Journal of the Korean Association of Oral and Maxillofacial Surgeons
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제41권1호
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pp.52-56
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2015
Clinical features of masticator-space abscess (MSA) are very similar to those of parotitis or temporomandibular disorder (TMD), making early differential diagnosis difficult. Local causes of MSA include nerve block anesthesia, infection after tooth extraction, and trauma to the temporomandibular joint (TMJ); the systemic cause is immunodeficiency. Odontogenic causes account for most etiologies, but there are also unusual causes of MSA. A 66-year-old male patient visited the emergency room (ER) presenting with left-side TMJ pain three days after receiving an acupressure massage. He was tentatively diagnosed with conventional post-trauma TMD and discharged with medication. However, the patient returned to the ER with increased pain. At this time, his TMD diagnosis was confirmed. He made a third visit to the ER during which facial computed tomographic (CT) images were taken. CT readings identified an abscess or hematoma in the left masticator space. After hospitalizing the patient, needle aspiration confirmed pus in the infratemporal and temporal fossa. Antibiotics were administered, and the abscess was drained through an incision made by the attending physician. The patient's symptoms decreased, and he was discharged.
A 63-year-old male who had subtotal gastrectomy for early gastric cancer three months ago underwent Tc-99m bone scintigraphy for the evaluation of skeletal metastases. He had no symptoms such as fever, tenderness, or wound discharge. On physical examination, the surgical scat along the midline of the upper abdomen had keloid formation and there was no radiographic evidence of calcification. Bone scintigraphy (Fig. 1A & 1B) demonstrated all unusual linear increased uptake along the midline of the upper abdomen that corresponded to the,skin incision for subtotal gastrectomy. Usually, an incisional scar will not be visualized in Tc-99m methylene diphosphate (MDP) scintigraphy beyond two weeks after surgery.$^{1)}$ Upon reviewing the literature, there were only a few reports where localization of Tc-99m MDP in surgical scars were found two months after surgery.$^{2)}$ It was also reported that a few cases with Tc-99m MDP uptake in the keloid scar developed after surgery. Although there are several potential mechanisms that may explain the uptake of Tc-99m MDP in scar tissue, the primary mechanism in older scars is suggested to be a result of pathological calcification.$^{2)}$ Siddiqui et al$^{3)}$ suggested it could be due to microscopic calcification in small resolving hematomas. However, the primary mechanism in keloid scar is not well-known. We should obtain oblique or lateral views to differentiate the uptake in healing surgical scars from the artifactual uptake.
Myxoma is a locally invasive neoplasm usually involving the jaw bones, typically occurs between the second and fourth decades. This tumor may comprise 3%-6% of odontogenic tumors. Myxomas of the soft tissue of the face are very rare. We present an unusual case of myxofibroma occurring in a 13-year-old man involving the soft tissue of the face. It congenitally occurred and was a 1 cm sized, ovoid in shape, swelling located on the glabella without any symptoms. An excisional biopsy was performed. A well encapsulated ovoid mass was attached to the corrugator supercilli muscle below the frontalis muscle. It was measured 1.1 × 1 × 0.8 cm and completely excised. Histological examination revealed myxofibroma showing stellate and spinde-shaped cells throughout myxoid ground substance. The unusual features of this case are the site of the tumor, which was localized to the non-tooth bearing area of the mandible and its congenital occurrence history.
1. Ounyukki(五運六氣) theory was first developed from observation of astronomical phenomena. Natural phenomena were explained and incorporated into the concepts of Yukki(六氣), and Ohaeng(五行, the concept that all matter in the world are comprised of five fundamental elements), during Chon-guk(戰國) and Han(漢) periods. In that period. Kanji(干支, the method to present time with ten and twelve different kinds of symbol's combinations) was used to record Ounyukki(五運六氣). Theoretical study of Un-gi(運氣, the abbreviation of Ounyukki) was almost completed in Un-gichilpyon(運氣七篇) of Naekyong(內經). Un-gi(運氣) theory was further studied and considered to be very important socially, as well as medically, in Tang(唐), Song(宋), Kum(金), and Won(元) periods. Hagan(河間) published various studies based on Un-gi(運氣) theory in Kum won(金元) periods. 2. Hagan(河間) realized the limitation of a remedy method, of Sanghan(傷寒) theory. Therefore, he made an assumption that the prevalence of diseases in his period are closely related to Hwayol(火熱, a fire and a super-heat; two things out of Yukki(六氣)). His new theory was a result of the study on Kyongjon(經典, bibles of the oriental medicine) and the phenomena of nature. 3. Hagan(河間) used a combination of two basic theories of Pimuripsang(比物立象) and Hanhaesungjeron(亢害承制論) to make understood Hwayol(火熱) theory, Pimuripsang(比物立象) theory explains a method to appreciate the essence of things by comparing Sang(象, an expression of how something appears on the outside) and then making another Sang(象) from the comparison. Hanhaesungjeron(亢害承制論) is a theory to emphasize the importance of a balance of Yukki(六氣). It is that, if one of the elements is exceeded, other thing in the other five elements dominate the exceeded thing to control it for the balance between Yukki(六氣). In addition, he articulated P'yobon(標本. inside and outside of a thing) theory to differentiate the disease symptoms. These theories will help to distinguish real and fake symptoms of diseases, on which Hagan(河間) emphasized its importance. 4. Hagan(河間) published a new theory to explain Ounyukki(五運六氣) theory based on the observation of the nature and the experience from medical practice. And he added Chobyonggi(燥病機, course and rule causing disease in dry conditions) to Pyonggishipkujo(病機十九條, nineteen course and rule causing disease), it strengthened Pyonggi(病機, course and rule causing disease) theories. Moreover. he utilized Un-gi (運氣) theory in a real life situation by applying Un-giron(運氣論) to diagnosis like Maekchin(脈診, a method to diagnose by taking the pulse) and to prescription. 5. Modern society is an era in which it is hard to appreciate the principles of the changes due to the various unusual weather. Therefore, it is necessary to make a new paradigm using Un-gi(運氣) theory, like Hagan(河間) did in Kumwon(金元) period. 6. Unusual weather changes and the geriatric diseases such as cancer and diabetes, may have Sang(象) of Hwayol(火熱) theory at the other side. These diseases have been and will create more serious problems in modern society. As a method to solve these problems. it seems to be very important to understand and apply Hagan's(河間) Hawyol(火熱) theory to modern society.
1. Ounyukki(五運六氣) theory was first developed from observation of astronomical phenomena. Natural phenomena were explained and incorporated into the concepts of Yukki(六氣), and Ohaeng(五行, the concept that all matter in the world are comprised of five fundamental elements), during Chon-guk(戰國) and Han(漢) periods. In that period. Kanji(干支, the method to present time with ten and twelve different kinds of symbol's combinations) was used to record Ounyukki(五運六氣). Theoretical study of Un-gi(運氣, the abbreviation of Ounyukki) was almost completed in Un-gichilpyon(運氣七篇) of Naekyong(內經). Un-gi(運氣) theory was further studied and considered to be very important socially, as well as medically, in Tang(唐), Song(宋), Kum(金), and Won(元) periods. Hagan(河間) published various studies based on Un-gi(運氣) theory in Kum won(金元) periods. 2. Hagan(河間) realized the limitation of a remedy method, of Sanghan(傷寒) theory. Therefore, he made an assumption that the prevalence of diseases in his period are closely related to Hwayol(火熱, a fire and a super-heat; two things out of Yukki(六氣)). His new theory was a result of the study on Kyongjon(經典, bibles of the oriental medicine) and the phenomena of nature. 3. Hagan(河間) used a combination of two basic theories of Pimuripsang(比物立象) and Hanhaesungjeron(亢害承制論) to make understood Hwayol(火熱) theory, Pimuripsang(比物立象) theory explains a method to appreciate the essence of things by comparing Sang(象, an expression of how something appears on the outside) and then making another Sang(象) from the comparison. Hanhaesungjeron(亢害承制論) is a theory to emphasize the importance of a balance of Yukki(六氣). It is that, if one of the elements is exceeded, other thing in the other five elements dominate the exceeded thing to control it for the balance between Yukki(六氣). In addition, he articulated P'yobon(標本. inside and outside of a thing) theory to differentiate the disease symptoms. These theories will help to distinguish real and fake symptoms of diseases, on which Hagan(河間) emphasized its importance. 4. Hagan(河間) published a new theory to explain Ounyukki(五運六氣) theory based on the observation of the nature and the experience from medical practice. And he added Chobyonggi(燥病機, course and rule causing disease in dry conditions) to Pyonggishipkujo(病機十九條, nineteen course and rule causing disease), it strengthened Pyonggi(病機, course and rule causing disease) theories. Moreover. he utilized Un-gi (運氣) theory in a real life situation by applying Un-giron(運氣論) to diagnosis like Maekchin(脈診, a method to diagnose by taking the pulse) and to prescription. 5. Modern society is an era in which it is hard to appreciate the principles of the changes due to the various unusual weather. Therefore, it is necessary to make a new paradigm using Un-gi(運氣) theory, like Hagan(河間) did in Kumwon(金元) period. 6. Unusual weather changes and the geriatric diseases such as cancer and diabetes, may have Sang(象) of Hwayol(火熱) theory at the other side. These diseases have been and will create more serious problems in modern society. As a method to solve these problems. it seems to be very important to understand and apply Hagan's(河間) Hawyol(火熱) theory to modern society.
Osteoarthritis is a noninflammatory degenerative disease affecting the articular surfaces and is accompanied by remodeling of the underlying bone. The sympotms of osteoarthritis of the temporomandibular joint are pain in the joint and muscles of mastication, limitation. Osteoarthritis is generally accepted that several factors can contribute to the trauma, aging process, internal derangement and MPDS. Radiographic features of the osteoarthritis are seen flattening of joint, sclerosis on flattened area and osteophyte or anterior lipping. In the past, osteoarthritis was considered to self-limiting disease. Currently, synovial chondromembrane is part of the process of osteoarthritis secondary to trauma. Synovial chondromatosis is an uncommon disease of cartilaginous transformation of synovial membrane with formation of loose bodies within the joint space. The pathogenesis is more an active metaplastic than a neoplastic process. The cause of synovial chondromatosis is unknown. Although trauma and inflammation have all been cited as possible factors in tis pathogenesis. The clinical sign and symptoms are unilateral swelling of the joint region, pain in the joint area and crepitus seem to be the most reliable signs and symptoms. Radiographic evidence of loose bodies may or may not be present. This is a case report of 66 year old female with synovial chondromatosis, that is advanced disease of the osteoarthrits. We treated patient with surgical excision of lose bodies, diskectomy and synovectomy. The defected articular fossa area was reconstructed with temporalis fascia flap. The result was satisfactory.
Nicotine poisoning arising from the use of nicotine patches is rare. However, because nicotine patches are classified as an OTC drug, the risk of misuse or abuse is increasing. Nicotine poisoning using nicotine patches shows an unusual clinical presentation compared to that from oral ingestion of multiple doses of nicotine. We present a case of misused nicotine patches that cause a nicotine poisoning. A thirty-nine year-old healthy man visited the ER with complaints of an intermittent cramping abdominal pain with nausea and vomiting. Upon physical examination, there were no specific findings except increased bowel sounds, and the patient's initial laboratory findings were also unremarkable except for an increased bilirubin level. CT revealed a mild degree of fatty liver. The patient's symptoms did not improve any further with conservative management. During his ED stay, we meticulously took his history again, and we discovered that he had used nicotine patches for three days, six days before admission, and had misused the nicotine patches as NSAID patches. The patient's diagnosis of nicotine poisoning was confirmed by a urine cotinine level ten times the normal value. After a 12-hour stay in the ED, his symptoms disappeared without any specific management.
This research is based on self-filling survey which 656 dental hygienists who work in, seoul, the metropolitan area, jeon-buk area participated on July 2006 through August 2006. This survey was analyzed the relationship between the subjective symptoms(6 types) and outdoor air quality($O_3,\;NO_2,\;CO,\;SO_2,\;PM_{10}$) As follows analyzed results. The health condition of dental hygienists were "Feel Good" more than 50% in last month. The experience the symptoms level is higher then non-experience level in "Dry eye, itch, smarting", "Headaches", "Fatigue and sleepiness", "Red eye", "Hypersensitivity", "Dorsalgia, omarthralgia, cervicodynia". We anticipated that the more experience the subjective symptom the more likely it is that outdoor air quality will be high rate level. But we could not find the uniformity in metropolitan-area and seoul-area. In the case of jeonbuk area, the group's pollution density levels which experienced the subjective symptom were appeared high rate than inexperienced group except $SO_2$. It probably comes from sensibility for an air pollution in this area. Dental hygienists who work in jeonbuk area have an unusual sensibility for an air pollution because outdoor air quality of jeonbuk area was rule good rather than others area. especially $SO_2$ was revealed out even though low rate level in inexperienced group it is that the number of cars in jeonbuk area is increasing rapidly.
Kim, Sang-Gyun;Park, Ju-Hun;Park, Han-Bin;Yoo, Dong-Hwi;Jang, Won-Suk;Shin, Won-Bin;Choi, Kang-Eah;Cho, Hyun-Woo
Journal of Acupuncture Research
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제37권4호
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pp.281-284
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2020
Filum terminale lipoma is an inherited lumbosacral abnormality that can cause tethered cord syndrome. This report describes an unusual case of lumbago and sciatica, pain suspected to be caused by a filum terminale lipoma where a herniated intervertebral disc had occurred. The patient was hospitalized for 43 days and received integrative Korean medicine treatment, including acupuncture, pharmacopuncture, Chuna therapy, cupping therapy, physiotherapy and herbal medicine. Treatment effectiveness was assessed using the numerical rating scale, Oswestry Disability Index, European Quality of Life 5-Dimensions, and patient symptoms. After inpatient treatment, the pain the patient suffered was significantly reduced, and the evaluation indices scores reflected this. Integrative Korean remedies may be an effective option for lower back pain and lower extremity symptoms which are caused by filum terminale lipoma where a herniated intervertebral disc has occurred. Additional clinical research is required to support this observation.
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