• Restorative Dentistry and Endodontics
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• 제9권1호
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• pp.15-24
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• 1983

Irradiation is frequently employed as the sole therapy for oral cancer. These irradiated patients presents peculiar and progressive dental problems. But there is only scanty informations concerning specific approaches to endodontic treatment for head and neck cancer patients who have been subjected to tumorcidal doses of radiation therapy. The purpose of the present study was to determine the effects of cobalt-60 radiation on the pulpal healing of dogs after the direct pulp capping. As the experimental animals, 10 dogs (above 7-8 months after birth) were divided into 3 groups (Control, Group I, Group II). The cobalt-60 was irradiated to the Group I and Group II each 1,009 and 1,562.5 rads as single dose. As the capping material Dycal$^{(R)}$(L.D. Caulk company) was selected. After the direct pulp capping the dogs were sacrified 1, 2, 3, 4, week interval and made the original slides cut with a thickness of 8 microns and stained with hematoxylin and eosin. After examination and comparision of all specimen, the results of this study were drawn as follows; 1. The formation of reparative dentin was observed from the 1st week in the Control group, the 2nd week in the Group I & II. The few and irregular tuble structure was appeared in the 4th week in the Control group only, but failed in the Group I & II. 2. The continuity of dentin bridge was appeared in the 3rd week in all group and the degeneration of odontoblast in the 1st week of the Group II. 3. The congestion and hemorrhage in the pulp tissue were observed in all groups until 3rd week. The inflammation was appeared within the 2nd week in the Group I and especially marked in the Group II, but absent in the Control group. 4. In cases Dycal into the pulp tissue deeply, the local necrosis of pulp and decrease of dentin formation was observed.

• Archives of Reconstructive Microsurgery
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• 제16권1호
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• pp.48-51
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• 2007

There could be several methods for trochanteric reconstruction including local flap, pedicled perforator flaps, free flap, etc. We performed greater trochanteric reconstruction with lumbar artery perforator free flap in some aberrant method. So we report this experience with review of literatures. A 42-year-old man visited our hospital with a large soft tissue defect in his left greater trochanteric area by traffic accident. The patient had wide skin and soft tissue defect combined with open femur fracture. During one month period of admission, he underwent femur open reduction and wound debridement four times. After that we planned thoracodorsal perforator free flap reconstruction. The flap was outlined as large as $20{\times}15\;cm$ and elevated in a suprafascial plane from the lateral border. During intramuscular perforator dissection, we found that two 1.5 mm diametered perforator vessels coursed inferomedially toward second lumbar region. Finally the flap became lumbar artery perforator flap based on second lumbar artery perforator as a main pedicle. After flap transfer, the perforator vessels were connected with inferior gluteal artery and vein microsurgically. The operation was successful without uneventful course. We found no significant postoperative complication and donor site morbidity during six months follow up periods. Lumbar artery perforator flap could be an alternative procedure for thoracodorsal perforator flap in some patients with anatomic variant features.

• Journal of Korean Neurosurgical Society
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• 제50권6호
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• pp.503-506
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• 2011

Objective : The aim of this study was to assess the safety and efficacy of radiation-sterilized allografts of iliac bone and fascia lata from cadaver specimens to repair skull base defects after transsphenoidal surgery. Methods : Between May 2009 and January 2010, 31 consecutive patients underwent endonasal transsphenoidal surgery and all patients received sellar reconstruction using allografts following tumor removal. The allografts were obtained from the local tissue bank and harvested from cadaver donors. The specimens used in our approach were tensor fascia lata and the flat area of iliac bone. For preparation, allografts were treated with gamma irradiation after routine screening by culture, and then stored at $-70^{\circ}C$. Results : The mean follow-up period after surgery was 12.6 months (range, 7.4-16 months). Overall, postoperative cerebrospinal fluid (CSF) leaks occurred in three patients (9.7%) and postoperative meningitis in one patient (3.2%). There was no definitive evidence of wound infection at the routine postoperative follow-up examination or during re-do surgery in three patients. Postoperative meningitis in one patient was improved with the use of antibiotics and prolonged CSF diversion. Conclusion : We suggest that allograft materials can be a feasible alternative to autologous tissue grafts for sellar reconstruction following transsphenoidal surgery under selected circumstances such as no or little intraoperative CSF leaks.

• Archives of Plastic Surgery
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• 제32권2호
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• pp.183-188
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• 2005

Defect on the temporal area caused by, surgical ablation of a tumor or an infection should be reconstructed immediately to prevent potentially life-threatening complications such as meningitis and cerebrospinal fluid leakage. The defect on the temporal area usually presents as a typical 'cone-shape'. Successful reconstruction requires sufficient volume of well-vascularized soft tissue to cover the exposed bone and dura. From 1994 through 2003, the authors applied rectus abdominis free flap for the reconstruction of the temporal defect from 1994 through 2003. There were 10 patients with a mean age of 52.1 years. Of these 10 patients, external auditory canal cancer was present in four patients, temporal bone cancer in two, parotid gland cancer in one and three patients were reconstructed after debridement of infection(destructive chronic otitis media). All the free flaps survived, and flap-related complications did not occur. Compared to a local flap, the rectus abdominis free flap can provide sufficient volume of well-vascularized tissue to cover the large defect and can be well-tolerated during an adjuvant radiation therapy. The long and flat muscle can be easily molded to fit in to the 'cone-shape' temporal defect without dead space. It is also preferred because of the low donor site morbidity, a large skin island and an excellent vascular pedicle. Two-team approach without position change is possible. In conclusion, the authors think that rectus abdominis free flap should be considered as one of the most useful method for the reconstruction of a cone-shaped temporal defect.

• Archives of Plastic Surgery
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• 제32권2호
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• pp.175-182
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• 2005

Skull base tumors have been determined inoperable because it is difficult to accurately diagnose the extent of the involvement and to approach and excise the tumor safely. However, recently, the advent of sophisticated diagnostic tools such as computed tomography and magnetic resonance imaging as well as the craniofacial and neurosurgical advanced techniques enabled an accurate determination of operative plans and safe approach for tumor excision. Resection of these tumors may sometimes result in massive and complex extirpation defects that are not amenable to local tissue closure. The purpose of this study is to analyze experiences of skull base reconstruction and to evaluate long term survival rate and complications. All cranial base reconstructions performed from July 1993 to September 2000 at Department of Plastic and Reconstructive Surgery of the Seoul National University Hospital were observed. The medical records were reviewed and analysed to assess the location of defects, reconstruction method, existence of the dural repair, history of preoperative radiotherapy and chemotherapy, complications and causes of death of the expired patients. There were 12 cases in region II, 8 cases in region I and 1 case in region III according to the Irish classification of skull base. Cranioplasty was performed in 4 patients with a bone graft and microvascular free tissue transfer was selected in 17 patients to reconstruct the cranial base and/or mid-facial defects. Among them, 11 cases were reconstructed with a rectus abdominis musculocutaneous free flap, 2 with a latissimus dorsi muscluocutaneous free flap, 1 with a fibular osteocutaneous free flap, 2 with a scapular osteocutaneous free flap, and 1 with a forearm fasciocutaneous free flap, respectively. During over 3 years follow-up, 5 patients were expired and 8 lesions were relapsed. Infection(3 cases) and partial flap loss(2 cases) were the main complications and multiorgan failure(3 cases) by cancer metastasis and sepsis(2 cases) were causes of death. Statistically 4-years survival rate was 68%. A large complex defects were successfully reconstructed by one-stage operation and, the functional results were also satisfactory with acceptable survival rates.

• Journal of Yeungnam Medical Science
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• 제20권2호
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• pp.117-128
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• 2003

Thallium-201 scintigraphy is used to discriminate the malignant bone tumor from the benign by qualitatively and quantitatively, and to predict the response of preoperative chemotherapy in osteosarcoma, by comparing the changes of thallium uptake ratio after chemotherapy to the tumor necrosis ratio. Thallium-201 scintigraphy scan should be done prior to surgical biopsy. PICKER Prism 2000 gamma camera with high resolution parallel hole collimator is usually used for scanning. The patient is injected with 2-3mCi of Tl-201 and the early phase is checked in 30 minutes and delayed phase in 3 hours. The scan images are visually evaluated by a blinded nuclear medicine physician. We could evaluate true positive, true negative, false positive and false negative by the comparison of results with those of biopsy, and calculate positive and negative predictive value(%), sensitivity(%), specificity(%) and diagnostic accuracy(%). For the quantitative analysis of thallium uptake, we drew the region of interest on the tumor side and contralateral normal side as mirror image, and calculated the uptake ratio with dividing the amount of gamma count in tumor side by normal side. We could calculate the percent changes of thallium uptake ratio in early and delayed phase, and compare them to the ratio of tumor necrosis. Thallium-201 scintigraphy proved as useful imaging study to discriminate malignant bone tumor from benign, but had exception in giant cell tumor and low grade malignant bone tumors. We can use T1-201 scan to differentiate the benign from the malignant tumor, and to evaluate the response of preoperative chemotherapy or radiotherapy, and to determine the residual tumor or local recurrence. For the better result, we need to have a more detail information about false positive cases and a more objective and quantitative reading technique.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제28권2호
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• pp.172-177
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• 2006

It is generally known that mucositis which often occur on hematopoietic disease patients, shows local necrosis of oral mucosa when the CBC is below the normal range. But sometimes, the lesions are occasionally infiltrate into adjacent tissue. When the pathologic destructive expansion is occurred, differential diagnosis with fungal infection, one of opportunistic infections, is needed. This means treatment and prognosis can be changed according to the diagnosis. So the diagnostic process is more important in this hematopoietic disease patients. In case of fungal infection, the range of tissue damage can expand broadly, and also proper antifungal agent and surgical extirpation should be done. After operation, continuous antifungal therapy and observations are needed. We made a comparative study of following 2 cases of fungal infection appeared on the acute lymphatic leukemia patients to discuss what the proper surgical treatment and medications are, and when the proper surgical intervention time is.

• 대한본초학회지
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• 제31권3호
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• pp.1-11
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• 2016

Objectives : The researcher investigated the anti-obesity effect of Platycodi Radix (P), Platycodi Radix and Cyperi Rhizoma combination water extract (PC) in mice fed a high fat diet and focused on the analysis of local area adipose tissue.Methods : Male ICR mice were divided into four groups, which were fed either a normal AIN diet (N group), a high fat diet (HFD group), or a high fat diet and orally administration with a concentraion of 300 mg/kg body weight (P group or PC group) for eight weeks.Results : Compared to mice in the HFD group, mice in the P group or PC group showed significant reductions in weight gain and relative weight of total fat. Compared to mice in the HFD group, mice in the P group showed significant reductions in relative weight of liver. In blood biochemistry analysis, AST, ALT, triglyceride, total-cholesterol and low density lipoprotein(LDL)-cholesterol, AI levels of P group or PC group were significantly lower than those of the control group AI. But serum serum high density lipoprotein(HDL)-cholesterol levels from the P group or PC group were significantly higher than those of the HFD mice in serum. And serum adiponectin levels from the P group or PC group were significantly increased that those of the HFD mice. And adipocyte number in the fat tissue from the P group or PC group was significantly higher than those of the HFD mice.Conclusions : Platycodi Radix, Platycodi Radix-Cyperi Rhizoma have an anti-obesity effect in mice and the effect is mediated by inhibition of fat gain.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제40권3호
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• pp.140-146
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• 2014

Pigmented villonodular synovitis (PVNS) is a benign but locally aggressive and destructive disease originating in the synovial membranes. It is a proliferative disorder of unknown etiology. Involvement of the temporomandibular joint (TMJ) is very rare. Computed tomography clearly reveals areas of lytic bone erosion and sclerosis, and also clearly defines the extent of the tumor which is the focal areas of hyperdensity within the soft-tissue mass. Magnetic resonance images invariably show profound hypointensity on both T1- and T2-weighted sequences due to hemosiderin pigmentation. Additionally, high signal intensity on T2-weighted images may indicate cystic loculation of the joint fluid. This case study describes a rare case of PVNS of the TMJ with bone destruction of the mandibular condyle. Complete surgical excision of the lesion was performed through a preauricular approach with temporal extension. During the 10-year follow-up, two more operations were performed due to local recurrence and the fracture of the reconstruction plate. Total joint reconstruction with Biomet was finally performed, and the absence of disease was confirmed with a biopsy report showing fibrosis with hyalinization and mild inflammation of the excised soft tissue from the old lesion.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제39권4호
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• pp.193-196
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• 2013

Artecoll (Artes Medical Inc., San Diego, CA, USA) has recently been developed as a permanent synthetic cosmetic filler. We experienced an inflammatory granuloma resulting from a previous injection of Artecoll at the upper lip, which was regarded as a rare side effect of this filler. A 50-year-old female patient complained of swelling, dull pain, and heat in the right upper nasolabial fold area, which had started one week before her visit to Kyungpook National University Hospital. The patient received topical steroid therapy at a local clinic, which was not effective. At the injection site, a hard nodule was palpated and erythema was observed with mild tenderness. Antibiotic treatment and subsequent incision and drainage did not result in complete cure of the facial swelling, and the facial swelling and pain persisted. Computed tomography showed a lesion approximately 1-cm in size without clear boundaries and relatively increased nodular thickening. Finally, a subdermal lesion was removed via an intraoral vestibular approach. The lesion was diagnosed as inflammatory granuloma by a permanent biopsy. The patient had healed at two months after the filler injection. Although the soft tissue filler is widely used for cosmetic purposes, there is potential for complication, such as the inflammatory granuloma should be considered before treatment.