Subcutaneous emphysema is a rare but serious side effect of dental and oral surgery procedures. The condition is characterized by air being forced underneath the tissue, leading to swelling, crepitus on palpation, and with potential to spread along the fascial planes to the periorbital, mediastinal, pericardial, and/or thoracic spaces. A wide range of causes have been documented for the origin of subcutaneous emphysema during dental treatment including: crown preparations, other operative procedures, endodontic therapy, extractions, as well as oral surgery procedures. The patient was a 58-year-old woman who presented to the Seoul Saint mary’s hospital emergency department with a chief complaint of facial edema, dyspnea and chest discomfort after periodontal treatment using an air-flow equipment in local dental clinic. During treatment in the emergency department, oxygen therapy and intravenous injection of steroid and anti-histamine was done. it was noted that the patient had pain and swelling on left lower molar region, pus discharging on same site. Severe edema was observed on periorbital region to neck with heatness. An audible crepitus sound was heard during palpation on facial area. Neck CT scan and antibiotic therapy was done, as symptom suggesting dental abscess is observed. 3 hours after injection of antibiotics, the patient’s symptom was relieved, but she felt chest discomfort continuously. CT scan with constrast depicted confluent and extensive soft tissue emphysematous changes involving face and deep neck spaces and pneumomediastinum. The patient was refered to thoracic surgery department, oxygen therapy was decided continuously. After 10 hours, patient’s chief complaint was resolved, and discharged. After 1 week, all symptom was disappear and follow-up neck CT scan finding was disappearance of edema and pnuemomediastinum. We report a case of cervical subcutaneous emphysema and pneumomediastinum occurring after periodontal treatment using an air-flow equipment and case on the diagnosis and treatment of subcutaneous emphysema and pneumomediastinum, along with a review of the literature.

The purpose of this study was to analyze and compare the effect of resistance exercise and balance exercise on proprioception and WOMAC index of patients with degenerative knee osteoarthritis. A total of 40 subjects participated in this study. The subjects were diagnosed with degenerative knee osteoarthritis and all were more than 60 years old. They were divided into three groups. Group Ⅰ(n=8) was trained with resistance exercise, Group Ⅱ(n=6) was trained with balance exercise and GroupⅢ(n=6) was trained with range of motion as a control. The results of this study were as follows. It was significantly indicated that the resistance exercise group and balance exercise group elicited error-reduction on proprioception goal-angle (p<.05). There was a statistically significant difference on proprioception between resistance exercise group and control(range of motion) group. There was a statistically significant reduction on WOMAC index between resistance exercise group and balance exercise group (p<.05) and on the WOMAC index between resistance exercise group and range of motion group(p<.05). In conclusion, resistance exercise and balance exercise are effective on degenerative knee osteoarthritis and resistance exercise is the most effective for improving proprioception and WOMAC index. More research on the intervention according to the degree of degenerative knee osteoarthritis is needed.