Macroglossia can cause dentomusculoskeletal deformities, instability of orthodontic and orthognathic surgical treatment, and create masticatory, speech and airway management problems. To determine whether a reduction glossectomy is necessary, it will important to identify the signs and symptoms of macroglossia. Development of dentoskeletal changes directly related with tongue size, such as an anterior open bite or a Angle Class III malocclusion tendency, would indicate that reduction glossectomy may be beneficial. For reduction glossectomy, several techniques have been reported. However, in most techniques the tip of tongue is removed. So its excision causes the loss of most mobile and sensitive portion of the tongue, and creates ankylosed, globular tongue. To avoid such problems, central tongue reduction technique have been proposed. This article will introduce central tongue reduction for anterior openbite case associated with macroglossia.
Airway Management ; Congenital Abnormalities ; Glossectomy ; Macroglossia* ; Malocclusion ; Malocclusion, Angle Class III ; Open Bite ; Tongue*

PURPOSE: As well as patient survival, the restoration of postoperative function such as ambulation is important in limb salvage operations for treatment of malignant bone tumors involving the proximal femur. The authors analyzed clinical outcomes of limb salvage operations using tumor prostheses for metastatic or primary malignant bone tumors in the proximal femur. MATERIALS AND METHODS: From February 2005 to January 2014, 20 cases (19 patients) with malignant bone tumor involving the proximal femur with pain or complicated pathologic fracture were treated with segmental resection and limb salvage operations with tumor prostheses. Mean age was 63.1 years (range 35-86). Fourteen patients were male and six ones were female. The mean follow-up period was 20 months (1-94 months). There were 15 cases of metastatic bone tumor, 4 cases of osteosarcoma, and 1 case of multiple myeloma. The primary tumors of the metastatic bone tumors included 4 lung cancers, 3 hepatocellular carcinomas, and 3 renal cell carcinomas. Other primary tumors were breast cancer, thyroid cancer, colon cancer, prostate cancer, and malignant spindle cell tumor, each in 1 case. Modular tumor prostheses were used in all cases; (Kotz's(R) Modular Tumor prosthesis (Howmedica, Rutherford, New Jersey) in 3 cases, MUTARS(R) proximal femur system (Implantcast, Munster, Germany) in 17 cases). Perioperative pain was assessed with Visual Analogue Scales (VAS). Postoperative functional outcome was assessed with Musculoskeletal Tumor Society (MSTS) grading system. RESULTS: Out of 20 cases (19 patients), 11 cases (10 patients) survived at the last follow-up. Average postoperative survival of the 9 deceased patients was 10.1 months (1-38 months). VAS score improved from pre-operative average of 8.40 (5-10) to 1.35 (0-3) after operation. Average postoperative MSTS function score was 19.65 (65.50%, 7-28). The associated complications were 2 local recurrences, 3 hematomas, 3 infections, 2 scrotal swellings, and 1 dislocation. There was no case of periprosthetic fracture or loosening. CONCLUSION: Limb salvage operation with tumor prosthesis is an appropriate treatment for early pain reduction and functional restoration in malignant bone tumors in the proximal femur with pain an/or complicated pathologic fractures.
Breast Neoplasms ; Carcinoma, Hepatocellular ; Carcinoma, Renal Cell ; Colonic Neoplasms ; Dislocations ; Female ; Femur* ; Follow-Up Studies ; Fractures, Spontaneous ; Hematoma ; Humans ; Limb Salvage* ; Lung Neoplasms ; Male ; Multiple Myeloma ; Osteosarcoma ; Periprosthetic Fractures ; Prostatic Neoplasms ; Prostheses and Implants* ; Recurrence ; Thyroid Neoplasms ; Walking ; Weights and Measures

BACKGROUND: With the recent development in arterial reconstructive procedure such as percutaneous transluminal coronary angioplasty or atherectomy, the incidence of vascular complications involving femoral artery is increasing due to greater use of larger percutaneous instruments(including arterial sheath) and periprocedural anticoagulant therapy. Femoral pseudoaneurysm requires rapid diagnosis and management to prevent limb ischemia, worsening of the arterial injury or repair of the arterial defect. Recently, accurate diagnosis of these injuries can be made nonivasively with duplex sonography and Doppler color flow imaging, and nonsurgical treatment may be possible by using external compression guided by ultrasound even in patients requiring prolonged anticoagulant therapy. METHOD: Three patients, one undergoing coronary angiography and two undergoing percutaneous transluminal coronary angioplasty, developed expansile groin masses at the vascular access sites diagnosed as femoral artery pseudoaneurysm s by Doppler ultrasound. All patients were hypertensives, taking aspirin and two patients who underwent PTCA received intravenous heparin after procedure. After diagnosis of femoral pseudoaneurysm, all patients underwent mechanical(C-clamp) external compression guided by ultrasound for 3 hours. RESULT: Follow up color flow scans were obtained after 24 hours and in one patients, blood flow in the tract was eliminated but persistent blood flow was observed in two patients who underwent PTCA. Before closure of pseudoaneurysm, one patient needed another 6 hours of ultrasound guided compression and the other needed more 12 hours. All patients were discharged without complication or recurrence of pseudoaneurysm. CONCLUSION: These cases suggest that nonsurgical closure of femoral pseudoaneurysms is feasible even in patients requiring prolonged antiplatelet and anticoagulant therapy.
Aneurysm, False* ; Angioplasty, Balloon, Coronary ; Aspirin ; Atherectomy ; Cardiac Catheterization* ; Cardiac Catheters* ; Coronary Angiography ; Diagnosis ; Extremities ; Femoral Artery ; Follow-Up Studies ; Groin ; Heparin ; Humans ; Incidence ; Ischemia ; Recurrence ; Ultrasonography

PURPOSE: This study aimed to find out whether there are relationships among anatomic characteristics of inferior oblique muscle insertion, corneal diameter, axial length and inferior oblique recession landmark. METHODS: Thirty-one Korean cadaver orbits were dissected to expose the full length of extraocular muscles and sclera, and then we measured the length from the recession landmark of inferior oblique to the lateral edge of insertion of inferior rectus and to the inferior edge of insertion of lateral rectus. RESULTS: The mean of angles between the inferior oblique muscle insertion and lateral rectus direction is 27.9+/-9.0degrees and the range is from 15 degrees to 50 degrees . There is a statistically significant correlation between cord length of 8 mm recession landmark of inferior oblique and angles of inferior oblique insertion with lateral rectus direction. We divided the shapes of inferior oblique insertion into straight and convexed curves. Twelve insertions are straight and thirteen insertions are curved. There is no statistically significant correlation between shape of inferior oblique insertion and cord length from recession landmark. In corneal diameter and axial length, we found correlations with cord length of 8 mm and 10 mm recession landmark of inferior oblique. CONCLUSIONS: We conclud that there are some correlations among anatomic characteristics, axial length and corneal diameter with recession landmark of inferior oblique.
Cadaver ; Muscles ; Orbit ; Sclera

To investigate the relationship between insulin response and morphometric changes of the mitochondria of pancreatic beta-cell, this study was performed using hyperglycemia and streptozotocin as oxidative stresses. Adult and neonatal rats were used. Intravenous glucose tolerance test (IVGTT) and morphologic examination of pancreas using immunohistochemical stain, in situ end-labeling method and electron microscopic study were performed. Various mitochondrial parameters were measured by image analyzer. Immunohistochemical stain revealed a markedly reduced islet size and decreased number of beta-cells and the increased number of non-beta-cell in adult and neonatoal streptozotocin group, and the appearance of insulin positive cells throughout the exocrine parenchyma in neonatal streptozotocin group. Three days after injection of streptozotocin in adult streptozotocin group, TUNEL stain showed increased apoptotic cells in islets. Ultrastructurally, beta-cells in adult streptozotocin group showed increase in number and size of mitochondria, and disruption of mitochondrial structures. Hyperglycemic group and neonatal streptozotocin group showed preserved mitochondrial ultrastructure. Ultrastructural morphometric study revealed increase in size and number of mitochondria and decrease in mitochondrial contour index in adult streptozotocin-treated rats, which suggested mitochondrial degeneration. Hyperglycemic group showed mild increase in size of mitochondria. Increased number of mitochondria was also observed in neonatal streptozotocin group. IVGTT revealed marked decrease in insulin response in adult streptozotocin group, and non-insulin-dependent diabetes mellitus pattern in glucose and insulin response in neonatal streptozotocin group. Hyperglycemic group showed a glucose and insulin response similar to control group. The above results suggest that a severe oxidative injury may cause degeneration and disruption of mitochondria of pancreatic beta-cell, and may be associated with substantial apoptotic cell death. The changes in the morphology and the number of mitochondria may result from streptozotocin treatment within neonatal period and hyperglycemia treatment, which may be associated with changes in insulin response.
Adult ; Animals ; Cell Death ; Diabetes Mellitus ; Diabetes Mellitus, Type 2 ; Glucose ; Glucose Tolerance Test ; Humans ; Hyperglycemia ; In Situ Nick-End Labeling ; Insulin* ; Mitochondria ; Oxidative Stress ; Pancreas ; Rats ; Streptozocin

No abstract available.
Adult* ; Humans ; Orbit*

PURPOSE: The subepithelial connective tissue graft(SCTG) has been proven to be a highly predictable treatment modality for coverage of gingival recession. This case report was performed to evaluate the effect of various root coverage procedures using SCTG on gingival recession. MATERIALS AND METHODS: Three patients presents with Miller's class I recession defect on the maxillary canine. Each other SCTG(coronally advanced flap, Bruno's Tech., envelope Tech.) were performed for root coverage. Clinical parameters assessed included recession depth, recession width, and keratinized gingival width. Measurements were taken at baseline and 2 months and follow up end. RESULTS: The average of root coverage was 4 mm(100% of the pre-operative recession depth) at the 2, 5 months examination. The average increase of keratinized tissue between the baseline and the 2 months amounted to 3.2mm. CONCLUSION: Within the above results, various root coverage using SCTG is an effective procedure to Miller's class I recession defect and patient could be satisfied aesthetic requirement.
Connective Tissue ; Follow-Up Studies ; Gingival Recession ; Humans ; Keratins ; Transplants

PURPOSE: The aim of this study is to compare two different gingival depigmentation techniques using an erbium:yttrium-aluminum-garnet (Er:YAG) laser and rotary instruments. METHODS: Two patients with melanin pigmentation of gingiva were treated with different gingival depigmentation techniques. Ablation of the gingiva by Er:YAG laser was performed on the right side, and abrasion with a rotary round bur on the opposite side. RESULTS: The patients were satisfied with the esthetically significant improvement with each method. However, some pigment still remained on the marginal gingival and papilla. The visual analog scale did not yield much difference between the two methods, with slightly more pain on the Er:YAG laser treated site. CONCLUSIONS: The results of these cases suggest that ablation of the gingiva by an Er:YAG laser and abrasion with a rotary round bur is good enough to achieve esthetic satisfaction and fair wound healing without infection or severe pain. Prudent care about the gingival condition, such as the gingival thickness and degree of pigmentation along with appropriate assessment is needed in ablation by the Er:YAG laser procedure.
Gingiva ; Humans ; Hyperpigmentation ; Melanins ; Pigmentation ; Wound Healing

PURPOSE: The objective of this study was to compare and evaluate the inflammatory responses of three widely used suture materials in the keratinized gingiva and buccal mucosa of beagle dogs. METHODS: Silk, polyglycolic acid, and nylon sutures were placed within the mandibular keratinized gingiva and maxillary buccal mucosa of four male beagle dogs. Biopsies were taken 3, 7, and 14 days after suturing. Specimens were prepared with hematoxylin-eosin stain for evaluation under a light microscope. RESULTS: The suture materials placed in the oral mucosa elicited more inflammatory reactions than did those placed in the keratinized gingiva. The multifilament suture materials caused more inflammatory tissue reactions than did the monofilament suture materials in the oral mucosa. CONCLUSIONS: If oral hygiene is well maintained and suture materials are placed in the keratinized gingiva, silk, nylon, and polyglycolic acid are considered to be proper suture materials for oral surgery. However, it is advisable to use monofilament suture materials if the suture site is within the oral mucosa.
Animals ; Biopsy ; Dogs ; Gingiva ; Humans ; Keratins ; Light ; Male ; Mouth Mucosa ; Nylons ; Oral Hygiene ; Polyglycolic Acid ; Silk ; Surgery, Oral ; Sutures

Fimbriae (fimA) of Porphyromonas gingivalis are filamentous components on the cell surface and are thought to play an important role in the colonization and invasion of periodontal tissue. P. gnigivalis fimA gene encoding fimbrillin, a subunit of fimbriae, has been classified into 5 genotypes (typesI to V) based on the nucleotide sequences. In the present study, we examined the prevalence of these fimA genotypes in patients with dental implant and the relationship between prevalence of these genotypes and peri-implantitis. Dental plaque specimens obtained from 80 peri-implant sulci of 50 patients with dental implants were analyzed by 16S rRNA fimA gene-directed PCR assay. P. gingivalis were detected in 74.4% of the samples of the control group (healthy peri-implant sulci; probing depth<5mm) and in 92.0% of the samples of the test group (peri-implant sulci with peri-iimplantitis; probing depth> or =5mm). Among the P. gingivalis-positive samples of the control group, the most prevalent fimA type was typeI(29.3%), followed by typeII(26.8%). In contrast, a majority among the P. gingivalis-positive samples of the test group was typeII(56.5%), followed by typeI(43.5%). TypeII fimA genotype organisms were detected more frequently in the test group and a significant difference in the occurrence of typeII was observed between test and the control groups. A correlation between specific fimA types and peri-implant health status was found in typeII(OR 3.545) and only a weak relationship was revealed in typeIV(OR 3.807). These findings indicate that P. gingivalis strains that possess typeII fimA are predominant in peri-implant sulci with peri-implantitis and are closely associated with peri-implant health status. P. gingivalis with typeII fimA may be involved in peri-implantitis.
Base Sequence ; Colon ; Dental Implants ; Dental Plaque ; Genotype* ; Humans ; Peri-Implantitis* ; Polymerase Chain Reaction ; Porphyromonas gingivalis* ; Porphyromonas* ; Prevalence*