• 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 Korean Neurosurgical Society
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• v.64 no.2
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• pp.217-228
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• 2021

Objective : Given the high risk of rebleeding and recurrence of blood blister-like aneurysms (BBAs), we treated ruptured BBAs of the internal carotid artery (ICA) with stent-assisted coil embolization (SAC). This study aimed to evaluate the efficacy and safety of SACs. Methods : We retrospectively reviewed clinical and radiological data from eight patients with ruptured BBAs of the supraclinoid ICA. The modified Rankin Scale (mRS) was used to assess clinical outcomes, while radiological outcomes were evaluated on angiographs. For a pooled analysis, data from literature reporting the outcomes of ruptured BBAs treated with SAC were collected and analyzed in conjunction with our data. Results : In our cohort, the mean Raymond classification score was 1.57±0.53 immediately after initial endovascular treatment. There were no perioperative complications or rebleeding events during the follow-up period. The mean mRS score at patient discharge was 1.00±0.81 and improved to 0.28±0.48 by the last follow-up day. The recurrence rate was 25% with an asymptomatic presentation and successful treatment with multiple stent insertion. Pooled analysis of 76 cases of SAC revealed a complete occlusion rate immediately after treatment of 54.8%, rebleeding rate 7.94%, and recurrence rate 24.2%. Good clinical outcomes with mRS score 0-2 were observed in 89.9% by the last clinical follow-up. Total mortality rate was 7.7%. Conclusion : This treatment appears to not only minimize the hemodynamic burden on the fragile dome specific to this type of aneurysm, but also provides an opportunity for safe and effective treatment in recurrent cases.

• The Journal of Advanced Prosthodontics
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• v.13 no.1
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• pp.55-64
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• 2021

PURPOSE. To investigate the biomechanical effect of marginal bone resorption (MBR) on the mandibular mini implant (MI)-retained overdenture (MI-OD) on the edentulous model. MATERIALS AND METHODS. The experimental mandibular edentulous model was modified from a commercial model with 2 mm thick artificial soft tissue under denture base. Two MIs (Φ2.6 mm × 10 mm) were bilaterally placed between the lateral incisor and the canine area and attached with magnetic attachments. Three groups were set up as follows: 1) alveolar bone around the MI without MBR (normal group), 2) with MBR to 1/2 the length of the implant (resorption group), and 3) complete denture (CD) without MI (CD group). Strain around the MI, pressure near the first molar area, and displacement of denture were simultaneously measured, loading up to 50 N under bilateral/unilateral loading. Statistical analysis was performed using independent-samples t test and one-way ANOVA (α=.05). RESULTS. The strain around the MI with MBR was approximately 1.5 times higher than that without MBR. The pressure in CD was higher than in MI-ODs (P<.05), while there was no statistical difference between the normal and resorption group (P>.05). Similarly, the CD demonstrated a greater displacement of the denture base than did the MI-ODs during bilateral and unilateral loadings (P<.05). CONCLUSION. The strain around the MI with MBR was approximately 1.5 times higher than that without MBR. The pressure on posterior alveolar ridge and denture displacement of MI-ODs significantly decreased compared to CDs, even when MBR occurs. Bilateral balanced occlusion was recommended for MI-ODs, especially when MBR occurred.

• Journal of Korean Neurosurgical Society
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• v.65 no.5
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• pp.710-718
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• 2022

Objective : Although endovascular treatment for intracranial aneurysms is considered effective and safe, its durability is still debated. Also, few studies have described angiographic follow-up plan after endovascular treatment of intracranial aneurysm, especially in ruptured cases. Hence, we report the long-term results of follow-up angiography protocol. Methods : Radiological records of 639 cases of coil embolization with ruptured aneurysms from March 2003 to December 2016 were retrospectively reviewed. Patients who received treatment of a saccular aneurysm less than 7 mm resulted with near complete occlusion were included. Two hundred thirty-eight aneuryms which received the follow-up angiography at least once were enrolled. We classified four periods of follow-up as follows : post-treatment 1 year (defined as the first period), from 1 to 2 years (the second period), 2 to 5 years (the third period), and over 5 years (long-term). Results : We identified 14 cases (6.4%) of recurrence from 218 aneurysms in follow-up angiography in the first period. Among 143 aneurysms in the second period, five cases (3.5%) of recurrence were identified. There were no findings suspicious of recanalization in 97 patients in the third period. Of the total 238 cases, there were 19 recurrences, for a recurrence rate of 8.0%. Six (31.6%) out of 19 recurrences showed a tendency toward repeat recurrences even after additional treatment. Twenty-eight received long-term follow-up over 5 years and there was no recurrence. Conclusion : Most of the recurrence were found during the first and the second year. We suggest that at least one digital subtraction angiography examination may be necessary around post-treatment 2 years, especially in ruptured cases. If the angiographic results are favorable at 2 years post-treatment, long-term result should be favorable.

• Journal of Dental Rehabilitation and Applied Science
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• v.39 no.3
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• pp.168-175
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• 2023

Long-term use of inappropriate prosthesis often results in habitual closure or irregular mandibular movements. In that case, guide to the stable centric position is difficult. Therefore, by using a treatment denture, the muscles and TMJ should be stabilized and the jaw relation should be acquired with the treatment position. Compared to the conventional method, digital technology in fabrication complete denture has the advantage of reproducing a stable tooth arrangement in cases of difficult tooth alignment, minimizing laboratory errors and reducing denture fabrication time. Therefore, in this case, the final denture was fabricated by digitally reproducing the stable treatment position, vertical dimension, and lip support with a treatment denture, and satisfactory results were obtained.

• Journal of Dental Rehabilitation and Applied Science
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• v.40 no.2
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• pp.39-45
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• 2024

The residual alveolar ridge below the denture base undergoes physiologic changes over time, which results in the existing dentures becoming less accurate with the residual alveolar ridge. In addition, changes of the occlusal plane, decreasing in vertical dimension and loss of denture retention and facial support can occur. Consequently, denture relining may be required to accommodate these changes and ensure an ongoing close fit. Relining a denture can be performed directly on the chairside using autopolymerizing relining materials or indirectly in the laboratory using heat-cured relining materials. A direct relining method is not only simple but also time and cost effective. However, irritation or burning sensation of the mucosa can occur, and poor bonding of the relining material to the denture base can be cited as disadvantages. The indirect relining method exhibits relatively high bonding strength between the relining material and the denture base, but the patient might experience discomfort during relining process period. This report will examine the characteristics of relining materials, including those used in the relining of CAD-CAM dentures, and explore the clinical considerations for relining procedures.

• Journal of Technologic Dentistry
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• v.10 no.1
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• pp.159-169
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• 1988

Fixed prosthetic appliance is the restorations of damaged teeth with cast metal or porcelain, and of replacing missing teeth with fixed, or cemented prosthesis. Successfully treating a patient by means of fixed prosthodontics requires the thoughtful combination of dentist and dental laboratory technician. In order to know the satisfaction of dentisits about fixed prosthetic appliances-porcelain, precious and non precious metal-, this study was conducted for 69 practicing dentisis in Pusan during Fed. to Mar. 1988 using a questionnaire method and was analyzed by the use of percentage, $X^2$-test The results are obtained as follow: 1. General characteristics of the respondents, The rate of age distribution of practcing dentists responded was as follow : 31$\sim$35 age group is 29.0%, 51$\sim$55age group 18.8%, 41$\sim$45 age group and 46$\sim$50 group each 11.6%, 36$\sim$40 age group and 56$\sim$60 age group 8.7%, over 60 age group 7.3%, below 30 age group 4.3% respectively. The tate of term of practice experience distribution of dentists responded was as follow : 6$\sim$10 year group 26.1%, 25$\sim$25year group 18.8%, 11$\sim$15 years group and 16~20 years group each 13.0%, below 5 years group and over 30 years group each 10.2%, 26$\sim$30 years group 8.7% in order. The rate of respondents’ degree was follow : bachelor group 81.2%, doctor group 13.0%, master group 5.8% in order. The rate of respondents’completed medical specialist course was as follow : non-complete group 75.4%, complete group 24.6%. The rate of having own laboratory in respondents’clinic was as follow : no having own laboratory group 58.0%, having own labiratory group 42.0% The rate of being lab. technician in respondent;s clinic was as follow: non-being lab. technician group 91.3%, being lab. technician group 8.7%. The rate of transactional commercial dental lab. numbers was as follow : I dental lab. group 40.6%, 2 dental lab. group 30.4%, 3 dental lab. group 20.3%, production at own lab. group 8.7% 2. Cognitions about the respondent's job, About cognition of patient numvers, there were neither many nor few group 62.3%, few group 17.4%, many group 15.9%, too many group 4.4% in order.(P<.01) As compared with the ratio of dentists to patient prothetic treatment, there were moderate level group 46.4%, high level group 33.6%, low level group 18.8% in order.(P<.01) By job satisfaction of respondents, the highest percentage group was satisfied group 44.9%, neither astisfied nor disstified group 33.3%, dissatisfied group 14.5%, much satisfied group 7.3%(P<.01). As compared with the level of prosthetics price, the were moderate level group 71.0%, low level group 23.2%, high level group 5.8%(P<.01) 3. Satisfaction and assessment of dissatisfied factor of the fixed prosthetic appliance, As compared with the satisfaction of al prosthetic appliance, there were neither satisfied nor dissatisfied group 59.4%, satisfied group 20.3% dissatisfied group 18.8%, much satisfied group 1.5% in order.(P<.01). About precious and non precious metal crown and bridge, there were neither satisfied nor dissatisfied group 60.9%, satisfied group 24.6%, dissatisfied group 11.6%, much satisfied group 2.9% in order.(P<.01) The reat of respondent;s satisfaction about porcelain crown and bridge was as follow : neither satisfied nor dissatisfied group 43.5%, dissatisfied group 33.3%, satisfied group 21.7%, much satisfied group 1.5%(P<.01). The rate of respondent's dissatisfied factor item of precious and non precious metal crown and bridge was as follow : inadequate margin fit item 39.1% respondent, inadequate occlusion item 24.6%, inadequate adaptation item 23.2%, poor anat omic form item 15.9%, inadequate contact item 31.9%, improper polishing item 4.4%, the rest item 11.6% respectively. The rate of respondent's dissatisfied factor item of porcelain crown and bridge was as follow : inadequate margin fit item 52.2%, inadequate occlusion item 2.9%, inadequate adaptation item 10.1%, poor anatomic form item 11.6%, improper polishing item 1.5%, shade mismatching item 71%, the rest item 7.2% respectively. The rate of cognition of respondents’ about cause of dissatisfied factor on fixed prosthetic appliance by item was as follow : deficiency of sincerity item 55.1%, deficiency of knowledge about work item 47.8%, deficiency of experience item 15.9%, poor quality of using material item 5.8%, the rest item 2.9% respectively.

• The Journal of Korean Academy of Prosthodontics
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• v.53 no.1
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• pp.19-25
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• 2015

Nowadays, CAD/CAM is broadly used in dentistry for inlays, crowns, implant abutments and its spectrum is expanding to complete dentures. Utilizing CAD/CAM to fabricate complete dentures is expected to decrease chair time and the number of visits, thus decreasing total fabrication time, expenses and errors caused during fabrication processes. One of the systems using CAD/CAM, DENTCA$^{TM}$ CAD/CAM denture (DENTCA Inc. Los Angeles, USA) scans edentulous impressions, designs dentures digitally, fabricates try-in dentures by 3D printing and converts them into final dentures. Patients can wear final dentures after only 2 - 3 visits with satisfying adaptation. This case report introduces a 71-year-old male patient who visited to consult remaking of existing old dentures. Residual teeth with bad prognosis and root remnants were extracted and the patient used reformed existing mandibular denture for 2 months. And then DENTCA system started. One-step border molding was done using conventional tray of adequate size provided by DENTCA system and wash impression was taken. Gothic arch tracing was completed based on the vertical dimension of existing dentures. Both maxillary and mandibular trays were placed to the resultant centric relation and bite registration was taken. Then DENTCA scanned the bite registration, arranged the teeth, completed the festooning and fabricated the try-in dentures by 3D printing. The try-in dentures were positioned, occlusal plane and occlusal relations were evaluated. The try-in dentures were converted to final dentures. To create bilateral balanced occlusion, occlusal adjustment was done after clinical remounting using facebow transfer. The result was satisfactory and it was confirmed by patient and operator.

• Journal of Chest Surgery
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• v.35 no.8
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• pp.573-579
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• 2002

Background: In this study, the role and the surgical outcome of the modified Blalock-Taussig shunt in the treatment of the infants with cyanotic complex congenital heart diseases were investigated. Material and Method: Over the last 12 years, 105 modified BT shunts were performed in 100 infants. Postoperative course, shunt patency rate, complications, mortality and its risk factors were reviewed restrospectively. Result: The mean age at operation was 43.0$\pm$36.6 days. Sex ratio was 60:40(M:F). The postoperative oxygen saturations were lowest after mean duration of 11 hours after the shunt procedure. The operative mortality was 8%(8) with 3 late deaths. Causes of operative death included failure of maintenance of minimum oxygenation during the procedure(2), immediate postoperative shunt occlusion(2), respiratory failure(2), low cardiac output due to heart failure and pericardial effusion(2) and sepsis(2). Late deaths resulted from acute cardiac arrest during the follow up cardiac catheterization, hypoxic myocardial failure, and arrhythmia. Year of surgery, shunt size, age at operation, and complexity of the anomalies were not the risk factors for mortality. Six month shunt patency rate was 97% and overall patency rate was 96%. Postoperative complications comprised of shunt occlusion(6), phrenic nerve palsy(3), and wound infection(2). Conclusion: We demonstrated that modified Blalock-Taussig shunt was a useful tool to palliate the infants with complex cyanotic heart disease in whom early complete repair was not feasible with acceptable mortality and patency rate. An adequate postoperative management and a meticulous surgical technique may be key factors for the better results.

• The Journal of Korean Academy of Prosthodontics
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• v.51 no.3
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• pp.147-152
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• 2013

Purpose: The aim of this study was to propose the position of maxillary anterior teeth and intercanine width measurements based on the incisive papilla in accordance with the cephalic type and gender of dentate Korean adult with normal teeth alignment. Materials and methods: 42 students with Class I normal occlusion, without crowding or spacing, were selected from the Chonnam National University School of Dentistry. The lateral skull radiographs of the subjects were taken and were classified as different cephalic types, based on their PFH / AFH ratios. 42 casts of their maxilla were prepared and both the distance between the upper central incisors and the middle of the incisor papilla was measured with a vernier caliper (A) and the distance between the maxillary canine cusp tips (B) were measured. Statistical analysis was performed using SPSS version 15 and their significance was investigated. Results: For dolichocephalic group, the mean values for A and B were 8.43 (SD: 0.61) and 36.73 (SD: 2.17), respectively. The mean value for A was 8.51 (SD: 1.27) for the mesocephalic group and 8.76 (SD 1.03) for the brachycephalic group. The mean value for B was 35.91 (SD: 1.86) for the mesocephalic group and 37.34 (SD: 2.23) for the brachycephalic group. For the male group, the mean A value was 8.86 (SD: 1.04) and the mean B value was 37.60 (SD: 0.24). For the female group, the mean A value was 8.41 (SD: 0.93) and the mean B value was 36.18 (SD: 2.01). The difference between male and female group in A values were not statistically significant (P>.05). The B values of the male subjects were greater than those of the female subjects and was statistically significant (P<.05). Conclusion: 42 students with normal dentition and occlusion in korea, the distance from the incisive papilla and the incisal edge of maxillary central incisors had no difference in cephalic type or gender. However, the distance between the cusp tip of both canines had significant difference in gender where the male showed higher values than the female, while having no difference in cephalic types.