PURPOSE: The aim of this study is to report a case of oral bisphosphonate-related osteonecrosis of the jaw (BRONJ) resulting in implant failure. METHODS: A patient suspected of having BRONJ was referred to the Department of Periodontology, Kyung Hee University School of Dentistry for the evaluation and treatment of exposed bone around implants. RESULTS: The patient, who had been taking oral bisphosphonates (BPs) for about a year, was successfully treated with systemic antibiotics, chlorhexidine mouth rinse, explantation, and surgical debridement of necrotic bone. CONCLUSIONS: The results of this case suggest that a patient taking BPs orally should be treated cautiously. Appropriate management including cessation of BPs and respective dental treatment may reduce the development of BRONJ.
Anti-Bacterial Agents ; Bisphosphonate-Associated Osteonecrosis of the Jaw ; Chlorhexidine ; Debridement ; Dentistry ; Diphosphonates ; Humans ; Mouth ; Osteonecrosis ; Osteoporosis

PURPOSE: Pink gingival esthetic especially on the anterior teeth has been an important success criterion in implant-supported restoration. Inter-implant papillae are a critical factor for implant esthetics, and various techniques for inter-implant papilla reconstruction have been introduced. The aim of this study is to suggest and evaluate a surgical technique for reconstructing inter-implant papillae. METHODS: A 28-year-old man had an implant placed on the #13 and #14 area. Four months after implant placement, a second stage surgery was planned for inter-implant papilla reconstruction. At the time of the abutment connection, I-type incisions were performed on the #13i & #14i area followed by full-thickness flap elevation and connection of a healing abutment on underlying fixtures without suture. RESULTS: Two weeks after the second stage implant surgery, soft tissue augmentation between the two implants was achieved. CONCLUSIONS: I-shaped incisions for papilla reconstruction performed during the second stage implant surgery were useful for inter-implant papilla reconstruction and showed a good esthetic result.
Adult ; Dental Implants ; Dental Papilla ; Esthetics ; Esthetics, Dental ; Humans ; Sutures ; Tooth

PURPOSE: To develop the dose volume histogram (DVH) management software which guides the evaluation of radiotherapy (RT) plan of a new case according to the biological consequences of the DVHs from the previously treated patients. MATERIALS AND METHODS: We determined the radiation pneumonitis (RP) as an biological response parameter in order to develop DVH management software. We retrospectively reviewed the medical records of lung cancer patients treated with curative 3-dimensional conformal radiation therapy (3D-CRT). The biological event was defined as RP of the Radiation Therapy Oncology Group (RTOG) grade III or more. RESULTS: The DVH management software consisted of three parts (pre-existing DVH database, graphical tool, and Pinnacle3 script). The pre-existing DVH data were retrieved from 128 patients. RP events were tagged to the specific DVH data through retrospective review of patients' medical records. The graphical tool was developed to present the complication histogram derived from the pre-existing database (DVH and RP) and was implemented into the radiation treatment planning (RTP) system, Pinnacle3 v8.0 (Phillips Healthcare). The software was designed for the pre-existing database to be updated easily by tagging the specific DVH data with the new incidence of RP events at the time of patients' follow-up. CONCLUSION: We developed the DVH management software as an effective tool to incorporate the phenomenological consequences derived from the pre-existing database in the evaluation of a new RT plan. It can be used not only for lung cancer patients but also for the other disease site with different toxicity parameters.
Humans ; Incidence ; Lung Neoplasms ; Medical Records ; Radiation Pneumonitis ; Retrospective Studies

The funding acknowledgment in this article was partially omitted as published.

Trisomy 9p syndrome was first described by Rethore et al in 1970 and about 100 cases have been reported since. The phenotypic spectrum of this syndrome is characterized by craniofacial malformation, facial deformity, skeletal and dermatoglyphic anomalies with variable degrees of mental retardation. We experienced a case of partial trisomy 9 syndrome in a 15-month-old female who had multiple congenital anomalies of frontal bossing, oblique antimongoloid palpebral fissures, enophthalmos, hypertelorism, globular prominent nose, down-turned mouth, prominent low-set ears, simian creases of both hands, clinodactyly and single crease of 5th finger, congenital dislocation of both knees and mental retardation. In cytogenetic studies using G banding technique and fluorescent in situ hybridization(FISH), she presented with an extra derivative chromosome No. 9. The karyotype of the patient was confirmed as 47,XX,+der (9),t (6:9) (q27;q21.2) mat. We report the case with the review of the associated literatures.
Congenital Abnormalities ; Cytogenetics ; Dermatoglyphics ; Dislocations ; Ear ; Enophthalmos ; Female ; Fingers ; Hand ; Humans ; Hypertelorism ; Infant ; Intellectual Disability ; Karyotype ; Knee ; Mouth ; Nose ; Trisomy*

BACKGROUND: The interest of medicine was moved from disease treatment to disease prevention and health promotion. Especially, there has been marked increased interest in health promotion recently. Perception and health behaviors held or acquired during medical training can influence the acceptance and prevention strategies. This exploratory study surveyed medical and non-medical student to assess both preventive health behaviors and perception, to find relations of personal behaviors and corresponding perception. METHODS: This survey were conducted 140 medical students and 131 non-medical students in one big city. Data were obtained by self-reported questionnaire. Weschler survey was adapted to assess perception toward preventive behavior, and Fantastic lifestyle was adapt,ed to assess health behavior. RESULTS: Among the questionnaire of perception of preventive behavior, quitting cigarette smoking ranked highest frequency as very important in medical student. In non-medical student, use seat-belt is ranked highest frequency. Mean score of FANTASTIC lifestyle is 29.98 in medical student, 28.86 in non-medical. The result show significant relationship between st,udent-reported behavior and corresponding perception in 6 qestionnaire that is eat breakfast, moderate or no alcohol use, eliminate smoking, use seat belt, limit coffee, get seven hours sleep. CONCLUSIONS: In comparing medical and non-medical students, health perception and health behavior were no significant difference. Overall, the result indicated that the preponderance of respondents that is engaging in health behaviors are high in health perception.
Breakfast ; Coffee ; Surveys and Questionnaires ; Health Behavior* ; Health Promotion ; Humans ; Life Style ; Seat Belts ; Smoke ; Smoking ; Students, Medical

A giant cell tumor of bone is a benign bone tumor, but has very high local recurrence rate and, very rarely metastasizes to the lung or a distant area. We report a case of a 29-year-old male patient presenting with a metastatic giant cell tumor of the soft tissue of the chest wall, who underwent a total resection of the radius for recurrence of the giant cell tumor. The tumor was not related to any bony structure of the thorax. We resected the tumor with a wide surgical margin. No evidence of malignancy was seen in the frozen and permanent pathological report.
Adult ; Giant Cell Tumor of Bone ; Giant Cell Tumors* ; Giant Cells* ; Humans ; Lung ; Male ; Radius ; Recurrence ; Thoracic Wall* ; Thorax

PURPOSE: We analyzed 10 cases of intraosseous lipoma to elucidate the clinical, radiographic and pathological features, and studied the correlation between of the radiographic and pathological findings. MATERIALS AND METHODS: Ten cases of 9 patients were the subjects of this study. One patient had intraosseous lipoma in bilateral calcaneus.For the analysis of clinical features, medical records were reviewed. The simple x-ray, MRI and CT images were reviewed. The MRI examinations included T1-weighted, T2-weighted and fat-suppressed (STIR) images in all cases. Histological findings were reviewed and classified with Milgram's stage classification, and the radiographic findings also in 3 stages, and correlation of radiographic and histological stage was studied. RESULTS: The mean age of the patients was 39 years (range, 34-60 years). Seven patients were men and three were women. The meansize of the lesion was 3.4 cm (range, 2.0-5.0 cm). The most common anatomical location was calcaneus as 7 cases. Only four patients complained pain as symptom and six patients were asymptomatic. We had curettage and bone graft for the treatment. There were nolocal recurrence or malignant change during the follow up. With Milgram's classification, two cases were stage I, four were stage II and the other four were stage III. In radiographic stage, two cases were stage I, three were stage II and five were stage III. The radiographicstages were very well correlated to the histological stage. CONCLUSION: Intraosseous lipomas had characteristic radiographic and histological features according to the presenting stages, and their radiographic findings were very well correlated to the histological findings.
Calcaneus ; Classification ; Curettage ; Female ; Follow-Up Studies ; Humans ; Lipoma* ; Magnetic Resonance Imaging ; Male ; Medical Records ; Recurrence ; Transplants

The appearance of a tumor in the chest wall is rare compared to that in any other part of the body. It can be classified into benign and malignant types and can be located in the rib, clavicle, sternum, cartilage and soft tissues. Tumors that are metastatic are commonly located in the lung, breast, bone and pleura. But, the soft tissue mass of anterior chest wall is rarely metastasized from a distant organ that is not confined to the thoracic cavity. This and thus has rarely been described. A 68-year-old man was admitted to our hospital with a chief complaint of resting dyspnea. A huge non-tender mass of about 10*15 cm in size was visible on his left lower anterior chest wall. We pathologically confirmed that the mass was a metastatic renal cell carcinoma of clear cell type by incision biopsy. Through an incision biopsy, the mass was pathologically confirmed as a metastatic renal cell carcinoma of the clear cell type.
Aged ; Biopsy ; Breast ; Carcinoma, Renal Cell* ; Cartilage ; Clavicle ; Dyspnea ; Humans ; Lung ; Neoplasm Metastasis* ; Pleura ; Ribs ; Sternum ; Thoracic Cavity ; Thoracic Wall* ; Thorax*

Ovarian metastases represent about 3-5% of all ovarian malignancies. Most of these tumors originate in the digestive tract and cholangiocarcinoma rarely involves the ovary. A 60-year-old woman was admitted for the investigation of abdominal distension that had lasted 1 week. One and a half years prior, the patient had undergone choledochal cyst excision, Roux-en Y hepaticojejunostomy and cholecystectomy. Computed tomography scans of the abdomen revealed a papillary mass in the remnant distal common bile duct and enlargement of both ovaries with a huge amount of ascites. An explorative laparotomy disclosed no peritoneal seeding with resectable cholangiocarcinoma and bilateral ovarian mass. Pylorus-preserving pancreatoduodenectomy and bilateral salphingo-oophorectomy with hysterectomy were performed. Histologically, it was a well-differentiated adenocarcinoma and all surgical margins were free of tumor. Both ovarian masses were consistent with metastatic adenocarcinoma from the common bile duct. The patient received six cycles of postoperative adjuvant systemic chemotherapy, dying after 10 months due to pulmonary embolism.
Abdomen ; Adenocarcinoma ; Ascites ; Cholangiocarcinoma ; Cholecystectomy ; Choledochal Cyst* ; Common Bile Duct* ; Drug Therapy ; Female ; Gastrointestinal Tract ; Humans ; Hysterectomy ; Laparotomy ; Middle Aged ; Neoplasm Metastasis* ; Ovarian Neoplasms ; Ovary ; Pancreaticoduodenectomy ; Pulmonary Embolism