracture around joints. Syndrome: Facet joint syndrome tends to produce pain or tenderness in the lower back that increases with twisting or arching the body, as well as pain that moves to the buttocks or the back of the thighs. Other symptoms include stiffness or difficulty standing up straight or getting out of a chair. Pain can be felt in other areas such as the shoulders or mid-back area. Treatment: Non-drug treatments include hot packs, ultrasound, electrical stimulation, and therapeutic exercises. Stimulating blood flow using massage or a hot tub may also help. Alternative treatments include yoga and relaxation therapy. If your pain persists after trying these treatments, a surgical procedure called radiofrequency rhizotomy, which destroys the sensory nerves of the joint, may bring relief. Facet joint injection has been helpful in diagnosis and therapy for this facet syndrome. Radiofrequency thermocoagulation of medial branches is known to be an effective method of relieving pain caused by facet joint problems. We conclude that spasmolytic treatment of muscles connecting the two vertebral articular space would be better for treatment and diagnosis of facet syndrome rather than facet block with local anesthetic and steroid only.

• Journal of International Society for Simulation Surgery
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• v.3 no.1
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• pp.36-38
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• 2016

Fibrous dysplasia is a relatively rare disease but the management would be quite challenging. Because this is not a malignant tumor, the preservation of the facial contour and the various functions seems to be important in treatment planning. Until now the facial bone reconstruction with autogenous bone would be the standard. Although the autogenous bone would be the ideal one for facial bone reconstruction, donor site morbidity would be the inevitable problem in many cases. Meanwhile, various types of allogenic and alloplastic materials have been also used. However, facial bone reconstruction with many alloplastic material have produced no less complications including infection, exposure, and delayed wound healing. Because the 3D printing technique evolved so fast that 3D printed titanium implant were possible recently. The aim of this trial is to try to restore the original maxillary anatomy as possible using the 3D printing model, based on the mirrored three dimensional CT images based on the computer simulation. Preoperative computed tomography (CT) data were processed for the patient and a rapid prototyping (RP) model was produced. At the same time, the uninjured side was mirrored and superimposed onto the traumatized side, to create a mirror-image of the RP model. And we molded Titanium mesh to reconstruct three-dimensional maxillary structure during the operation. This prefabricated Titanium-mesh implant was then inserted onto the defected maxilla and fixed. Three dimensional printing technique of titanium material based on the computer simulation turned out to be successful in this patient. Individualized approach for each patient could be an ideal way to restore the facial bone.

• Journal of International Society for Simulation Surgery
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• v.1 no.2
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• pp.99-102
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• 2014

The skull defect can be made after the trauma, oncologic problems or neurosurgery. The skull reconstruction has been the challenging issue in craniofacial fields for a long time. So far the skull reconstruction with autogenous bone would be the standard. Although the autogenous bone would be the ideal one for skull reconstruction, donor site morbidity would be the inevitable problem in many cases. Meanwhile various types of allogenic and alloplastic materials have been also used. However, skull reconstruction with many alloplastic material have produced no less complications including infection, exposure, and delayed wound healing. Because the 3D printing technique evolved so fast that 3D printed titanium implant were possible recently. The aim of this trial is to try to restore the original skull anatomy as possible using the 3D printed titanium implant, based on the mirrored three dimensional CT images based on the computer simulation. Preoperative computed tomography (CT) data were processed for the patient and a rapid prototyping (RP) model was produced. At the same time, the uninjured side was mirrored and superimposed onto the traumatized side, to create a mirror-image of the RP model. And we fabricated Titanium implant to reconstruct three-dimensional orbital structure in advance, using the 3D printer. This prefabricated Titanium-implant was then inserted onto the defected skull and fixed. Three dimensional printing technique of titanium material based on the computer simulation turned out to be very successful in this patient. Individualized approach for each patient could be an ideal way to manage the traumatic patients in near future.

• Journal of Society of Preventive Korean Medicine
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• v.14 no.3
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• pp.77-92
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• 2010

Objectives : There has been little known about the Tibetan medicine in the society for Korean medicine. The aim of this study is to review the system of Tibetan medicine and compare with Korean medicine. Methods : The authors investigated several literatures that mentioned Tibetan medicine and organized in physiology, pathology, diagnostics, and treatment. And then, we interpreted the characteristics of Tibetan medicine as well as compared Tibetan medicine with Korean medicine. After that, we analyzed the commons and the differences, and also found out the meaning of Tibetan medicine. Results : The theory of Tibetan medicine is basically constituted of three elements of Lung, Tripa, and Peken in every parts of physiology, pathology, diagnostics, and treatment. Many organs of human body are compared to the fabrications of building. There is a detail explanation about the process of the development of fetus in Tibetan medicine. Tibetan medicine uses taking pulse in wrist, analysis of urine, watching of tongue, sperm, and menstruation, and etc. for diagnosis. In Tibetan medicine, regimen is prior to other treatments such as surgical treatment and medications. Conclusions : There is the oriental thought of '3' in Tibetan medicine, and esoteric buddhism is solved in Tibetan medicine. The anatomy and the diagnostics using urine, sperm, and menstruation have especially been developed in Tibetan medicine. Tibetan medicine emphasizes the feature of preventive medicine.

• Journal of Chest Surgery
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• v.28 no.7
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• pp.658-665
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• 1995

Between March 1989 and December 1994, one-stage repair was performed for correction of the intracardiac malformations associated with aortic coarctation in 34 patients or interrupted aortic arch in 8 patients via median sternotomy. There were 26 male and 16 female patients, and their body weight ranged from 1.8 to 8kg[mean weight, 4.0$\pm$l.4kg . The age at the operation ranged from 7 days to 18 months [mean age, 3.1$\pm$3.8 months . The repair of aortic coarctation or interrupted aortic arch was performed using extended end-to-end anastomosis in most of the patients[86%, 36/42 , and six patients underwent ductal tissue excision and patch aortoplasty. Intracardiac defects were corrected concomitantly through the right atrium unless the anatomy dictated otherwise. Obstructive outlet septurn was resected whenever necessary. There were seven early deaths[16.8% , and three late deaths with a mean follow-up period of 25 months [range from 1 to 65 months . Three patients were reoperated upon residual subaortic stenosis,stenosis at the RPA origin, and subacute bacterial endocarditis respectively. None showed any significant residual or anastomotic stenosis postoperatively. One stage repair of the aortic coarctation and interrupted aortic arch associated with intracardiac defect leaves no native coarctation shelf tissue or residual hypoplasia in the repaired segment, has low incidence of recurrent or residual stenosis, minimizes reoperation and incisions, and manages arch hypoplasia easily.We conclude that surgical results of one-stage repair for the intracardiac malformation associated with aortic coarctation or interrupted aortic arch are resonable.

• Journal of Clinical Otolaryngology Head and Neck Surgery
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• v.29 no.2
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• pp.198-203
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• 2018

Background and Objectives : Pediatric orbital blowout fractures occur in discreet patterns, in reference to the characteristic developmental anatomy of the facial skeleton at the time of injury. The purpose of this study was to investigate the clinical characteristics, ocular symptom, fracture type and postoperative results of orbital blowout fractures in the pediatric population. Material and Methods : A retrospective study was conducted from January 2009 to June 2015 in 116 patients with orbital floor fractures ; all less than 18 years old. Patients were divided into 3 groups by age : 0 to 6, 7 to 12, and 13 to 18 years of age. The cause of fracture, fracture site and type, preoperative and postoperative ocular symptoms, timing of surgery were reviewed from their records. Results : Medial wall fractures were the most common site in the 0 to 6 years old group, and floor fractures were the most common site in other age groups. However, floor fracture was the most common site of the need for surgery in all age groups. Trapdoor type of fractures occurred more frequently than open door type of fractures in all age groups. Preoperative symptoms did not differ among the 3 age groups. In case of need surgery, frequency of preoperative ocular symptoms increased with age. However, as age group was young, rate of residual postoperative ocular symptoms were increased. Conclusions : The younger patients are more to have trapdoor type fracture and residual postoperative ocular symptom. Earlier surgical intervention more needed for children with entrapment results.

• The Journal of Advanced Prosthodontics
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• v.11 no.3
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• pp.169-178
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• 2019

PURPOSE. While dental implants have displayed high success rates, poor mechanical fixation is a common complication, and their biomechanical response to occlusal loading remains poorly understood. This study aimed to develop and validate a computational model of a natural first premolar and a dental implant with matching crown morphology, and quantify their mechanical response to loading at the occlusal surface. MATERIALS AND METHODS. A finite-element model of the stomatognathic system comprising the mandible, first premolar and periodontal ligament (PDL) was developed based on a natural human tooth, and a model of a dental implant of identical occlusal geometry was also created. Occlusal loading was simulated using point forces applied at seven landmarks on each crown. Model predictions were validated using strain gauge measurements acquired during loading of matched physical models of the tooth and implant assemblies. RESULTS. For the natural tooth, the maximum vonMises stress (6.4 MPa) and maximal principal strains at the mandible ($1.8m{\varepsilon}$, $-1.7m{\varepsilon}$) were lower than those observed at the prosthetic tooth (12.5 MPa, $3.2m{\varepsilon}$, and $-4.4m{\varepsilon}$, respectively). As occlusal load was applied more bucally relative to the tooth central axis, stress and strain magnitudes increased. CONCLUSION. Occlusal loading of the natural tooth results in lower stress-strain magnitudes in the underlying alveolar bone than those associated with a dental implant of matched occlusal anatomy. The PDL may function to mitigate axial and bending stress intensities resulting from off-centered occlusal loads. The findings may be useful in dental implant design, restoration material selection, and surgical planning.

• Journal of Yeungnam Medical Science
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• v.36 no.3
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• pp.208-218
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• 2019

Background: The anatomy of middle cerebral artery (MCA) aneurysms has been noted to be unfavorable for endovascular treatment. The purpose of this study was to assess the feasibility and efficacy of coiling for MCA aneurysms. Methods: From January 2004 to December 2015, 72 MCA aneurysms (38 unruptured and 34 ruptured) in 67 patients were treated with coils. Treatment-related complications, clinical outcomes, and immediate and follow-up angiographic outcomes were retrospectively analyzed. Results: Aneurysms were located at the MCA bifurcation (n=60), 1st segment (M1, n=8), and 2nd segment (M2, n=4). Sixty-nine aneurysms (95.8%) were treated by neck remodeling techniques using multi-catheter (n=44), balloon (n=14), stent (n=8), or combination of these (n=3). Only 3 aneurysms were treated by single-catheter technique. Angiographic results were 66 (91.7%) complete, 5 (6.9%) remnant neck, and 1 (1.4%) incomplete occlusion. Procedural complications included aneurysm rupture (n=1), asymptomatic coil migration to the distal vessel (n=1), and acute thromboembolism (n=10) consisting of 8 asymptomatic and 2 symptomatic events. Treatment-related permanent morbidity and mortality rates were 4.5% and 3.0%, respectively. There was no bleeding on clinical follow-up (mean, 29 months; range, 6-108 months). Follow-up angiographic results (mean, 26 months; range, 6-96 months) in patients included 1 major and 3 minor recanalizations. Conclusion: Coiling of MCA aneurysms could be a technically feasible and clinically effective treatment strategy with acceptable angiographic and clinical outcomes. However, the safety and efficacy of this technique as compared to surgical clipping remains to be ascertained.

• Journal of Dental Rehabilitation and Applied Science
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• v.37 no.4
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• pp.268-273
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• 2021

Paramolar tubercle is a rare developmental dental anomaly defined as an additional cusp occurring on the buccal or lingual surfaces of the molar. Permanent molar fused with paramolar tubercles can be a cause of difficulty in root canal treatment. Therefore, proper understanding of these variations is important in order to ensure successful endodontic treatment. Cone beam computed tomography (CBCT) can be helpful to understand anatomy of complicated cases. This case report describes nonsurgical endodontic treatment of maxillary second premolar fused with paramolar tubercle.