• Korean Journal of Otorhinolaryngology-Head and Neck Surgery
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• v.61 no.12
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• pp.705-709
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• 2018

It is challenging to achieve sufficient hearing gain in patients with mixed hearing loss. In chronic middle ear diseases, conventional passive reconstructive surgeries often result in suboptimal hearing gain and additional hearing aids may have limitations due to insufficient sound amplification, occlusion effect, acoustic feedback, and skin irritation. Middle ear implantation (MEI) using Vibrant Soundbridge (VSB) is another option for auditory rehabilitation in mixed hearing loss as well as sensorineural hearing loss. The floating mass transducer of VSB can be placed on various middle ear structures either directly or using different types of couplers in order to deliver vibratory mechanical energy to the cochlea. We report a patient who presented with bilateral mixed hearing loss due to chronic otitis media and had limitations using conventional hearing aids in the worse hearing ear. The patient was successfully treated with MEI using the Bell coupler together with middle ear surgery in a single step.

• Journal of the Korean neurological association
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• v.36 no.4
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• pp.350-353
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• 2018

Ischemic stroke caused by the cerebral vasculopathy is a rare complication of polyneuropathy, organomegaly, endocrinopathy, monoclonal gammopathy, and skin changes (POEMS) syndrome. We present a case of recurrent ischemic strokes caused by cerebral vasculopathy in a patient with POEMS syndrome. A 34-year-old man presented with gait disturbance and dizziness. Brain magnetic resonance imaging demonstrated acute ischemic stroke in the middle cerebral artery-anterior cerebral artery (MCA-ACA) border zones of bilateral hemispheres. Repeated angiographic studies showed progressive worsening of the left distal internal carotid artery, ACA, and MCA stenoses, along with sustained steno-occlusion of right MCA.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.17 no.2
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• pp.171-179
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• 1995

The conservative treatment of the condylar fracture has been used for a long time because of its simplicity, good prognosis and less complication. Traditionally the conservative treatment has been carried out by maxillomandibular fixation using arch bar and wire. But a simplified technique of maxillomandibular fixation introduced here is a procedure that 4 bone screws are placed above the apecies of the maxillary and mandibular canines and then ipsilaterally placed maxillary and mandibular bone screws are linked by a loop of wire each other. This procedure has several advantages compared with the traditional maxillomandibular fixation method. 1) it provides simplicity for the operators. 2) it sustains maxillomandibular fixation more rigidly compared with arch bar technique. 3) it keeps stable maxillomandibular fixation in the region of the anterior teeth so that anterior open bite tendency can be remarkably minimized. 4) it does not injure the periodontal tissue because the teeth are not engaged and causes less discomfort to the patient. 5) it decreases the possibility of operator's AIDS infection through inadvertent skin puncture. 6) it is highly recommended for the patients whose teeth are available for maxillomandibular fixation. The two male patients were diagnosed as bilateral condylar and symphyseal fracture of the mandible. They restored stable occlusion and functional mandibular movement only by a simplified technique of maxillomandibular fixation.

• The Korean Journal of Pain
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• v.14 no.2
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• pp.199-206
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• 2001

Background: The lumbar sympathetic ganglia are variable in both position and numbers. The aim of this study was to detect the appropriate lumbar vertebral level where the lumbar sympathetic ganglia primarily aggregate. Methods: Forty patients comprising of hyperhidrosis (26 cases), complex regional pain syndrome (10 cases), peripheral artery occlusion disease (3 cases) and postherpetic neuralgia (1 case) underwent lumbar sympathetic block. We randomly selected one of two (L2 or L3) levels and the L4 level. The position of the needle tip and distribution of dye was verified by injection of a mixture of radio-opaque dye (1.5 ml) and 4% lidocaine (1.5 ml) and subsequently confirmed by L-spine anteroposterior and a lateral view X-ray. We considered the response positive when the skin temperature increased more than $1^{\circ}C$ in 5 min. Results: In general, the positive response ratio was greater when the needle tip located at the L2 or L4 level vice L3 and when the drug was distributed on the lower half of the L4 body and in the L4/5 intervertebral disc space. In a right side block, the positive response ratio was greater when the drug was distributed on the lower half of the L4 body and in the L4/5 intervertebral disc space, although in a left side block there was no significant difference seen between the levels. The complications of the neurolytic block were alcohol neuritis (7.5%) and hypoesthesia (5%) on the L1 or L2 dermatome. Conclusions: The best effect with least chance of complication may be induced by spreading the drug on the lower half of the L4 body and/or into the L4/5 intervertebral disc space by placing the needle tip on the L4 body.

• Journal of Korean Neurosurgical Society
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• v.58 no.6
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• pp.508-512
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• 2015

Background : Cerebral ischemia is as a result of insufficient cerebral blood flow for cerebral metabolic functions. Resveratrol is a natural phytoalexin that can be extracted from grape's skin and had potent role in treating the cerebral ischemia. Apoptosis, a genetically programmed cellular event which occurs after ischemia and leads to biochemical and morphological changes in cells. There are some useful markers for apoptosis like Bcl-2, bax, and p53. The last reports, researchers verify the apoptosis with early markers like Annexin V. Methods : We preferred in this experimental study a model of global cerebral infarction which was induced by bilateral common carotid artery occlusion method. Rats were randomly divided into 4 groups : sham, ischemia-reperfusion (I/R), I/R plus 20 mg/kg resveratrol and I/R plus 40 mg/kg resveratrol. Statistical analysis was performed using Sigmastat 3.5 ve IBM SPSS Statistics 20. We considered a result significant when p<0.001. Results : After administration of resveratrol, Bcl-2 and Annexin levels were significantly increased (p<0.001). Depending on the dose of resveratrol, Bcl2 levels increased, p53 levels decreased but Annexin V did not effected. P53 levels were significantly increased in ishemia group, so apoptosis is higher compared to other groups. Conclusion : In the acute period, Annexin V levels misleading us because the apoptotic cell counts could not reach a certain level. Therefore we should support our results with bcl-2 and p53.

• The korean journal of orthodontics
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• v.30 no.6 s.83
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• pp.739-745
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• 2000

Ectodermal dysplasia is a hereditary disease characterized by a congenital dysplasia of one or mote ectodermal structures. Characteristic manifestations Include scanty hair and eyebrows, pigmented and hyperkeratinized skin around the eyes and mouth, frontal bossing with prominent supraorbital ridges, nasal bridge depression and dental anomalies. Hyperthermia or unexplained high fever as a result of the deficiency of sweat glands is common medical history. Findings of intraoral structures are anodontia or oligodontia with conical crowns. Consequently, generalized spacing and loss of vertical dimension of occlusion. Interdisciplinary approach has been performed to treat a 10-year old boy with ectodermal dysplasia. Orthodontists and a prosthodontist worked together on this case, and the result was satisfactory.

• Archives of Plastic Surgery
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• v.35 no.2
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• pp.152-158
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• 2008

Purpose: Mandibulotomy approach and mandible sparing approach are most common methods for oropharyngeal cancer surgery. Good surgical view and convenience of flap inset are advantages of mandibulotomy approach but deformity of mandible contour, postoperative malocclusion and radionecrosis are its limitations. To make up for the limitations, mandible sparing method is commonly performed, but limited surgical view and difficulties of flap inset are the weak points of this approach. The purpose of the study is to compare mandibulotomy and mandible sparing approaches in postoperative complications and progression of the treatment in oropharyngeal cancer operation and reconstruction. Methods: Single reconstructive microsurgeon operated for oropharyngeal cancer patients with different surgeons of head and neck department who prefer mandibulotomy and mandible sparing approach respectively, and we compared the frequency of postoperative complication, operation time, duration of hospitalization and recurrence rate between two different surgical approaches. Results: Mandibulotomy approach was used in 18 patients and mandible sparing approach was used in 15 patients. In mandibulotomy approach, there happened one case of teeth injury and one case of necrosis of skin and gingiva, but there happened no malocclusion and radionecrosis. In mandible sparing approach, there were 3 cases of fistula and 2 cases of infection which are significantly higher than mandibulotomy approach. There were no significant differences between early regional recurrence and duration of hospitalization. Conclusion: In this study we compared two different methods for the surgical approach in oropharyngeal cancer surgery. As mandible sparing approach has difficulties of limited surgical view, it can be used for the limited indications of anterior tongue and mouth floor cancer. Mandibulotomy approach has advantages of good surgical view and convenience of flap inset. In this method preservation of gingival tissue, watertight fashion suture, delicate osteotomy and plate fixation to maintain occlusion are the key points for the successful results.

• Journal of the korean academy of Pediatric Dentistry
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• v.32 no.4
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• pp.682-686
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• 2005

Incontinentia pigmenti(IP), so called Block-Sulzberger syndrome is a rare genodermatosis that occurs almost in female infant; usually lethal in males, X-linked dominantly inherited disorder. IP is characterized by abnormalities of mesodermal and ectodermal tissues including eye, tooth, skin, nail, breast and hair as well as neurological deficiencies. Dental problems are congenital missing of teeth, delayed eruption, abnormal crown shape and so on. Here is a case of 6 year-old female with IP. She had congenital missing of primary and permanent teeth, delayed eruption, maxillary deficiency and extra cusps, resulting in unstable occlusion. Systemically, she had a history of operating eyes due to problem of retina and hyperpigmented macules on her trunk and extremities as typical character of IP.

• Journal of Dental Rehabilitation and Applied Science
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• v.16 no.2
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• pp.123-132
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• 2000

The field of maxillofacial prosthetics is concerned with the prosthetic reconstruction of missing head and neck tissue. Currently, facial prostheses are usually applied in cases of defects caused by the surgical removal of tumors or congenital defects. While silicone has been most widely used for the reconstruction of missing maxillofacial defects, it does not have ideal physical properties. Therefore, bonding a thin polyurethane sheet to silicone prostheses was recommended. In this case skin adhesives were used for the retention of maxillofacial prostheses. But retention of devices has always been problematic. The contributions of implants can be made to solve these problems. Implants have reduced the need for adhesive use, simplifying cleaning procedures and thus extending the life of the prostheses. For implant-retained prostheses, retentive matrix is necessary to hold attachments and/or magnets. The retentive matrix is usually fabricated with autopolymerizing acrylic resin or visible light- polymerized resin. The purpose of this study was to compare the adhesion-in-peel force of silicone adhesive to autopolymerizing acrylic resin and polyurethane sheet with two different surface textures : pumice polish only or retention groove, and three surface primers : Dow corning 1205 primer or Dow corning S-2260 primer or FactorII A-304 primer, and two polymerization methods : room temperature or dry heat oven. The t-peel bond strength of specimens was determined as described in ASTM Standard D1876-72. The results were statistically analyzed using the ANOVA test, multiple range test and t-test The results were as follows. 1. The t-peel bond strength of A-304 primer was the highest and statistically higher than that of S-2260(p<0.05). 2. The t-peel bond strength of specimens with retention groove was statistically higher than that of specimens polished with pumice(p<0.05). 3. The t-peel bond strength of specimens polymerized in dry heat oven was statistically higher than that of specimens in room temperature(p<0.01).

• Archives of Reconstructive Microsurgery
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• v.5 no.1
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• pp.35-45
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• 1996

After transplantation of groin free flap was sucessed by the Daniel and Taylor in 1973, the reconstruction of plastic surgery was extensive and universal due to rapidly developement of anatomic study of the donor site and technique of microvascular surgery. The free tissue transfers is possible to be early activity and rehabilitation by one stage operation. It currently available allow transfer of specific tissue quality as bone, muscle, nerve to achieve a functional and cosmetic result as well as the most favorable secondary defect. But free flaps require critical, skillful technique and lengthy operating time. Also it has disadvantage of donor site morbity at the large tissue transfer. Authors were transferred with 107 cases in 103 patients from May 1987 to June 1996, and then we analysed free tissue transfer to acquire more increased sucess rate, satisfactory functional and cosmetic results. The sexual distribution was male prominent in 79 cases(76.7%), female in 24(23.3%) and age was variable distribution from 3 to 76 years old. The cause of defects was most prevalent in trauma of traffic and industrial accident in 51 cases(49%). The common recipient site were lower extremities in 47 cases(43.9%), upper extremities in 28 cases(26.5%), head and neck in 25 cases(23.4%), and trunk in 7 cases(6.5%). The type of transfer were free skin flaps in 46 cases(43%), free muscle or musculocutaneous flaps in 31 cases(29%), free vasculized or osteocutaneous flaps in 10 cases(9.3%), and specilized free flaps in 20 cases(18.7%). The anastomosis of artery was end to end anastomosis in 94 cases(87.9%), end to side anastomosis in 13 cases(12.1%) and all vein was end to end anastomosis. The number of anastomosed vessels were one artery one vein in 62 cases(57.9%), one artery two vein in 45 cases(42.1%) and vein graft was performed only one case. The postoperative mornitoring were used with temperature, color of flap, capillary refilling time, ultrasonogram, bone scan, doppler, and endoscopy. The reexploration was performed in 9 cases(8.4%), and then flap was loss in 3 cases(2.8%). Accordingly overall success rate was 97.2%. The postoperative complication was early vascular occlusion, hematoma, partial necrosis and late bulkiness, scarring, color dismatch etc. Therefore, free tissue transfer is the preferred method of treatment, even through conventional local and distant flaps are available.