1.Conservative surgical treatment for ameloblastoma: a report of three cases.
Se Won KIM ; Yu Jin JEE ; Deok Won LEE ; Hyung Kyung KIM
Journal of the Korean Association of Oral and Maxillofacial Surgeons 2018;44(5):242-247
Ameloblastoma treatment varies based on the clinical, histopathologic, and radiographic characteristics. Aggressive surgical treatments, such as marginal or segmental resection, have traditionally been implemented, but some conservative surgical methods are also being introduced, including decompression, enucleation, or curettage. The aim of the present study was to evaluate the possibility of applying these conservative surgical treatments to ameloblastoma and to analyze the prognosis of the procedures and their healing aspects. Among all patients who visited our clinic (Department of Oral and Maxillofacial Surgery, Kyung Hee University Dental Hospital at Gangdong) from 2009 to 2017, three who had undergone conservative surgery were recruited. One of these three patients underwent both excision of the lesion and an iliac bone graft during the same procedure. In the other two patients, due to the size of the lesion, decompression was performed to reduce the size of the lesion, and then conservative surgical treatments followed. As shown in the cases of this study, patients were only treated with conservative surgical methods, such as decompression or enucleation. During the follow-up period, there were no recurrences. In conclusion, the use of conservative surgical treatment in ameloblastoma can be a reliable, safe, and successful method.
Ameloblastoma*
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Curettage
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Decompression
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Follow-Up Studies
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Humans
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Methods
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Prognosis
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Recurrence
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Surgery, Oral
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Transplants
2.schwannoma developed from trigeminal nerve.
Journal of the Korean Association of Oral and Maxillofacial Surgeons 2008;34(5):578-581
Schwannoma named neurinoma, peripheral glioma, perineural fibriblastoma and Neurilemmoma is a ectodermal benign neoplasm which originates from schwann cell or neuro axons. It usually develops in peripheral systems of sensory nerves of gastrointestinal tract, oral cavity, and bone. It occurs more frequently in soft tissue than hard tissue, and is extremely rare in intraoral area. We report a case of Schwannoma that showed large mass on buccal cheek with Rt. midfacial swelling, pain, tenderness to palpation and involvement with maxillary branch of trigeminal nerve. We present this case and review the literature.
Axons
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Cheek
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Ectoderm
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Gastrointestinal Tract
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Glioma
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Mouth
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Neurilemmoma
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Palpation
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Trigeminal Nerve
3.Chronic Subdural Hematoma in Young Adult: An Age Comparison Study.
Yu Deok WON ; Hyeong Joong YI ; Young Jun LEE ; Hyoung Joon CHUN ; Hyun CHO ; Koang Hum BAK
Korean Journal of Neurotrauma 2013;9(1):6-11
OBJECTIVE: Incidence of chronic subdural hematoma (CSDH) is gradually increasing in young adults for several reasons. In this study, we aimed to identify features of CSDH noted in young adults that distinguish the disease from CSDH diagnosed in the elderly. METHODS: One hundred eighty-two patients with CSDH who underwent a total of 218 surgical procedures between January 2003 and February 2010 were retrospectively reviewed with regard to clinical presentation, radiographic results and prognosis including recurrence. To compare younger patients with the elderly, patients were divided into three groups on the basis of age (Group A: < or =40, Group B: 41-64, Group C: > or =65 years). RESULTS: Group A showed a male predominance (p=0.0001), lower rate of recurrence (p=0.0012), shorter symptom duration (p=0.035), and fewer leading signs such as hemispheric symptoms (p=0.005) compared to Groups B and C. Radiologic findings such as maximal hematoma thickness (p<0.0001) and degree of midline shift (p=0.028) were less severe in Group A than Groups B and C. Alcoholism was the most prevalent illness in all three groups. When exempting infants with hematologic malignancy, non-recurrence, previous trauma history, headache as leading symptom, and no mortality were all common in younger adults (all p<0.05). CONCLUSION: Young adults with CSDH show less severe clinical and radiologic features as well as fewer recurrences than noted in the elderly population. Even if a clinician's index of suspicion of CSDH in young adults complaining of headache is not high, meticulous radiologic surveillance could find CSDH, leading to satisfactory results including less frequent recurrence.
Adult
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Aged
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Alcoholism
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Headache
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Hematologic Neoplasms
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Hematoma
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Hematoma, Subdural, Chronic
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Humans
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Incidence
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Infant
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Male
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Prognosis
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Recurrence
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Retrospective Studies
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Young Adult
4.The evaluation of reproducibility of operation plan with the comparison between STO and post-operative jaw position in orthognathic surgery.
Seok Woo KWON ; Yu Jin JEE ; Baek Soo LEE ; Deok won LEE
Journal of the Korean Association of Oral and Maxillofacial Surgeons 2008;34(6):628-634
The purpose of this study is to examine reproducibility of operation plan and 3-dimentional jaw movement patterns by comparing jaw position of STO with post-operative jaw position. Twenty patients with class III dental and skeletal malocclusion who were treated with Le-Fort I osteotomy and B-SSRO were reviewed. Lateral cephalometric radiographs were taken within two weeks before operation and two days after operation. Cephalometric radiographs were compared and analyzed with orthognathic computer program 'V-Ceph(TM)'. Post-operative maxillary advancement was insufficient compared to maxillary advancement through STO. Post-operative setback movement was over compared to mandibular setback movement through STO. But statistically this is not significant. Maxillary vertical location is insignificant on the whole. Especially post-operative maxillary clockwise rotation is significant compared to maxillary rotation through STO. Post-operative maxillary clockwise rotation tendency is generally observed in all patients. So surgeons and staffs must consider this tendency when operation plan is established ans operation is being performed. Using intra or extra oral marking points, face bow, and bite plate will make exact surgery possible.
Bites and Stings
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Humans
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Jaw
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Malocclusion
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Orthognathic Surgery
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Osteotomy
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Software
5.Molecular biology in dental implant.
Yu Jin JEE ; Dong Mok RYU ; Deok Won LEE
Journal of the Korean Association of Oral and Maxillofacial Surgeons 2008;34(6):616-621
Osseointegration is a result of bone formation and bone regeneration processes, which takes place at the interface between bone and implant, and it indicates a rigid fixation that can be stably maintained while functional loading is applied inside the oral cavity as well as after implant placement. Although many researches were carried out about osseointegration mechanism, but cellular and molecular events have not been clarified. With recent development of molecular biology, some researches have examined biological determinants, such as cytokine, growth factors, bone matrix proteins, during osseointegration between bone and implant surface, other researches attempted to study the ways to increase bone formation by adhering protein to implant surface or by inserting growth factors during implant placement. Cellular research on the reaction of osteoblast especially to surface morphology (e.g. increased roughness) has been carried out and found that the surface roughness of titanium implant affects the growth of osteoblast, cytokine formation and mineralization. While molecular biological research in dental implant is burgeoning. Yet, its results are insignificant . We have been studying the roles of growth factors during osseointegration, comparing different manifestations of growth factors by studying the effect of osseointegration that varied by implant surface. Of many growth factors, TGF-beta, IGF-I, BMP2, and BMP4, which plays a significant role in bone formation, were selected, and examined if these growth factors are manifested during osseointegration. The purpose of this article is to present result of our researches and encourage molecular researches in dental implant.
Bone Matrix
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Bone Regeneration
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Dental Implants
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Hypogonadism
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Insulin-Like Growth Factor I
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Intercellular Signaling Peptides and Proteins
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Mitochondrial Diseases
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Molecular Biology
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Mouth
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Ophthalmoplegia
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Osseointegration
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Osteoblasts
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Osteogenesis
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Proteins
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Titanium
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Transforming Growth Factor beta
6.Skull Perforation and Depressed Fracture Following Skull Fixation for Stereotactic Surgery.
Yu Deok WON ; Choong Hyun KIM ; Jin Hwan CHEONG ; Jae Min KIM
Korean Journal of Neurotrauma 2012;8(1):48-50
We report an unusual case of skull perforation and depressed fracture with epidural hematoma in a 61-year-old woman who has been undertaken a skeletal fixation for stereotactic evacuation of intracerebral hematoma. Most neurosurgeons secure the patient's head in a skeletal fixation device with a three- or four-pronged pin-type headrest for stereotactic procedure or microsurgery. Although a variety of complications have been reported secondary to the use of head fixation devices, these potential complications of skull fixation have been infrequently described in the medical literatures. Consideration of calvarial thickness, tightening force, and adequate location of skull fixation may reduce the risk of skull perforation and depressed fracture.
Female
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Fracture Fixation
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Head
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Hematoma
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Humans
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Microsurgery
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Skull
8.Risk Factors for Prevertebral Soft Tissue Swelling Following Single-level Anterior Cervical Spine Surgery
Junsang PARK ; Sang Mook KANG ; Yu Deok WON ; Myung-Hoon HAN ; Jin Hwan CHEONG ; Byeong-Jin HA ; Je Il RYU
Journal of Korean Neurosurgical Society 2023;66(6):716-725
Objective:
: Anterior cervical spine surgery (ACSS) is a common surgical procedure used to treat cervical spinal degenerative diseases. One of the complications associated with ACSS is prevertebral soft tissue swelling (PSTS), which can result in airway obstruction, dysphagia, and other adverse outcomes. This study aims to investigate the correlation between various cervical sagittal parameters and PSTS following single-level ACSS, as well as to identify independent risk factors for PSTS.
Methods:
: A retrospective study conducted at a single institution. The study population included all patients who underwent single-level ACSS between January 2014 and December 2022. Patients with a history of cervical spine surgery or trauma were excluded from the study. The presence and severity of PSTS was assessed by reviewing pre- and postoperative imaging studies. The potential risk factors for PSTS that were examined include patient age, sex, body mass index, tobacco use, comorbidities, serum albumin levels, operative time, implant type, implanted level, and various cervical spine sagittal parameters. Multivariate linear regression analysis was performed to identify the independent risk factors for PSTS.
Results:
: A total of 62 consecutive patients who underwent single-level ACSS over a 8-year period at a single institution were enrolled in this study. Only preoperative segmental angle showed positive correlation with PSTS among various cervical spine sagittal parameters (r=0.36, p=0.005). Artificial disc replacement showed a negative correlation with PSTS (β=-0.38, p=0.002), whereas the use of demineralized bone matrix (DBM) had a positive impact on PSTS (β=0.33, p=0.009). We found that male sex, lower preoperative serum albumin, and implantation of upper cervical level (above C5) were independent predictors for PSTS after single-level ACSS (β=1.21; 95% confidence interval [CI], 0.27 to 2.15; p=0.012; β=-1.63; 95% CI, -2.91 to -0.34; p=0.014; β=1.44; 95% CI, 0.38 to 2.49; p=0.008, respectively).
Conclusion
: Our study identified male sex, lower preoperative serum albumin levels, and upper cervical level involvement as independent risk factors for PSTS after single-level ACSS. These findings can help clinicians monitor high-risk patients and take preventive measures to reduce complications. Further research with larger sample sizes and prospective designs is needed to validate these findings.
9.SARS-CoV-2 Antibody Response to the BNT162b2 mRNA Vaccine in Persons with Past Natural Infection
Yu Min KANG ; Kang-Won CHOE ; Ki-Deok LEE ; Kwang Nam KIM ; Moon Jung KIM ; Jaegyun LIM
Journal of Korean Medical Science 2021;36(35):e250-
There are still no agreed guidelines on the vaccination of coronavirus disease 2019 (COVID-19) for previously infected patients. Here, we present two seropositive healthcare workers (HCWs) working in an isolation ward who recovered from COVID-19 in April 2020 and got vaccinated with BNT162b2 vaccine in March 2021. We have assessed the clinical course, vaccine-related adverse events, and antibody response after natural infection and after first and second dose vaccination. One of the two HCWs was asymptomatic during quarantine, but the other had mild upper respiratory infection symptoms 1 day before admission, and the symptoms continued for 9 days. There was no pneumonic infiltration in chest X-ray in both patients, and no COVID-19 specific treatment was administered.Total immunoglobulin antibody and neutralizing antibody to anti-spike protein receptorbinding domain of severe acute respiratory syndrome coronavirus 2 were confirmed to be present in both HCWs in blood tests performed at 2 weeks and 4 weeks after discharge.Antibody response to mRNA vaccination showed marked elevation after the first vaccination, which was 30–40 times higher than that of antibody titer after natural infection in each patient (83.2 U/mL vs. > 2,500 U/mL in patient 1; 61.6 U/mL vs. > 2,500 U/mL in patient 2).Signal inhibition rate of neutralizing antibodies was also increased to over 97%. Due to this increased effect, there was little difference in antibody levels after the first and second dose. Both patients 1 and 2 suffered more from adverse vaccine reactions after the second vaccination than from COVID-19 symptoms.
10.The Osteoporotic Condition as a Predictive Factor for Hemorrhagic Transformation in Acute Cardioembolic Stroke
Yu Deok WON ; Jae-Min KIM ; Je-Il RYU ; Seong-Ho KOH ; Myung-Hoon HAN ; Jin-Hwan CHEONG
Journal of Korean Neurosurgical Society 2021;64(5):763-775
Objective:
: Hemorrhagic transformation (HT) can be occurred after acute cerebral infarction. HT can worse symptoms in severe cases and adversely affect long-term prognosis. As bone and vascular smooth muscle are composed of type 1 collagen, we aimed to identify a potential relationship between bone mineral density (BMD) and HT after acute cardioembolic stroke.
Methods:
: As an indicator of BMD, we used mean frontal skull Hounsfield unit (HU) values on brain computed tomography (CT). Multivariative hazard ratios were calculated using Cox regression analysis to identify whether the osteoporotic condition was an independent predictor of HT after acute cardioembolic stroke.
Results:
: This 11-year analysis enrolled 506 patients who diagnosed as acute cardioembolic infarction. The first tertile of skull HU value was an independent predictor of HT development compared to the third tertile (hazard ratio, 2.12; 95% confidence interval, 1.13–3.98; p=0.020). We observed no interactions between age and skull HU with respect to HT statistically.
Conclusion
: The results of this study revealed an association between osteoporotic conditions and HT development after acute cardioembolic stroke. A convenient method to measure the cancellous bone HU value of the frontal skull using brain CT images may be useful for predicting HT in patients with acute cerebral infarction.