Bisphosphonate-related osteonecrosis of the jaw (BRONJ) is a side effect of Bisphosphonates (BPs) use. These days, oral bisphosphonates are normally prescribed to treat osteoporosis. Intravenous BPs are used extensively to treat osteolytic bone lesions related to multiplemyeloma and bone metastasis of solid cancers, breast cancer or prostate cancer. As the prescription of BPs is universalized and the number of people treated with BPs is increasing, an accurate understanding and proper management of BRONJ are required. The aim of this study was to improve the clinicians'understanding of BRONJ by reviewing the literature. To achieve this, this paper introduces case reports as well as the current concept of BRONJ based on the 2009 updates by American Association of Oral and Maxillofacial (AAOMS) including the definition, epidemiology, etiology, diagnosis, treatment and prevention of BRONJ.
Bisphosphonate-Associated Osteonecrosis of the Jaw ; Breast Neoplasms ; Diphosphonates ; Jaw Diseases ; Neoplasm Metastasis ; Osteonecrosis ; Osteoporosis ; Prescriptions ; Prostatic Neoplasms

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BACKGROUND AND OBJECTIVES: Fungal sinusitis has been reported increasingly in immunocompetent patients and the fungus ball is the most frequent and best recognized form of fungal sinusitis. Fungus ball is usually unresponsive to appropriate medical treatment and surgery is the treatment of choice. The aim of this study is to evaluate the incidence, clinical symptoms and signs, and CT findings, the proportion of the patients with fungus ball. MATERIALS AND METHODS: In retrospective study, we reviewed medical records and CT findings of 255 patients with fungus ball confirmed by histopathologically among 6,217 patients who had undergone endoscopic sinus surgery between 1995 and 2004 at five medical centers in Daegu. RESULTS: The symptoms of fungus ball were nasal obstruction (64.4%), rhinorrhea (56.7%), PND (49.2%), cheek pain (26.4%) and foul odor (25.1%). Fungus ball was mostly encountered in only one maxillary sinus (76.4%) of an otherwise healthy person and preoperative computerized tomography (CT) revealed mottled calcific densities within the involved sinus in 55.2% of cases. The success rate of fungus ball surgery by endoscopy was 98.4%. CONCLUSION: This is the retrospective study to evaluate the prevalence of fungus ball (nearly 5%) among the endoscopic sinus surgery. To make a diagnosis of fungus ball, a high index of suspicion to unilateral symptomatic chronic sinusitis, often painful, unresponsive to appropriate medical treatment is necessary and endoscopic sinus surgery is and should remain the mainstay of treatment.
Cheek ; Daegu* ; Diagnosis ; Endoscopy ; Fungi ; Humans ; Incidence ; Maxillary Sinus ; Medical Records ; Nasal Obstruction ; Odors ; Prevalence ; Retrospective Studies ; Sinusitis

Arytenoid cartilage dislocation is not a common complication, but its delayed diagnosis reduces the therapeutic effect of treatment. A male patient underwent reversed total shoulder replacement surgery in the beach chair position under general anesthesia. The patient experienced postoperative hoarseness, and it was revealed that he had right arytenoid dislocation. Voice restoration was accomplished with closed reduction. We discussed changes in patient position during the operation and how they may contribute to the arytenoid dislocation. Flexion and a slight rotation of the neck during the operation can lead to an increase in intracuff pressure of the endotracheal tube. It is necessary to check neck position and monitor intracuff pressure in patients undergoing operations in the beach chair position. Also, the anesthesiologist should suspect arytenoid dislocation in the case of persistent hoarseness after surgery in the beach chair position.
Anesthesia, General ; Arytenoid Cartilage* ; Delayed Diagnosis ; Dislocations* ; Hoarseness ; Humans ; Intubation, Intratracheal ; Male ; Neck ; Patient Positioning ; Shoulder* ; Voice

This study was undertaken to investigate the change of ear swelling response (ESR) of the mice according to repetitive ultraviolet radiation. 100mJ/crn of UVB was irradiated daily for 4 weeks, and a total of 25 C57BL mice were used as subjects. The results were as follows : 1. After 1 day, 2 days and 3 days irradiation of UVB, ESR reached 21.3+/-1.5, 22.3+/-1.1 and 24.3+/-1.6 respectively with increasing tendency, but there was no statistical significance (Wilcoxon rank sum test p>0.05). 2. ESR reached at maximum, 78.0+/-1.8, after 1 week(p<0.01), thereafter ESR decreased gradually with reparative process. 3. Inspite of continued irradiation, ESR decreased gradually after 2 weeks. After 2 weeks, 3 weeks and 4 weeks irradiation, ESR decreased to 51.6+/-11.8, 45.1+/- 3.3 and 42.8+/-6.8 respectively, but, there were still increment of ESR (p<0.01).
Animals ; Ear* ; Mice ; Mice, Inbred C57BL* ; Skin*

According to the increase in use of implants in clinical dentistry, new kinds of complications happen. Complications that can happen during implant placement are bleeding, nerve injury, jaw fracture, fenestration of maxillary sinus or nasal cavity, dehiscence, fenestration, injury of adjacent tooth. And complications that can happen after implant operation are infection, bleeding, hematoma, chronic sinusitis, peri-implantitis. Problems that are confronted during implant placement happen by inadequate preoperative treatment plan, inadequate consideration about individual anatomic difference, inadequate operation process and lack of experience of clinician. It is important that clinicians consider possible complications in advance and make a comprehensive treatment plan. We report the patient who was happened ramus fracture during block bone harvesting from ramus of severely atrophic mandible, the patient who came to emergency ward due to postoperative swelling and bleeding and the patient whose implant was migrated to maxillary sinus with a review of literature.
Dental Implants* ; Dentistry ; Emergency Service, Hospital ; Hematoma ; Hemorrhage ; Humans ; Jaw Fractures ; Mandible ; Mandibular Fractures ; Maxillary Sinus ; Nasal Cavity ; Peri-Implantitis ; Sinusitis ; Tooth

Verrucous carcinoma (VC) is a rare subtype of squamous cell carcinoma that commonly occurs in the oral cavity. However, VC of the facial skin is relatively rare. We report a case of a 91-year-old woman with VC of the facial skin in the left zygoma area. She was diagnosed with actinic keratosis (4 × 3 cm) of the same site approximately 12 years previously, but declined further treatment. The mass was excised with a minimum of 0.4 cm from gross margins with the result of free from tumor of all margins by frozen section, allowing for primary closure after skin undermining. Basal resection was performed in the preplatysmal plane. The diagnosis of VC was confirmed by histopathological examination. Postoperatively, the wound healed without incident and with no signs of facial nerve injury. To our knowledge, this is the first reported case of VC of facial skin arising from actinic keratosis.

PURPOSE: This study was performed to examine the impact of gestational diabetes mellitus (GDM) on perinatal outcomes, especially macrosomia and metabolic complications in Korean women. Subjects and METHODS: We studied perinatal outcomes of 65 women with GDM who delivered a singleton infant and were not complicated by medical disease that might effect the fetal growth, 65 women with normal glucose tolerance were selected to match subject with GDM matched to age, height, and prepregnancy weight. RESULTS: 1) Mean birth weight in infants of mothers with GDM was significantly heavier than that in infants of control mothers, even though the delivery was almost one week earlier (3524 vs. 3364gm). 2) Although length and head circumference of infants were not different between 2 groups, chest circumference and Ponderal index were significantly higher in infants of mothers with GDM. 3) The frequencies of LGA infants and macrosomia were higher in GDM group, but frequency of prematurity was not different between 2 groups. 4) The proportion of disproportionate growth among macrosomic infants was significantly higher in GDM group. 5) In infants of mothers with GDM, the frequencies of LGA infants were not significantly different between 2 groups which were separated according to the fasting glucose level measured at the time of diagnosis. 6) In infants of mothers with GDM, the frequencies of hypoglycemia, polycythemia, hypocalcemia and hyperbilirubinemia were 21.5%, 18.5%, 3.1% and 33.8% respectively. When infants of mothers with GDM were divided to 2 groups (LGA, AGA), the frequencies of polycythemia and hyperbilirubinemia in LGA infants were higher than those in AGA infants (30.8 vs. 10.3% and 50.5 vs. 23.1%, respectively). 6) There was a significant positive correlation between Ponderal index and chest circumference/head circumference ratio (r=0.37, p<0.01). CONCLUSIONS: Inspite of tight metabolic control of mothers with GDM, perinatal complications, such as macrosomia, hypoglycemia, hyperbilirubinemia were frequent in infants of mothers with GDM. In case of infants of mothers with GDM, perinatal complication should be treated earlier or prevented by careful physical examination and intensive management.
Birth Weight ; Diabetes, Gestational* ; Diagnosis ; Fasting ; Female ; Fetal Development ; Glucose ; Head ; Humans ; Hyperbilirubinemia ; Hypocalcemia ; Hypoglycemia ; Infant* ; Mothers* ; Physical Examination ; Polycythemia ; Pregnancy ; Thorax

PURPOSE: The aims of this study were to examine the methylation status of the p16 and MGMT promoters in hepatocellular carcinoma (HCC), and to evaluate the relationship between the loss of gene expression, the promoter methylation status and hepatocarcinogenesis. METHODS: We included 24 HCC tissues and their adjacent non-tumorous tissues and 5 normal liver tissues in our study, and all the specimens were obtained by hepatectomy. The methylation status of the p16 and MGMT promoter regions were evaluated by methylation-specific polymerase chain reaction (MSP) and quantitative analysis by using a Gel-pro analyzer (Media Cybernetics, CA, USA). We also analyzed the p16 and MGMT gene expressions by performing immunohistochemical staining of the HCC tissues. RESULTS: Methylation of the p16 promoter was detected in HCC (100%, 24/24) and the adjacent non-tumorous tissues (79.2%, 19/24), but not in the normal liver tissues. Methylation of the MGMT promoter was detected in the HCC (8.3%, 2/24) and the adjacent non-tumorous tissues (4.2%, 1/24), but not in the normal liver tissues. Methylation positive HCC samples showed the loss of p16 expression in 58.3% (14/24). The loss of the p16 expression in the HCC tissues was well correlated with the increased rate of p16 promoter methylation (p=0.009). When the p16 promoter methylation status of the HCC tissues was higher than that of the adjacent non-tumorous tissues, 77.8% of the cases showed the loss of the p16 expression (p=0.002). No correlation was observed between MGMT promoter methylation and the loss of the gene expression in the HCC tissues. CONCLUSION: These results suggest that methylation of the p16 promoter and the resulting loss of p16 protein expression are significant events in hepatocarcinogenesis, and further studies are needed to evaluate the relationship between the methylation of the MGMT promoter and HCC carcinogenesis.
Carcinogenesis ; Carcinoma, Hepatocellular* ; Cybernetics ; Gene Expression ; Hepatectomy ; Liver ; Methylation* ; Polymerase Chain Reaction ; Promoter Regions, Genetic

PURPOSE: Sensitivity of tumor cells to chemotherapeutic regimen may be accentuated by their abnormal expression of oncogene. p53 is required for the efficient activation of apoptosis following irradiation or treatment with chemotherapeutic agents. The aim of this study was to evaluate the relationship between chemosensitivity and apoptosis related proteins such as p53, bcl-2 in small cell lung cancer cell lines. MATERIAL AND METHODS: Six human small cell lung cancer cell lines, NCI-H69, NCI-H128, NCI-H1436, NCI-H1092, derived from untreated and treated patients were tested for chemo sensitivity and the expression of the p53, bcl-2 genes were examined in each cell lines with western blot analysis. We used 4 drugs including adriamycin, cisplatin, vincristine and VP-16. RESULTS: NCI-H128 was the most sensitive cell line to four drugs. NCI-H82 and NCI-H1092 were highly resistant to VP-16, adriamycin and vincristine and determination of an IC50 was not possible. In western blot analysis, NCI-H128 alone was strong positive to p53 monoclonal antibody and the rest of cell lines were negative. All but NCI-H128 were positive to bcl-2 monoclonal antibody. NCI-H128 which was strong positive to p53 and negative to bcl-2. NCI-H1092 was strong positive to bcl-2 and negative to p53 monoclonal antibody. CONCLUSION: We were not able to explain the expression of p53 in small cell lung cancer cell lines in relation to senitivity to anti-cancer chemotherapeutic agents. But the expression of bcl-2 in small cell lung cancer cell lines was correlated with the chemosensitivity well.
Apoptosis ; Blotting, Western ; Cell Line* ; Cisplatin ; Doxorubicin ; Drug Therapy* ; Etoposide ; Genes, bcl-2 ; Humans ; Inhibitory Concentration 50 ; Oncogenes ; Small Cell Lung Carcinoma* ; Vincristine