• Journal of the korean academy of Pediatric Dentistry
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• v.46 no.3
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• pp.239-246
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• 2019

The purpose of this study was to examine dental complications and to evaluate the effects of initial treatment age, treatment modalities, and treatment duration on the disorder after radiation and chemotherapy in pediatric cancer patients. For 93 children with clinical and radiographic data, the number of teeth, the morphology of teeth, the shape of the roots, and development status of the dentition were evaluated. Dental development disorders were found in 61.3% of the children. The mostly found abnormality was root deformity with the prevalence of 31.2%. In children submitted to the therapy before the age of 6, the number of missing teeth (p = 0.029) and microdontia (p = 0.003) were greater compared to the children who started to receive the treatment after the age of 6. The combination of radiation and chemotherapy showed significantly greater incidences of missing teeth (p = 0.030), microdontia (p = 0.046), and root deformity (p = 0.009) when compared with the sole application of chemotherapy. When the children were submitted to anticancer therapy for 18 months or longer duration, greater number of missing teeth (p = 0.032), microdontia (p = 0.011), root deformity (p = 0.025), and total number of teeth affected (p = 0.036) were observed compared with duration less than 18 months. The number of dental abnormalities increased when the children were treated at earlier ages, with combination of radiation and chemotherapy, and for longer period of time.

• The Journal of Korea Assosiation for Disability and Oral Health
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• v.15 no.1
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• pp.55-59
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• 2019

Pierre Robin sequence(PRS) is characterized by a triad of clinical signs: micrognathia, glossoptosis and cleft palate. These anatomical deformities of PRS predispose patients to respiratory problems and feeding difficulties at birth. Maintaining oral hygiene and enduring dental treatment are complicated by their general conditions of PRS patients. We present a case of dental treatment of PRS patient under general anesthesia. A 3-year-old boy with PRS visited Seoul National University Dental Hospital for caries treatment. Clinical and radiographic examinations revealed multiple carious lesions. Considering the patient's medical condition and compliance of treatment, dental treatment under general anesthesia was decided. Despite expected challenges of managing the airway of the patient, intubation was performed successfully. The patient was treated with pulp treatments and restorations using composite resin and stainless steel crowns. No complications were observed during and after the procedure.

• The Journal of Korea Assosiation for Disability and Oral Health
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• v.15 no.1
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• pp.74-78
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• 2019

Atypical teratoid rhabdoidal tumor(AT/RT) is a rare and fast-growing tumor usually diagnosed in childhood. Routine magnetic resonance imaging(MRI) assessment of AT/RT patients is done to detect metastatic tumors and recurrent lesions. The purpose of this case report is to present a case about caries treatment of a 3-year-8-month old female patient with AT/RT under general anesthesia. A 3-year-8-month old patient with AT/RT visited Seoul National University Dental Hospital for caries treatment. At the first dental visit, she was receiving chemotherapy. Multiple caries were observed from clinical and radiographic examination. The dental procedure was successfully performed under general anesthesia. Patients with brain tumor may take routine MRI to detect metastatic tumors and recurrent lesions. Dentists should take into consideration of possible dislodgement of restoration by ferromagnetic properties and artifact formation on MRI image. Ready-made zirconia crowns can be a good restoration option for such patients.

• The Journal of Korea Assosiation for Disability and Oral Health
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• v.15 no.1
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• pp.60-64
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• 2019

Swyer-James syndrome (SJS), also known as Swyer-James-MacLeod syndrome and unilateral hyperlucent lung syndrome, is rare acquired pulmonary disorder develops secondary to infectious etiologies in early childhood. Viral respiratory infection such as adenoviruses or Mycoplasma pneumoniae in infancy or early childhood rarely cause Swyer-James syndrome. It is generally characterized on radiographs by a unilateral small lung with hyperlucency and air trapping on expiration. In many cases unaffected lung tissue functions normally, compensating for affected lung portion. Preoperative assessment is needed to determinate individual's pulmonary function. A 4-year-old boy with Swyer-James syndrome visited Seoul National University Dental Hospital Department of pediatric dentistry for caries treatment. Clinical and radiographic examinations revealed multiple carious lesions on deciduous teeth. Considering patient's underling disease, age, and level of cooperation, dental treatment under general anesthesia was scheduled. Dental treatment was done with composite resin and stainless-steel crown. Since ventilation of Swyer-James syndrome patients was diminished because of airway obstruction, close monitoring of ventilation is necessary during dental treatment. Considering pulmonary pathology, general anesthesia rather than sedation is recommended when special behavior management is required for dental treatment. Swyer-James syndrome patients can tolerate general anesthesia and surgery well, according to several reports.

• The Journal of Korea Assosiation for Disability and Oral Health
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• v.15 no.1
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• pp.79-83
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• 2019

Treacher Collins syndrome(TCS) is an autosomal craniofacial development disorder which results from mutations in the gene TCOF1. Major features include midface hypoplasia, micrognathia, microtia, conductive hearing loss. Oral manifestations are characterized by cleft palate, shortened soft palate, malocclusion, anterior open bite and enamel hypoplasia. The purpose of this presentation is to describe the interesting aspects of dental treatment of a patient with TCS. A 6-year-old boy with TCS visited Seoul National University Dental Hospital for dental caries. Multiple caries was observed from clinical and radiographic examination. Because of multiple caries and behavior management ploblem, dental treatment under general anesthesia was planned. Treatment of posterior teeth was performed and some primary teeth were extracted. General anesthesia was induced and maintained with sevoflurane, nitrous oxide and oxygen. Under general anesthesia, successful dental procedure was done. Considering behavior management problem and medical condition of patient with TCS, general anesthesia can be useful.

• Journal of Periodontal and Implant Science
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• v.49 no.1
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• pp.2-13
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• 2019

Purpose: The aim of this study was to conduct a histologic evaluation of irradiated calvarial defects in rats 4 weeks after applying fibroblast growth factor-2 (FGF-2) with hyaluronan or biphasic calcium phosphate (BCP) block in the presence or absence of adjunctive hyperbaric oxygen (HBO) therapy. Methods: Twenty rats were divided into HBO and non-HBO (NHBO) groups, each of which was divided into FGF-2 and BCP-block subgroups according to the grafted material. Localized radiation with a single 12-Gy dose was applied to the calvaria of rats to simulate radiotherapy. Four weeks after applying this radiation, 2 symmetrical circular defects with a diameter of 6 mm were created in the parietal bones of each animal. The right-side defect was filled with the materials mentioned above and the left-side defect was not filled (as a control). All defects were covered with a resorbable barrier membrane. During 4 weeks of healing, 1 hour of HBO therapy was applied to the rats in the HBO groups 5 times a week. The rats were then killed, and the calvarial specimens were harvested for radiographic and histologic analyses. Results: New bone formation was greatest in the FGF-2 subgroup, and improvement was not found in the BCP subgroup. HBO seemed to have a minimal effect on new bone formation. There was tendency for more angiogenesis in the HBO groups than the NHBO groups, but the group with HBO and FGF-2 did not show significantly better outcomes than the HBO-only group or the NHBO group with FGF-2. Conclusions: HBO exerted beneficial effects on angiogenesis in calvarial defects of irradiated rats over a 4-week healing period, but it appeared to have minimal effects on bone regeneration. FGF-2 seemed to enhance new bone formation and angiogenesis, but its efficacy appeared to be reduced when HBO was applied.

• Journal of Dental Rehabilitation and Applied Science
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• v.36 no.4
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• pp.272-281
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• 2020

Agenesis of permanent tooth in adolescent patients can be treated either by orthodontic treatment for space closure or by maintaining the space until implant restoration can be carried out in adult. However, gradual atrophy of alveolar bone width makes it difficult to restore the prosthesis in the future or may cause unaesthetic results. Therefore, maintaining of not only the missing space but also the alveolar bone width should be considered. This case is a treatment whereby a temporary replacement of missing 2 mandibular incisors in adolescent patient was carried out using 2 temporary anchorage devices (TADs). Two TADs were placed horizontally 2 - 3 mm below the top of alveolar ridge, and fixed with artificial teeth by stainless steel wires extended. During the 2 year follow-up, neither gingival inflammation nor loss of the TADs have occurred. In the radiographic evaluation, the growth of the adjacent alveolar bone was not inhibited, and the width of the alveolar bone was maintained.

• Journal of the Korean Society of Radiology
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• v.15 no.1
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• pp.21-28
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• 2021

Computed tomography (CT) has the problem of having more radiation exposure compared to other radiographic apparatus. There is a low-dose imaging technique for reducing exposure, but it has a disadvantage of increasing noise in the image. To compensate for this, various noise reduction algorithms have been developed that improve image quality while reducing the exposure dose of patients, of which the median modified Wiener filter (MMWF) algorithm that can be effectively applied to CT devices with excellent time resolution has been presented. The purpose of this study is to optimize the mask size of MMWF algorithm and to see the excellence of noise reduction of MMWF algorithm for existing algorithms. After applying the MMWF algorithm with each mask sizes set from the MASH phantom abdominal images acquired using the MATLAB program, which includes Gaussian noise added, and compared the values of root mean square error (RMSE), peak signal-to-noise ratio (PSNR), coefficient correlation (CC), and universal image quality index (UQI). The results showed that RMSE value was the lowest and PSNR, CC and UQI values were the highest in the 5 x 5 mask size. In addition, comparing Gaussian filter, median filter, Wiener filter, and MMWF with RMSE, PSNR, CC, and UQI by applying the optimized mask size. As a result, the most improved RMSE, PSNR, CC, and UQI values were showed in MMWF algorithms.

• Journal of Korean Neurosurgical Society
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• v.64 no.5
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• pp.791-798
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• 2021

Objective : The period of mechanical ventilator (MV)-dependent respiratory failure after cervical spinal cord injury (CSCI) varies from patient to patient. This study aimed to identify predictors of MV at hospital discharge (MVDC) due to prolonged respiratory failure among patients with MV after CSCI. Methods : Two hundred forty-three patients with CSCI were admitted to our institution between May 2006 and April 2018. Their medical records and radiographic data were retrospectively reviewed. Level and completeness of injury were defined according to the American Spinal Injury Association (ASIA) standards. Respiratory failure was defined as the requirement for definitive airway and assistance of MV. We also evaluated magnetic resonance imaging characteristics of the cervical spine. These characteristics included : maximum canal compromise (MCC); intramedullary hematoma or cord transection; and integrity of the disco-ligamentous complex for assessment of the Subaxial Cervical Spine Injury Classification (SLIC) scoring. The inclusion criteria were patients with CSCI who underwent decompression surgery within 48 hours after trauma with respiratory failure during hospital stay. Patients with Glasgow coma scale 12 or lower, major fatal trauma of vital organs, or stroke caused by vertebral artery injury were excluded from the study. Results : Out of 243 patients with CSCI, 30 required MV during their hospital stay, and 27 met the inclusion criteria. Among them, 48.1% (13/27) of patients had MVDC with greater than 30 days MV or death caused by aspiration pneumonia. In total, 51.9% (14/27) of patients could be weaned from MV during 30 days or less of hospital stay (MV days : MVDC 38.23±20.79 vs. MV weaning, 13.57±8.40; p<0.001). Vital signs at hospital arrival, smoking, the American Society of Anesthesiologists classification, Associated injury with Injury Severity Score, SLIC score, and length of cord edema did not differ between the MVDC and MV weaning groups. The ASIA impairment scale, level of injury within C3 to C6, and MCC significantly affected MVDC. The MCC significantly correlated with MVDC, and the optimal cutoff value was 51.40%, with 76.9% sensitivity and 78.6% specificity. In multivariate logistic regression analysis, MCC >51.4% was a significant risk factor for MVDC (odds ratio, 7.574; p=0.039). Conclusion : As a method of predicting which patients would be able to undergo weaning from MV early, the MCC is a valid factor. If the MCC exceeds 51.4%, prognosis of respiratory function becomes poor and the probability of MVDC is increased.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.21 no.12
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• pp.43-51
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• 2020

This study examined how the eight-week spinal stabilization exercise program affects the cervical disability index, postural balance ability, and body shape change. The exercise program performed 60 minutes of spinal stabilization exercise three times a week for eight weeks. Sixteen patients with chronic neck pain, who complained of neck pain for six months, were classified into exercise group (n=8 patients) and control group (n=8 patients). The results before and after the eight-week exercise program were observed. Significant differences were observed in the time, group, and interaction of the neck disability index (p<.05). The balance ability showed significant interaction effects between the groups and periods (p<.05). Significant differences were noted in the timing and interaction in the pelvic inclination angle in posture change (p<.05), and there were significant differences in the group, timing, group, and interaction in the cervical and shoulder position angles (p<.05). The above results showed that the spinal stabilization exercise significantly improved the cervical disability index, balance ability change, and body shape change in patients with chronic neck pain. Future studies will analyze the specific changes in spinal structure through radiographic imaging to increase the validity of spinal stabilization exercise.