• Archives of Plastic Surgery
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• v.37 no.5
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• pp.691-694
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• 2010

Purpose: Central giant cell granuloma is a rare, benign giant cell tumor which commonly develops in areas near the teeth. It accounts for approximately less than 7% of benign tumors of the mandible. Clinically, central giant cell granuloma is classifed into aggressive and non-aggressive type, and usually requires surgical treatment. There has been no report of central giant cell granuloma in plastic surgery field of the country, and we report a case with a brief review of the diagnosis and treatment of the disease. Methods: A 23-year-old male presented with a hard, non-tender, growing mass with the size of $4.0{\times}3.0\;cm$ on mandible for several months. Computed tomography scan showed a solid mass within thinned outer cortex on mandible. The thinned outer cortex was excised with the mass and the inner cortex was partially removed burring. After the tumor removal, mandible was fixed by reconstruction plate. Results: Pathologic report showed numerous large multinucleated giant cells, diffusely distributed in a background of ovoid-to-spindle-shaped mononuclear cells. There was no evidence of recurrence after 1 year follow up. Bony defect was regenerated and we removed the reconstruction plate. Conclusion: Removal of central giant cell granuloma results in defect of outer cortex, which can be reconstructed by using reconstruction plate, autologous bone graft or bone cement. We used reconstruction plate as a conservative method to induce secondary healing of the outer cortical defect area, which resulted in normal mastication and occlusion with no recurrence.

• Journal of Hospice and Palliative Care
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• v.8 no.1
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• pp.57-64
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• 2005

Cyclooxygenase-2 (COX-2) selective inhibitors were specifically developed to reduce the risks of gastrointestinal bleeding associated with other NSAID drugs. However, the APPROVe (Adenomatous Polyp Prevention on VIOXX) trials revealed that rofecoxib sometimes exerts prothrombotic effects. Meanwhile, cancer patients, who also carry a risk of thrombosis due to a variety of mechanisms, are often treated with COX-2 selective inhibitors, due to their relative gastrointestinal safety. This report concerns the case of a 46-year old woman with advanced cervical cancer, who had been treated with opioids and a COX-2 selective inhibitor (celecoxib) for 2 months, for the relief of pain associated with her cancer. The patient was admitted due to swelling of the left leg, which was also accompanied by pain. A computerized tomography scan revealed deep vein thrombosis occurring in multiple veins of both legs. After the administration of low-molecular weight heparin and oral warfarin, the patient's symptoms were relieved initially. However, her prothrombin time was found to be prolonged, necessitating the discontinuation of anticoagulation therapy. The patient's dyspnea worsened, ultimately resulting in her death. In conclusion, the administration of cox-2 selective inhibitors should be carefully considered in patients with a number of different risk factors, and assessed on a case-by-case basis.

• The Journal of Korean Academy of Prosthodontics
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• v.58 no.4
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• pp.282-289
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• 2020

Purpose: The aim of this in vitro study was to evaluate the accuracy of three different intraoral scanners (IOSs) on digital impressions of different types of endocrown cavity preparations. Materials and methods: Two human mandibular molar teeth were prepared with different endocrown abutment designs: one with a buccal wall (Class 2) and the other without a buccal wall (Class 3). Both cavity designs were scanned using a reference desktop scanner (E3) and three different intraoral scanners: Trios3 (TRI group), Cerec Omnicam (CER group), and i500 (I5 group). The obtained Standard Tessellation Language (.stl) datasets were exported to metrology software. The precision was evaluated based on deviations among repeated scan models recorded by each IOS. The trueness was evaluated based on deviations between the reference data and repeated scans. For detecting interaction, data were statistically analyzed using a univariate analysis of variance (ANOVA) and for analyzing the comparison of the test groups data were analyzed by one-way ANOVA and post-hoc Tukey test at the significance level of .05. Results: The deviation values for both cavity designs in the I5 group were significantly lower than those in the other IOS groups in terms of trueness. For both cavity designs, the TRI group exhibited better precision than the other IOS groups. Conclusion: Different technologies of IOS device's and different endocrown prepration designs affected the accuracy of the digital scans.

• Journal of Gastric Cancer
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• v.10 no.1
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• pp.40-44
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• 2010

The natural history of gastric cancer is unclear. We report here on a rare case of advanced gastric cancer for which we performed curative gastrectomy 78 months after the diagnosis. A 74-year-old woman with epigastric pain underwent esophagogastroscopy in January, 2000 and she was diagnosed with advanced gastric cancer. Suspicious omental cake was noted on CT. After refusing all kinds of treatment, she underwent a follow up CT scan on September, 2002, which no longer suggested omental cake. She once again refused treatment, but she visited the hospital in June, 2006 due to severe epigastric pain and a decreased oral intake. Abdominal CT showed no distant metastasis, and so radical subtotal gastrectomy with regional lymph node dissection was performed in July, 2006 and the TNM stage was T2bN1M0 (stage II).

• Clinical and Experimental Pediatrics
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• v.53 no.2
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• pp.262-266
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• 2010

Tumor necrosis $factor-{\alpha}$ ($TNF-{\alpha}$) is a major proinflammatory cytokine involved in the pathophysiology of juvenile rheumatoid arthritis. Etanercept is an effective inhibitor of $TNF-{\alpha}$ and has shown a beneficial effect in patients with JRA. However, the most important cause of concern related to etanercept administration is infection. We report a case of encephalitis in a JRA patient receiving long-term treatment with etanercept. The patient was a 4-year-old boy with refractory JRA, and he received etanercept subcutaneously at a dose of $0.4\;mg\;kg^{-1}\;day^{-1}$ twice a week for 14 months, along with non-steroidal anti-inflammatory drugs, methotrexate, oral steroids, and sulfasalazine. The patient presented with sudden fever, headache, vomiting, a generalized tonic seizure, and changes in mental status. We suspected a central nervous system infection, and simultaneously administered antibiotics, an antiviral agent, and steroids. After 2 days of hospitalization, his mental function returned to normal, and he showed no further seizure-like movements. Brain magnetic resonance imaging scan of the patient showed a multifocal cortical lesion on both sides of the temporoparietooccipital lobe, which indicated encephalitis. Although we were unable to identify the causative organism of encephalitis, we think that the encephalitis may be attributed to infection, and the use of etanercept may have increased the risk of severe infection. Therefore, etanercept was discontinued and the patient recovered shortly after. To the best of our knowledge, this is the first case of encephalitis in a juvenile rheumatoid arthritis patient treated with etanercept.

• Tuberculosis and Respiratory Diseases
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• v.42 no.4
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• pp.618-623
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• 1995

Cryptococcosis is a systemic mycosis that most often involves the lungs and central nervous system and, less frequently, the skin, skeletal system, and prostate gland. Cryptococcus neoformans, the causative organism, is a yeastlike round or oval fungus, 4 to $6{\mu}m$ in diameter, which is surrounded by a polysaccharide capsule and reproduces by budding and found in soil and other environmental areas, especially those contaminated by pigeon droppings. Humans and animals acquire infection after inhalation of aerosolized spores. Condition or factors that predispose to cryptococcosis include corticosteroid therapy, lymphoreticular malignancies, HIV infection, and sarcoidosis etc. We discribed a case of cryptococcosis involving lung and CNS coincidently without specific underlying disease and the literature on subject were reviewed. A fifty-six year-old previously healthy female presented with headache of 3 months of duration. She had no history suggesting immunologic suppression and we could not find any abnormal laboratory findings including blood sugar, serum immunoglobulin and complement level, HIV antibody, and T cell subsets. Chest roentgenogram and CT scan showed a solitary soft tissue mass in LUL with distal pneumonitis. Brain MRI showed granulomatous lesion in cerebellum and parasagittal cortex of right frontal lobe. The diagnosis was made by bronchoscopic brushing cytology, transthoracic fine needle aspiration, and sputum KOH mount and culture. She was treated 6 weeks course of Amphotericin B and switched to oral fluconazole therapy for 3 months. Her symptoms and X-ray findings were improved gradually and she is now under regular clinical follow up.

• Journal of The Korean Ophthalmological Society
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• v.59 no.12
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• pp.1195-1200
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• 2018

Purpose: To report a case of anterior segment ischemia after superior and inferior rectus muscle surgery in a patient with superior rectus muscle enlargement. This is the first report in the Republic of Korea of anterior segment ischemia after two rectus muscles surgery. Case summary: An 80-year-old male was referred to our clinic with a 3 years history of diplopia. The patient had 30 prism diopters right eye hypertropia in the primary position and downgaze limitation. The orbital computed tomography scan revealed enlargement of the right superior rectus muscle. He underwent right superior rectus recession and inferior rectus resection. On postoperative day 2, slit lamp examination revealed diffuse corneal edema, Descemet's membrane folding, an aqueous flare and a dilated pupil. Treatment with 45 mg oral steroid was initiated, and 1% prednisolone acetate and 0.5% Levofloxacin eye drops were administered. At postoperative 1 month, the patient was orthophoric in the primary position, and there was no corneal edema, pupil abnormality or aqueous flare. Conclusions: Base on the present case, the possibility of anterior segment ischemia should be considered after even two muscles surgery, and older patients with vertical muscle surgery should be considered more carefully.

• Therapeutic Science for Rehabilitation
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• v.11 no.4
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• pp.55-68
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• 2022

Objective : This review aimed to provide information for clinical application by confirming the principles and characteristics of the tool through a review of tongue movement and measurement tools for patients with swallowing disorders. Results : We identified 15 tools used as tongue exercises and measurement tools in the field of dysphagia. According to principle, the tools were classified as either a bulb sensor, resistive sensor sheet, mouthpiece with sensor, or other techniques. The bulb sensor was easy to use but had limitations in fixing the position when measuring tongue pressure. The resistive sensor sheet could be measured at a more stable position than the bulb sensor. A mouthpiece with a sensor could be used in an individual's oral cavity such that the position was fixed when measuring the tongue pressure. Other techniques had the advantage of being wireless and capable of sensing light. Conclusion : Based on this literature review, it is necessary to facilitate the selection of the best tool for quantitative tongue measurement in dysphagia. The review can also be used to develop a Korean tongue movement tool model that can be used in hospitals and community centers.

• The Korean Journal of Nuclear Medicine Technology
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• v.17 no.1
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• pp.48-52
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• 2013

Purpose: Bed, living a long time is required in adult patients with brain lesions such as stroke, traumatic brain injury, and Parkinson's disease, causing pneumonia and respiratory diseases may be due to aspiration of food or saliva. In patients with recurrent pneumonia or pulmonary symptoms, there is a need to determine the possibility of pulmonary aspiration due to aspiration of saliva. Materials and Methods: Saliva due to aspiration pneumonia diagnosis in patients with brain lesions request for inspection to the Department of Nuclear Medicine, 10 patients (male 6, female 4) were included in this study. Patients were fasted before the test, $^{99m}Tc_{O4}$ 185 MBq (5 mCi) of less than 1 mL of solution was administered in the oral cavity. Administration and 20 minutes of dynamic imaging acquisition, and immediately after that the static images were acquired. Delayed scan after 2-4 hours if necessary. Results: Positivity rate of all 10 patients was 60%. In 4 patients showed positive reactions after the administration of oral cavity in a 20-minute dynamic imaging were able to confirm whether the aspiration. In the remaining 2 patients, four hours of additional delay tests were able to confirm whether the aspiration. Conclusion: Does not require changes in patient posture compared to the other checks that can be diagnosed with aspiration pneumonia. A simple test and takes less time. Therefore be useful in providing information for the diagnosis and treatment modality.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.34 no.2
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• pp.166-179
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• 2008

Excessive concentration of stress which is occurred in occlusion around the implant in case of the implant supported fixed partial denture has been known to be the main cause of the crestal bone destruction. Therefore, it is essential to evaluate the stress analysis on supporting tissue to get higher success rates of implant. The purpose of this study was to evaluate the effects of stress distribution and deformation in 3 different types of three-unit fixed partial denture sup-ported by two implants, using a three dimensional finite element analysis in a three dimensional model of a whole mandible. A mechanical model of an edentulous mandible was generated from 3D scan, assuming two implants were placed in the left premolars area. According to the position of pontic, the experiments groups were divided into three types. Type I had a pontic in the middle position between two implants, type II in the anterior posi-tion, and type III in the posterior position. A 100-N axial load was applied to sites such as the central fossa of anterior and posterior implant abutment, central fossa of pontic, the connector of pontic or the connector between two implants, the mandibular boundary conditions were modeled considering the real geometry of its four-masticatory muscular supporting system. The results obtained from this study were as follows; 1. The mandible deformed in a way that the condyles converged medially in all types under muscular actions. In comparison with types, the deformations in the type II and type III were greater by 2-2.5 times than in the type I regardless of the loading location. 2. The values of von Mises stresses in cortical and cancellous bone were relatively stable in all types, but slightly increased as the loading position was changed more posteriorly. 3. In comparison with type I, the values of von Mises stress in the implant increased by 73% in Type II and by 77% in Type III when the load was applied anterior and posterior respectively, but when the load was applied to the middle, the values were similar in all types. 4. When the load was applied to the centric fossa of pontic, the values of von Mises stress were nearly $30{\sim}35%$ higher in the type III than type I or II in the cortical and cancellous bone. Also, in the implant, the values of von Mises stress of the type II or III were $160{\sim}170%$ higher than in the type I. 5. When the load was applied to the centric fossa of implant abutment, the values of von Mises stress in the cortical and cancellous bone were relatively $20{\sim}25%$ higher in the type III than in the other types, but in the implant they were 40-45% higher in the type I or II than in the type III. According to the results of this study, musculature modeling is important to the finite element analysis for stress distribution and deformation as the muscular action causes stress concentration. And the type I model is the most stable from a view of biomechanics. Type II is also a clinically accept-able design when the implant is stiff sufficiently and mandibular deformation is considered. Considering the high values of von Mises stress in the cortical bone, type III is not thought as an useful design.