• Imaging Science in Dentistry
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• v.51 no.1
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• pp.17-25
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• 2021

Purpose: This study was performed to investigate mandibular canal displacement in patients with ameloblastoma using a 3-dimensional mirrored-model analysis. Materials and Methods: The sample consisted of computed tomographic scans of patients with ameloblastoma (n=10) and healthy controls (n=20). The amount of mandibular canal asymmetry was recorded as a continuous variable, while the buccolingual (yaw) and supero-inferior (pitch) directions of displacement were classified as categorical variables. The t-test for independent samples and the Fisher exact test were used to compare groups in terms of differences between sides and the presence of asymmetric inclinations, respectively (P<0.05). Results: The length of the mandibular canal was similar on both sides in both groups. The ameloblastoma group presented more lateral (2.40±4.16 mm) and inferior (-1.97±1.92 mm) positions of the mental foramen, and a more buccal (1.09±2.75 mm) position of the middle canal point on the lesion side. Displacement of the mandibular canal tended to be found in the anterior region in patients with ameloblastoma, occurring toward the buccal and inferior directions in 60% and 70% of ameloblastoma patients, respectively. Conclusion: Mandibular canal displacement due to ameloblastoma could be detected by this superimposed mirrored method, and displacement was more prevalent toward the inferior and buccal directions. This displacement affected the mental foramen position, but did not lead to a change in the length of the mandibular canal. The control group presented no mandibular canal displacement.

• Journal of Dental Anesthesia and Pain Medicine
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• v.23 no.5
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• pp.273-280
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• 2023

Background: Intraoral local anesthesia is essential for delivering dental care; however, injection of this local anesthetic is perceived as the most painful and distressing agent for children, parents, and healthcare providers. Reducing pain as much as possible is essential to ensure smooth subsequent treatment procedures, especially in pediatric dentistry. In clinical practice, oral sucrose administration has been reported to decrease the pain during heel lance and cold pressor tests in neonates and children. This study aimed to determine whether the prior administration of a 30% sucrose solution reduced the pain related to inferior alveolar nerve block in children. Methods: A total of 42 healthy children aged 7-10 years requiring dental treatment of mandibular molars involving inferior alveolar nerve block were recruited. The participants' demographic details were recorded, height and weight were measured, and the anesthetic injection was delivered after receiving the respective intraoral sucrose solution and distilled water by the intervention (group 1) and control (group 2) group participants for 2 min. The subjective pain perceived during injection was measured using an animated emoji scale. The pain scores between the groups were compared using the Mann-Whitney U test. Results: The median pain score and range for the intervention and control groups were 4 (2 - 6) and 6 (4 - 8), respectively, and statistically significant differences (P < 0.001) were observed in the intervention group. Age, sex, height, and weight did not influence the analgesic effect of the sucrose solution. Conclusion: Oral administration of sucrose may relieve pain associated with inferior alveolar nerve block in children.

• Korean Journal of Radiology
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• v.20 no.6
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• pp.931-938
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• 2019

Objective: To compare inferior capsular redundancy by using magnetic resonance arthrography (MRA) images in patients with multidirectional instability (MDI) of the shoulder and control subjects without instability and thereby develop a screening method to identify the presence of shoulder MDI. Materials and Methods: The MRA images of patients with MDI of the shoulder (n = 65, 57 men, 8 women; mean age, 24.5 years; age range, 18-42 years) treated over an eight-year period were retrospectively reviewed; a control group (n = 65, 57 men, 8 women; mean age, 27.4 years; age range, 18-45 years) without instability was also selected. The inferior capsular redundancy was measured using a new method we named the glenocapsular (GC) ratio method. MRA images of both groups were randomly mixed together, and two orthopedic surgeon reviewers measured the cross-sectional areas (CSAs) and sagittal capsule-head ratios on oblique sagittal images, as well as the axial capsule-head ratios on axial images and GC ratios on oblique coronal images. Results: The CSAs and GC ratios were significantly higher in patients than in controls (both, p < 0.001); however, the sagittal capsule-head ratios and axial capsule-head ratios were not significantly different (p = 0.317, p = 0.053, respectively). In addition, GC ratios determined the presence of MDI more sensitively and specifically than did CSAs. A GC ratio of > 1.42 was found to be most suggestive of MDI of the shoulder, owing to its high sensitivity (92.3%) and specificity (89.2%). Conclusion: GC ratio can be easily measured and used to accurately screen for MDI of the shoulder.

• Journal of Cerebrovascular and Endovascular Neurosurgery
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• v.25 no.4
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• pp.452-461
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• 2023

The Anterior Inferior Cerebellar Artery-Posterior Inferior Cerebellar Artery (AICA-PICA) common trunk is a rare variant of cerebral posterior circulation in which a single vessel originating from either the basilar or vertebral arteries supplies both cerebellum and brainstem territories. We present the first case of an unruptured right AICA-PICA aneurysm treated with flow diversion using a Shield-enhanced pipeline endovascular device (PED, VANTAGE Embolization Device with Shield Technology, Medtronic, Canada). We expand on this anatomic variant and review the relevant literature. A 39-year-old man presented to our treatment center with vertigo and right hypoacusis. The initial head CT/CTA was negative, but a 4-month follow-up MRI revealed a 9 mm fusiform dissecting aneurysm of the right AICA. The patient underwent a repeat head CTA and cerebral angiogram, which demonstrated the presence of an aneurysm on the proximal portion of an AICA-PICA anatomical variant. This was treated with an endovascular approach that included flow diversion via a PED equipped with Shield Technology. The patient's post-procedure period was uneventful, and he was discharged home after two days with an intact neurological status. The patient is still asymptomatic after a 7-month follow-up, with MR angiogram evidence of stable aneurysm obliteration and no ischemic lesions. Aneurysms of the AICA-PICA common trunk variants have a high morbidity risk due to the importance and extent of the territory vascularized by a single vessel. Endovascular treatment with flow diversion proved to be both safe and effective in obliterating unruptured cases.

• Anatomy and Cell Biology
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• v.55 no.2
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• pp.135-141
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• 2022

Although adequate venous drainage from the cranium is imperative for maintaining normal intracranial pressure, the bony anatomy surrounding the inferior petrosal sinus and the potential for a compressive canal or tunnel has, to our knowledge, not been previously investigated. One hundred adult human skulls (200 sides) were observed and documented for the presence or absence of an inferior petrosal groove or canal. Measurements were made and a classification developed to help better understand their anatomy and discuss it in future reports. We identified an inferior petrosal sinus groove (IPSG) in the majority of specimens. The IPSG began anteriorly where the apex of the petrous part of the temporal bone articulated with the sphenoid part of the clivus, traveled posteriorly, in a slight medial to lateral course, primarily just medial to the petro-occipital fissure, and ended at the anteromedial aspect of the jugular foramen. When the IPSGs were grouped into five types. In type I specimens, no IPSG was identified (10.0%), in type II specimens, a partial IPSG was identified (6.5%), in type III specimens, a complete IPSG (80.0%) was identified, in type IV specimens, a partial IPS tunnel was identified (2.5%), and in type V specimens, a complete tunnel (1.0%) was identified. An improved knowledge of the bony pathways that the intracranial dural venous sinuses take as they exit the cranium is clinically useful. Radiological interpretation of such bony landmarks might improve patient diagnoses and surgically, such anatomy could decrease patient morbidity during approaches to the posterior cranial fossa.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.23 no.5
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• pp.461-470
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• 2001

A unhealthy 58-year-old male patient required extraction of left upper second molar due to advanced periodontitis. Lidocaine contained 1 : 100000 epinephrine for left posterior superior alveolar nerve block was administered in the mucobuccal fold above the second molar to be treated at the local private dental clinic. After four hours of posterior superior alveolar block anesthesia, patient feeled double vision and discomfort of eyeball movement. At next day, he complained difficulty of left eyeball movement, vertigo and diplopia. He was referred to our department via local clinic and department of ophthalomology of our hospital. He was treated by medication and eyeball exercise, and then follow up check. The double vision and medial rectus muscle palsy disappeared patially after 2 months of block anesthesia. We described herein an ocular complication of diplopia and inferior rectus muscle palsy after posterior superior alveolar nerve block for extraction of left upper second molar, and review the cause or origin of this case. The autonomic nervous system is presented as the logical basis for the untoward systems of ophthalmologic sign likely to diplopia and inferior rectus muscle palsy, rather then simple circulation of anesthetic solution in the vascular network.

• Journal of Chest Surgery
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• v.28 no.3
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• pp.268-273
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• 1995

Budd- chiari syndrome resulting from a membranous obstruction of the inferior vena cava[IVC is a rare congenital anomaly. From January 1989 to December 1993, 8 cases of IVC obstruction was treated in Kyung Hee Univ. Hospital. There were 2 male and 6 female patients between 34 and 66 years of age[mean 47.3$\pm$11.9 years of age . 4 patients were treated with angioplasty by balloon catheter and 4 patients were treated with operative correction using cardiopulmonary bypass, profound hypothermia and total circulatory arrest. These 4 patients were repaired the constricted IVC with autologous pericardial patch. In surgically treated patients, all of the specimens were confirmed to be membranous web histopathologically. Postoperative outcome in operative correcting patients was uneventful and postoperative angiography showed unobstructed flow through the IVC with filling of the hepatic veins.The above 8 patients were followed up from 10 months to 56 months [ mean 36.43 17.24 months and recurrent IVC obstruction or stenosis was not seen.

• Journal of Korean Neurosurgical Society
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• v.44 no.4
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• pp.205-210
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• 2008

Objective : Aneurysms are very rarely encountered in the distal posterior inferior cerebellar artery (PICA). The authors experienced 5 cases with a distal PICA aneurysm among 368 cases of intracranial aneurysms during the period from January 2003 to January 2008. Here, the authors describe their clinical and surgical experiences and include a review of the relevant literature. Methods : Using radiologic findings and charts, we retrospectively reviewed the surgical results of 5 cases with a distal PICA aneurysm treated from January 2003 to January 2008. Results : The current five cases were composed of four cases of 'Good' and one case of 'Fair'. No postoperative complications occurred other than a ventriculo-peritoneal shunt due to hydrocephalus in Case 2. In all five cases, treatment was successful without neurological deficit. Conclusion : Surgical outcome of PICA aneurysms have been reported to be excellent because the amount of intraparenchymal injury is limited. More clinical experience, microsurgical technique developments, and endovascular surgery advancements are certain to improve treatment outcomes.

• Journal of Korean Neurosurgical Society
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• v.46 no.6
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• pp.577-580
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• 2009

A 47-year-old man presented with a subarachnoid hemorrhage (SAH) and right cerebellar hematoma was referred for evaluation. Cerebral angiography revealed a distal anterior inferior cerebellar artery (AICA) aneurysm associated with an arteriovenous malformation (AVM). Successful obliteration and complete removal of the aneurysm and AVM were obtained using transcortical approach under the guidance of neuronavigation system. The association of a peripheral AICA aneurysm and a cerebellar AVM by the same artery is unique. The reported cases of conventional surgery for this disease complex are not common and their results are variable. Less invasive surgery using image-guided neuronavigation system would be helpful and feasible for a peripheral aneurysm combining an AVM of the posterior fossa in selective cases

• Archives of Plastic Surgery
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• v.32 no.2
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• pp.194-198
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• 2005

In many reports on the reconstruction of an orbital blowout fracture, CT(computed tomography) imaging has been used for postoperative evaluation. However, in most cases, only one plane of the CT scan was presented, which may not be sufficient for accurate evaluation. This study reviewed the CT scans presented in the related 49 articles (56 cases), and investigated our patients (150 cases) to investigate where were the most frequent unfavorable reconstructions, and to determine which planes should be presented for accurate evaluation. One plane of the CT scan was presented in 70% of the cases. On the other hand, 30% of the cases presented two planes of the CT scans. In our cases, the most prevalent sites for an unfavorable reconstruction were the posterior portion of the inferior wall, and the posterior and the inferior portion of the medial wall. In order to accurately evaluate an orbital wall reconstruction, at least two planes of a CT scan are needed. For an inferior wall evaluation, both the middle and the posterior planes of the coronal section or both the coronal and the sagittal sections are necessary. In addition, for the medial wall evaluation, both the axial and the coronal sections or both the middle and the posterior planes of the coronal section are required.