• Archives of Plastic Surgery
• /
• v.40 no.4
• /
• pp.392-396
• /
• 2013

Background The typical clinical symptoms of glomus tumors are pain, tenderness, and sensitivity to temperature change, and the presence of these clinical findings is helpful in diagnosis. However, the tumors often pose diagnostic difficulty because of variations in presentation and the nonspecific symptoms of glomus tumors. To the best of our knowledge, few studies have reported on the usefulness of magnetic resonance imaging (MRI) in diagnosing glomus tumors in patients with unspecific symptoms. Methods The inclusion criteria of this study were: having undergone surgery for subungual glomus tumor of the hand, histopathologic confirmation of glomus tumor, and having undergone preoperative MRI. Twenty-one patients were enrolled. The characteristics of the tumors and the presenting symptoms including pain, tenderness, and sensitivity to temperature change were retrospectively reviewed. Results Five out of 21 patients (23%) did not show the typical glomus tumor symptom triad because they did not complain of pain provoked by coldness. Nevertheless, preoperative MRI showed well-defined small soft-tissue lesions on T1- and T2-weighted images, which are typical findings of glomus tumors. The tumors were completely resected and confirmed as glomus tumor histopathologically. Conclusions Early occult lesions of glomus tumor in the hand may not be revealed by physical examination because of their barely detectable symptoms. Moreover, subungual lesions may be particularly difficult to evaluate on physical examination. Our cases showed that MRI offers excellent diagnostic information in clinically undiagnosed or misdiagnosed patients. Preoperative MRI can accurately define the character and extent of glomus tumor, even though it is impalpable and invisible.

• The korean journal of orthodontics
• /
• v.48 no.3
• /
• pp.172-181
• /
• 2018

Objective: This study was performed to investigate buccal facial depth (BFD) changes after extraction and nonextraction orthodontic treatments in post-adolescent and adult female patients, and to explore possible influencing factors. Methods: Twelve and nine female patients were enrolled in the extraction and nonextraction groups, respectively. Changes in BFD in the defined buccal region and six transverse and two coronal measuring planes were measured after registering pretreatment and posttreatment three-dimensional facial scans. Changes in posterior dentoalveolar arch widths were also measured. Treatment duration, changes in body mass index (BMI), and cephalometric variables were compared between the groups. Results: BFD in the buccal region decreased by approximately 1.45 mm in the extraction group, but no significant change was observed in the nonextraction group. In the extraction group, the decrease in BFD was identical between the two coronal measuring planes, whereas this differed among the six transverse measuring planes. Posterior dentoalveolar arch widths decreased in the extraction group, whereas these increased at the second premolar level in the nonextraction group. The treatment duration of the extraction group was twice that of the nonextraction group. No differences were found in BMI and Frankfort horizontal-mandibular plane angle changes between the groups. BFD changes in the buccal region moderately correlated with treatment duration and dental arch width change. Conclusions: BFD decreased in adult female patients undergoing extraction, and this may be influenced by the long treatment duration and constriction of dentoalveolar arch width. However, nonextraction treatment did not significantly alter BFD.

• The Journal of Korean Academy of Orthopedic Manual Physical Therapy
• /
• v.24 no.2
• /
• pp.51-58
• /
• 2018

Backdround: Using RUSI (Rehabilitation Ultra Sound Imiging) method, which showed high reliability in soft tissue measurements, we compared the muscle relax and contraction, sex, and physical characteristics of the activity of the multifidus muscle in patients with chronic low back pain and normal subjects. Methods: In this study, 16 patients (male: 8, female: 8) with chronic low back pain and 16 healthy adult (male: 8, female: 8) were participated. Subjects lied prone posture on the table with elbow flexed $90^{\circ}$ and shoulder abducted $120^{\circ}$ (starting position). Test was applied two types that muscle relax position and muscle contraction position. Muscle relax position is equal to starting position and muscle contraction position is that upper extremity lift up about 5cm from the table. We measured the thickness of the multifidus muscle in each position by ultrasound. Results: There was a statistically significant difference between the two groups in deviation of Both Side Difference of Activated resting-Arm Lifting Ratio according to posture change between the chronic low back pain patient group and the normal group. Conclusion: The result of this study support previous study showing that there is an imbalance in the activity of multifidus in patients with chronic low back pain.

• Clinics in Shoulder and Elbow
• /
• v.21 no.4
• /
• pp.220-226
• /
• 2018

Background: This study introduces a surgical technique with good clinical outcome useful in the treatment of osteoporotic displaced 3- or 4-part proximal humeral fractures. Methods: From May 2014 to February 2016, 16 patients with displaced 3- or 4-part proximal humeral fractures were treated by application of a locking plate with an endosteal strut allograft via a deltoid splitting approach with a minimum follow-up of 12 months. The allograft was inserted through a fractured gap of the greater tuberosity to support the humeral head and then fixed by a locking plate with meticulous soft tissue dissection to protect the axillary nerve. Surgical outcomes were evaluated by the American Shoulder and Elbow Surgeons (ASES) and visual analogue scale (VAS) scores, radiological imaging, and clinical examination. Fixation failure on radiographs was defined as a >$5^{\circ}$ loss of neck shaft angle (NSA) compared to that on an immediate postoperative radiograph. Avascular necrosis (AVN) of the humeral head was also evaluated. Results: In all cases, complete union was achieved. The ASES and VAS scores were improved to $85.4{\pm}2.1$ and $3.2{\pm}1.3$, respectively. Twelve patients (75.0%) had greater than a $5^{\circ}$ change in NSA; the average NSA change was $3.8^{\circ}$. Five patients (31.3%) had unsatisfactory ranges of motion exhibiting a <$100^{\circ}$ active forward flexion. No axillary nerve injuries or AVN were observed at the last follow-up. One patient was converted to reverse total arthroplasty due to severe pain and functional deficit. Conclusions: Minimally invasive fixation via a locking compression plate and an endosteal fibula strut allograft in Neer classification 3-or 4-part fractures with severe osteoporosis in elderly patients can achieve good clinical results.

• The korean journal of orthodontics
• /
• v.37 no.4
• /
• pp.272-282
• /
• 2007

The purposes of this study were to evaluate the nasolabial angle changes between closed lip position at centric occlusion and relaxed lip position at which the bite is open so that the lips do not touch and to elucidate the significance of the relaxed lip position for dentofacial diagnosis. Methods: The subjects consisted of 60 (35 Males, 25 Females) skeletal Class III malocclusion adult patients (mean age 23.3 years) with anterior crossbite. Results: In Class III malocclusion adult patients, there were significant differences in the nasolabial angle changes between closed lip position and relaxed lip position. Using the cluster analysis, the subjects were divided into three groups according to the pattern of nasolabial angle change: Group 1 (N = 27, 45%, $-8\;{\sim}\;1$), Group 2 (N = 30, 50%, $2^{\circ}\;{\sim}\;17$), and Group 3 (N = 3, 5%, over 18). Conclusion: The results showed that the pattern of the nasolabial angle change between closed lip position and relaxed lip position varies in skeletal Class III malocclusion patients. Thus, relaxed lip position should be taken into account when diagnostic records are obtained and analyzed to accurately to evaluate the facial soft tissues and predict facial esthetics after surgical-orthodontic treatment.

• The Journal of the Korean bone and joint tumor society
• /
• v.5 no.1
• /
• pp.9-16
• /
• 1999

A new method of limb sparing by resection, extracorporeal irradiation and reimplantation has several theoretical advantages. This method preserves the mobility of a joint and avoids the problem of loosening or breakage of tumor prosthesis. This study involved using extracorporeal irradiated autogenous joint transplantation for reconstruction after en bloc resection, and observed the periods of functional union and histological changes in irradiated tissue of the knee joint. This study also aimed to clarify whether the degeneration of articular cartilage is induced in rabbits by a single 50Gy dose of irradiation at the knee joint. Twenty New Zealand rabbits about three kilograms were randomized into two groups of 10 rabbits each. In group 1, as control, we resected the knee joint followed by reimplantation without irradiation. Group 2 received extracorporeal irradiation on the resected knee joint followed by reimplantation. Following are the results of these observations. The osteotomy site showed external callus formation in the roentgenographic finding eight weeks after reimplantation. There was marked degenerative changes in the collagen fiber of the irradiated anterior cruciate ligament and meniscus during the fourth week, but new blood-vessel formation was observed in the vicinity. There was degenerative changes in the collagen fiber of articular cartilage treated extracorporeal irradiation at four and eight weeks in the scanning electron micrographic findings. These findings was in contrast to those of subchondral bone which showed decreased cellularity and empty lacuna at four and eight weeks. Autoradiography demonstrated active [$^3H$]uridine incorporation by irradiated chondrocyte at eight weeks after reimplantation. These results indicate that when destruction of the articular cartilage and soft tissue of the knee joint is not severe, extracorporeal irradiation and reimplantation can be used with several advantage in maintaining movement of the joint while avoiding problems of tumor prosthesis and rejection, and therefore extracorporeal irradiated autogenous joint transplantation can be used as a limb-sparing procedure for temporary biological spacer in the childhood bone tumor around the knee.

• The Journal of the Korean bone and joint tumor society
• /
• v.9 no.2
• /
• pp.190-199
• /
• 2003

Purpose: The aim of this study was to find out a clinically appliable method to insert a biodegradable solid material containing holmium-166-chitosan complex into the surgical field, and to evaluate the histological changes in the normal tissues after ${\beta}$ -ray irradiation from holmium-166 according to the dose, period and type of tissues. Materials and Methods: 3.0 mCi, 50 ${\mu}l$ of the liquid state $^{166}$Ho-chitosan complex was attached to the absorbable gelatin sponge. The radiation activity measured by dose caliberator was 1.5 mCi. These $^{166}$Ho-chitosan complex containing absorbable gelatin sponges were inserted into the thigh muscles and over the femur bones of the Wistar rats. The cases were evaluated at 2 weeks after insertion, and 4, 6 weeks with respect to the histological changes of the soft tissues and bone, the depth of the tissue necrosis, and the changes of the $^{166}$Ho-chitosan complex containing absorbable gelatin sponges. Results: At 2 weeks, the muscles showed coagulation necrosis, degenerating myocytes, regenerating myocytes, intermuscular edema, and inflammatory cells. The necrosis depth was 3.3 mm. In the bones, there was no osteocyte in the lacuna of cortex (empty lacuna), marrow fibrosis, inflammation. The necrosis depth was 2.9 mm. At 4 weeks, in the muscle, calcification and increased fibrosis with necrosis depth by 3.3 mm were the additional findings. In the bone, marrow fibrosis with necrosis depth by 3.3 mm were detected. At 6 weeks, soft tissue shrinkage, increased fibrosis and granulation tissue formation, and nearly resolving inflammatory reaction were the findings. Conclusion: The local application of the $^{166}$Ho-chitosan complex attached to biodegradable gelatin material with surgery in the laboratory animals resulted in no mortality and morbidity, and satisfactory tissue necrosis. Holmium-166 can be applied to the treatment of the malignant tumor patients.

• Restorative Dentistry and Endodontics
• /
• v.34 no.2
• /
• pp.154-161
• /
• 2009

This clinical study evaluated the whitening effect and safety of polymer based-pen type BlancTis Forte (NIBEC) containing 8.3% carbamide peroxide. Twenty volunteers used the BlancTis Forte whitening agent for 2 hours twice a day for 4 weeks. As a control. Whitening Effect Pen (LG) containing 3% hydrogen peroxide was used by 20 volunteers using the same protocol. The change in shade (${\Delta}E^*$, color difference) was measured using $Shadepilot^{TM}$ (DeguDent) before, during, and after bleaching (2 weeks, 4 weeks, and post-bleaching 4 weeks). A clinical examination for any side effects (tooth hypersensitivity or soft tissue complications) was also performed at each check-up. The following results were obtained. 1. Both the experimental and control groups displayed a noticeable change in shade (${\Delta}E$) of over 2. No significant differences were found between the two groups (p > 0.05), implying that the two agents have a similar whitening effect.2. The whitening effect was mainly due to changes in a and b values rather than in L value (brightness). The experimental group showed a significantly higher change in b value, thus yellow shade, than the control (p < 0.05). 3. None of the participants complained of tooth hypersensitivity or soft tissue complications, confirming the safety of both whitening agents.

• Maxillofacial Plastic and Reconstructive Surgery
• /
• v.32 no.1
• /
• pp.49-56
• /
• 2010

Objective: To evaluate nasal and upper lip changes after Le Fort I surgery by means of images taken with a three-dimensional computed tomography (3D-CT). Methods: Fifteen patients (9 female and 6 male, mean age 21.9 years) with preoperative and postoperative 3D-CT were studied. The patients underwent maxillary movement with impaction or elongation, and advancement or setback. With the 3D-CT which presents reconstructive soft tissue images, preoperative and postoperative measurement and analysis were performed for nasal tip projection angle, columellar angle, supratip break angle, nasolabial angle, interalar width, internostril width, columella length and nasal tip projection. Results: Postoperative interalar and internostril widening was significant for all categories of maxillary movement. However, there was little significant relation in all parameters between the amount and direction of maxillary movement. Interestingly, movement of the maxilla with upward did show a little decrease in the columellar angle, supra tip break angle and nasolabial angle. Also movement of the maxilla with forward did show a little advancement in the upper lip position. Conclusion: Changes to the nose clearly occur after orthognathic surgery. There was a significant increase in postoperative interalar width and internostril width with maxillary movement. However, no clear correlation could be determined between amount of change and maxillary movement. Interestingly, maxillary impaction did show a little decrease in the columellar angle, supra tip break angle and nasolabial angle. In addition, we used 3D-CT for more precise analysis as a useful tool.

• Tuberculosis and Respiratory Diseases
• /
• v.70 no.2
• /
• pp.165-169
• /
• 2011

Pheochromocytomas are neuroendocrine tumors of chromaffin cell that originate in the paraganglia of the adrenal medulla. Approximately 10% of pheochromocytomas are found in the extra-adrenal paraganglia and are called paragangliomas. However, cases of middle mediastinal paragangliomas are very rare. In this case, the patient presented with a voice change and a headache. A middle mediastinal soft tissue mass with marked enhancement was detected on computed tomography of the chest. The 24-hour urine catecholamine level was markedly elevated. The middle mediastinal mass was biopsied via mediastinoscopy and the resulting immunohistochemical staining was compatible with a diagnosis of middle mediastinal paraganglioma. The mass was resected surgically and the symptoms were relieved.