Bisphosphonate-related osteonecrosis of the jaw in a patient with osteoporosis following treatment of testicular cancer: a case report

Bisphosphonate-related osteonecrosis of the jaw (BRONJ) occurs mainly in female patients. In males the occurrence rate is low, which seems to be related to the low incidence of osteoporosis in men. Unfortunately, BRONJ tends to be ignored in general dental clinics in male patients with a history of osteoporosis treatment. BRONJ occurred in a male patient due to the clinician's lack of interest in the patient's history. In this case, the male patient was on bisphosphonate therapy because of a orchiectomy, and a dental treatment was performed without consideration of his medical history, resulting in BRONJ. We performed careful examinations and treatment with antibiotics and surgical operations. The postoperative healing was successful. In light of this particular case, we concluded that careful listening to the patient's history is very important.

Chronic maxillary sinusitis and diabetes related maxillary osteonecrosis: a case report

Dental infections and maxillary sinusitis are the main causes of osteomyelitis. Osteomyelitis can occur in all age groups, and is more frequently found in the lower jaw than in the upper jaw. Systemic conditions that can alter the patient's resistance to infection including diabetes mellitus, anemia, and autoimmune disorders are predisposing factors for osteomyelitis. We report a case of uncommon broad maxillary osteonecrosis precipitated by uncontrolled type 2 diabetes mellitus and chronic maxillary sinusitis in a female patient in her seventies with no history of bisphosphonate or radiation treatment.

Eagle's syndrome: a case report

Eagle's syndrome is a disease caused by an elongated styloid process or calcified stylohyoid ligament. Eagle defined the disorder in 1937 by describing clinical findings related to an elongated styloid process, which is one of the numerous causes of pain in the craniofacial and cervical region. The prevalence of individuals with this anatomic abnormality in the adult population is estimated to be 4% with 0.16% of these individuals reported to be symptomatic. Eagle's syndrome is usually characterized by neck, throat, or ear pain; pharyngeal foreign body sensation; dysphagia; pain upon head movement; and headache. The diagnosis of Eagle's syndrome must be made in association with data from the clinical history, physical examination, and imaging studies. Patients with increased symptom severity require surgical excision of the styloid process, which can be performed through an intraoral or an extraoral approach. Here, we report a rare case of stylohyoid ligament bilaterally elongated to more than 60 mm in a 51-year-old female. We did a surgery by extraoral approach and patient's symptom was improved.

Retrospective clinical study of mandible fractures

OBJECTIVES: The purpose of this article is to analyze the incidence, demographic distribution, type, and etiology of mandible fractures that were treated by the Department of Oral and Maxillofacial Surgery in Kyung Hee University Dental Hospital from January 2002 to December 2012. MATERIALS AND METHODS: This was a descriptive and analytic retrospective study that evaluated 735 patients that were treated for mandible fracture. RESULTS: This study included 1,172 fractures in 735 patients. The ratio of male to female patients was 5.45 : 1; the maximum value was in patients between 20 and 29 years (38.1%) and the minimum in patients over 70 years old. The monthly distribution of facial fractures peaked in the fall and was lower during winter. No specific correlation was identified based on the annual fracture distribution. Among the 735 fracture patients, 1.59 fracture lines were observed per patient. The most frequent site was the symphysis, which accounted for a total of 431 fractures, followed by the angle (348), condyle (279), and body (95). The symphysis with angle was the most common site identified in combination with fracture and accounted for 22.4%, followed by symphysis with condyle (19.8%). The angle was the most frequent site of single fractures (20.8%). The major cause of injury was accidental trauma (43.4%), which was followed by other causes such as violence (33.9%), sports-related accidents (10.5%), and traffic accidents (10.1%). Fracture incidents correlated with alcohol consumption were reported between 10.0%-26.9% annually. CONCLUSION: Although mandible fracture pattern is similar to the previous researches, there is some changes in the etiologic factors.

Low-grade mucosa-associated lymphoid tissue(MALT) marginal zone B-cell lymphoma of the tongue : A case report

Out of all oral malignant tumor, malignant lymphoma occurs in only 3.5%. Especially, most of the primary malignant lymphomas, which occur in the head & neck region are high-grade diffuse large B-cell lymphoma and mucosa-associated lymphoid tissue (MALT) marginal zone B-cell lymphoma is very rare. In the head & neck region, malignant lymphoma is reported to occur in the thyroid, salivary gland, trachea, larynx, orbital lobe and the Waldeyer's ring. Among the Waldeyer's ring, palatal tonsil is reported to be the most common region, but, only 1 case report was published in Korea. Until now, there were no case reports of MALT lymphoma that occurred in the tongue. The purpose of this case report is to report and discuss on a case of MALT lymphoma of the tongue.

Treatment of OKC on Ramus of Mandible by Sagittal Splitting Technique

Recurrent cementoblastoma in left mandible : A case report

The histologic study of bone healing after horizontal ridge augmentation using auto block bone graft

The Effect of Genetic Variation in The Dna Base Repair Genes on the Risk of Head and Neck Cancer

DNA damage accumulates in cells as a result of exposure to exogenous agents such as benzopyrene, cigarette smoke, ultraviolet light, X-ray, and endogenous chemicals including reactive oxygen species produced from normal metabolic byproducts. DNA damage can also occur during aberrant DNA processing reactions such as DNA replication, recombination, and repair. The major of DNA damage affects the primary structure of the double helix; that is, the bases are chemically modified. These modification can disrupt the molecules' regular helical structure by introducing non-native chemical bonds or bulky adducts that do not fit in the standard double helix. DNA repair genes and proteins scan the global genome to detect and remove DNA damage and damage to single nucleotides. Direct reversal of DNA damage, base excision repair, double strand break. DNA repair are known relevant DNA repair mechanisms. Four different mechanisms are distinguished within excision repair: direct reversal, base excision repair, nucleotide excision repair, and mismatch repair. Genetic variation in DNA repair genes can modulate DNA repair capacity and alter cancer risk. The instability of a cell to properly regulate its proliferation in the presence of DNA damage increase risk of gene mutation and carcinogenesis. This article aimed to review mechanism of excision repair and to understand the relationship between genetic variation of excision repair genes and head and neck cancer.

The Clinical Manifestations and the Effect on Prognosis of Seizures during Acute Lymphoblastic Leukemia Treatment in Children

PURPOSE: This study was designed to assess the clinical manifestations and the effect on prognosis of seizures in children with acute lymphoblastic leukemia(ALL). METHODS: The study group consisted of 20 patients(10 males and 10 females) who experienced seizures out of the 198 pediatric ALL patients(117 males and 81 females) who were diagnosed and treated at the Department of Pediatrics, St. Mary's Hospital, the Catholic University of Korea. RESULTS: The overall incidence of seizure developing after the diagnosis of ALL was 10.1% and in 11 patients(5.6%), seizure recurred one or more times. An average of 6.5+/-3.6 months(range 0-42 months) elapsed between the beginning of treatment and the new onset of seizures. In 13 patients(65%), the first seizure occurred during the induction or re-induction chemotherapy phase. Seizure type was partial seizure in 11 patients(55%), and generalized seizure in 9 patients(45%). In 15 patients(88.2%), brain imaging study showed abnormal findings and in 18 patients(90%), EEG revealed abnormal findings. 11 patients were diagnosed with epilepsy and were treated with long-term anticonvulsants. In these patients, 4 patients(36.4%) had no seizure recurrence, but 2 patients(18.2%) showed no response to anticonvulsants. The 5-year survival rate of the patients experiencing seizures was 47%, while the rate was 78% for those did not experience seizures (P<0.001). CONCLUSION: Seizures in pediatric patients with ALL was closely related to the 5-year survival rate. Therefore, these patients require early careful observation, evaluation and intensive care. Also, further studies such as ways to diminish the side effects of antileukemic agents are necessary to reduce the risk of seizure.

The Influence of the Initial Stability After Dental Implant Installation on the Osseointegration

Understanding of epigenetics and DNA methylation

Combined Application of Bicuculline and 4-Aminopyridine-Induced Epileptiform Activity are Resistant to Conventional Anticonvulsants and AMPA in Young Rat Visual Cortex / 대한간질학회지

PURPOSE: The goal of the present study was to find out whether blockade of GABAergic synaptic transmission by bicuculline (BIC) in the presence of 4-aminopyridine (4-AP) would lead to expression or suppression of epileptiform activity in the immature brain and to observe the effect of commonly used anticonvulsants (valproic acid (VPA), carbamazepine (CBZP)) and 6-cyano-7-nitroquinoxalinedione (CNQX) on that epileptiform activity. METHODS: The visual cortex slices were obtained from 14-18 day-old Sprague-Dawley rats. Extracellular cellular recording was performed to observe the induction of epileptiform activity perfused by artificial CSF (ACSF) with combined application of BIC and 4-AP and the effect of VPA, CBZP and CNQX on that epileptiform activity for at least 1 hour. RESULTS: Epileptiform activity perfused by ACSF with combined application of BIC and 4-AP was insensitive to commonly used anticonvulsants (VPA, CBZP) and sensitive to CNQX. CONCLUSION: This study suggests that the epileptiform activity induced by combined application of BIC and 4-AP is present even in immature visual cortex slices. And, the blockade of GABAergic inhibition by BIC under 4-AP showed the increase of immature brain excitability as mature brain. The attenuation of that epileptiform activity by a-amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid (AMPA) antagonist (CNQX) showed that AMPA receptor had relevance to the induction of that epileptiform activity.

High K-induced Epileptiform Activity under GABA Antagonist and Carbamazepine in the Rat Visual Cortex

PURPOSE: The goal of this study was to investigate the effect of increase of K on the excitability of the visual cortex under GABA antagonist, carbamazepine(CBZP), 6-cyano-7-nitroquinoxaline-dione disodium(CNQX) and D-(-)-2-amino-5-phosphonopentanoic acid(D-AP5) on the increase of K-induced epileptiform activity. METHODS: The visual cortex slices were obtained from Sprague-Dawley rats. Extracellular recordings were performed to observe the induction of epileptiform discharges perfused by artificial CSF(ACSF) with an increase of K and the effect of 0.5 and 1 mM CBZP, 10 micrometer CNQX and 50 micrometer D-AP5 on the increase of K-induced epileptiform activity. RESULTS: Spontaneous epileptiform activities were increased by ACSF with 10 mM K under bicuculline compared to 4 mM K. CBZP blocked and 10 micrometer CNQX and 50 micrometer D-AP5 decreased the 10 mM K-induced spontaneous epileptiform activity. CONCLUSION: An increase of K augmented spontaneous epileptiform activity. This experimental model increased the excitability of the brain, which may be influenced by GABA. CBZP blocked the increase of K-induced epileptiform activity, which showed the increase of excitability. An increase of K-induced epileptiform activity was decreased by CNQX and D-AP5, which may show the attenuation of voltage-dependent low magnesium effect and decrease the excitability in terms of synapse induction.

The Recurrence Rates of Febrile Seizures Related to the Degree of Fever

PURPOSE: Recently, many studies on febrile convulsions again suggest that the degree of pyrexia may be related to the recurrence of febrile convulsions. In a previous study, we advocated that a low body temperature during the initial febrile convulsions is associated with an increase of recurrent febrile convulsions. Therefore, we have expanded the study by including 246 febrile convulsions during 6 years and investigated risk factors and especially the relationship between pyrexia and the recurrence rates. METHODS: Children with febrile convulsions were divided into three groups according to the degree of fever. Group I showed body temperatures higher than 39.5 degrees, group II from 38.5 to 39.4 degrees, and group III lower than 38.4 degrees. Then, we analyzed the recurrence rates of febrile convulsions. RESULTS: There occurred recurrent febrile convulsions in 19(41.3%) children with family history of febrile convulsion and 5(35.7%) children whose first-degree relatives diagnosed epilepsy. In group I, 5(13.5%) infants aged 6-18 months and 5(19.2%) aged 19-30 months had recurrent febrile convulsions. In group II, 22(36.1%) infants aged 6-18 months and 8(24.2%) aged 19-30 months had recurrent febrile convulsions. In group III, 21(42.0%) infants aged 6-18 months and 8(38.1%) aged 19-30 months had recurrent febrile convulsions. CONCLUSION: Children with a lower degree of pyrexia and also younger age at the onset of the first febrile convulsion were more susceptible to recurrent febrile convulsios than otherwise.

The Influence of Low Serum Sodium Levels on the Risk of Repeated Febrile Convulsions during the Same Febrile Illness

PURPOSE: Hyponatremia may be common in febrile convulsions and lower the threshold for febrile convulsions. We evaluated the association between hyponatremia and febrile convulsions and also examined the effect of hyponatremia on the recurrence of convulsions during the same febrile illness. METHODS: Serum sodium levels were measured from 98 children with febrile convulsions, among whom there were 21 recurrent and 77 non-recurrent patients during the same febrile illness. Also, as a control group, we selected 32 febrile and 48 non-febrile children, who did not have febrile convulsions. Results were analyzed by Student's t-test and logistic regression. RESULTS: The average serum sodium level in febrile convulsions was 135.5+/-3.7 mEq/ L, which was significantly lower than 138.7+/-3.2 mEq/L of febrile children and 138.0+/-3.0 mEq/L of non-febrile children in the control group(P<0.05). The average serum sodium level in recurrent febrile convulsions during the same febrile illness was 133.1+/-4.1 mEq/ L, which was significantly lower than 136.1+/-3.3 mEq/L in non-recurrent febrile convulsions(P<0.05). CONCLUSION: The serum sodium levels of the patients with febrile convulsions were significantly lower than those of the children in the control group. Also, the lower the sodium levels were, the higher recurrent febrile convulsions during the same febrile illness occurred.

The Clinical Manifestations and the Risk Factors of Seizures after Hematopoietic Stem Cell Transplantation in Children

PURPOSE:This study was designed to assess the clinical manifestations and the risk factors of seizures after hematopoietic stem cell transplantation(HSCT) in children. Also we analyzed the 3-year survival rates of those who experienced such seizures and those who did not. METHOD:The study group consisted of 28 patients(21 males and, 7 females) who experienced seizures out of the 197 patients(113 males and, 84 females) who underwent HSCT at St. Mary's Hospital HSCT Center of the Catholic University of Korea. RESULTS:The overall incidence of seizures developing after HSCT was 13.8%, with boys reporting a higher incidence than girls. No significant difference was found with regards to the onsets and the types of seizures. In terms of the possible risk factors for seizures, the age of the patient and the stage of acute graft versus host disease(aGVHD) were statistically significant. The patients who were 5 years or more showed a 4.2 times greater incidence rate of seizures(P=0.025) than those who were younger. Also, the patients with stage 2-4 aGVHD showed a 2.77 times greater incidence of seizures(P= 0.034) than those with stage 0-1 aGVHD. The 3-year survival rate of the patients experiencing seizures was 37+/-18%, while the rate increased to 67+/-8% for those who did not(P< 0.001). CONCLUSION:Among the recipients of HSCT in children, the patients aged 5 years or older and aGVHD of the stage 2 or above showed a greater likelihood of seizures occurring after HSCT. The patients who experienced seizures should undergo a close observation and an intensive care since those patients reported a lower 3-year survival rate than those who did not.

Diagnostic problem of squamous papilloma and oral mucosa malignancy

Squamous papilloma is a benign proliferation of stratified squamous epithelium, resulting in a papillary or verruciform mass. Verrucous carcinoma is a differentiated variant of squamous cell carcinoma and may present diagnostic difficulties as it may be erroneously diagnosed as squamous papilloma. Squamous papilloma is similar to other oral mucosa malignancy in microscopic view. So, it is difficult to distinguish between squamous cell papilloma and other oral mucosa malignancy. Here are three patients. they were diagnosed as squamous papilloma initially, but the lesion was recurred. In recurred lesion, verrucous carcinoma or squamous cell carcinoma were found. So we report that recurred oral mucosa malignency(verrucous carcinoma or squamous cell carcinoma) which was diagnosed as squamous papilloma.

A study of computer-based cephalometric analysis and prediction system in orthognathic surgery

A Case Report Of Basal Cell Nevus Syndrome

Basal cell nevus syndrome is inherited as an autosomal dominant trait with variable expressivity. This syndrome comprises a number of abnormalities such as multiple nevoid basal cell carcinomas of the skin, skeletal abnormalities as bifid rib and fusion of vertebrae, central nervous system abnormalities as mental retardation, eye abnormalities, and multiple odontogenic kerato cysts. In 1960, Gorlin and Goltz first described the features of this disease as constituting a true syndrome; since then, it has been realized that it is much more complex and encompassing than initially thought. This patient has many symtoms of basal cell nevus syndrome. we has known multiple jaw cysts through panorama and facial computed tomography. He has hyperchromatism on basal cell through skin biopsy. In ophthalmologic consult, he has blindness on right. On his past medical history, amputation was done on his toes for polyductalism. - So we report with literature reviews