성견하악골의 신연 부위에서 골형성에 대한 혈소판-풍부 혈장의 효과

류수장,이충국,최병호,Ryu, Soo-Jang,Yi, Choong-Kook,Choi, Byung-Ho 대한구강악안면외과학회 2001 대한구강악안면외과학회지 Vol.27 No.6

Distraction osteogenesis refers to the biological process responsible for new bone formation between bone segments by gradual distraction after osteotomy. For the past several years, various inconveniences including a protracted consolidation period that requires patients to wear a distractor frame longer, as well as higher medical costs, have not been remedied by improvements in osteotomy, distraction rate and monitoring system. Furthermore, side effects such as pin tract infections and soft tissue swelling may arise due to the long treatment period. These drawbacks form the rationale of this study which purports to seek a method by which the consolidation period can be reduced. This paper examines how platelet-rich plasma(PRP), known to facilitate osteogenesis, influences bone formation when applied in distracted area. Ten mongrel dogs, which were made to wear external distractor frames after osteotomy in both sides of the mandible, were used as subjects. After a 7day period of latency, distraction was carried out at a rate of 1mm/day for 14 consecutive days. After the onset of distraction, 2ml of PRP and a mixture of calcium gluconate and thrombine were injected into the center of the distracted callus on the left side of the mandible. The left was injected with PRP while the right side was set as the control site without PRP treatment. Execution at the onset of distraction and in 2 weeks, 4 weeks and 8 weeks after the consolidation period, clinical and radiographic tests, bone mineral density examination, histological examination and histomorphometric analysis were conducted to compare both sides. The results are summarized as follows: 1. Based on the clinical examination at two weeks, more remarkable cortical bone formation was found on the buccal and lingual side of the distracted area in the PRP treatment site than in the control site. No visual difference was found between the PRP treatment site and the control site at four eight weeks. 2. Based on the radiological examination, a distinct increase in the radiopaque appearance of the PRP treatment site was revealed at two weeks, but this increase appeared to slow down at four and eight weeks. 3. Examination of bone mineral density revealed a significant difference at two weeks with the PRP treatment site yielding density two times higher than the control site. This difference lessened after four weeks, and disappeared at eight weeks. 4. The histomorphometric examination revealed that about 20% more bony trabeculae area(20%, higher) was formed in the PRP treatment site than in the control site. In conclusion, it can be said that PRPs effect on stimulating bone formation in the PRP treatment site manifest as early as two weeks. Trabeculae formation likewise increased throughout the whole period. If this result can be applied to humans, the consolidation period can be reduced by injecting PRP into the distracted area.

안면골 골절로 인한 시신경 손상

김종배,양영철,류수장 大韓顎顔面成形再建外科學會 1994 Maxillofacial Plastic Reconstructive Surgery Vol.16 No.4

Optic nerve injury serious enough to result in blindness had been reported to occur in 3% of facial fractures. When blindness is immediate and complete, the prognosis for even partial recovery is poor. Progressive or incomplete visual loss may be ameliorated either by large dosage of steroid or by emergency optic nerve decompression, depending on the mechanism of injury, the degree of trauma to the optic canal, and the period of time that elapses between injury and medical intervention. We often miss initial assessment of visual function in management of facial fracture patients due to loss of consciousness, periorbital swelling and emergency situations. Delayed treatment of injuried optic nerve cause permanent blindness due to irreversible change of optic nerve. But by treating posttraumatic optic nerve injuries aggressively, usable vision can preserved in a number of patients. The following report concerns three who suffered visual loss due to optic nerve injury with no improvement after steroid therapy and/or optic nerve decompression surgery.

하악골에 발생된 백아종 2예

유재하,류수장 大韓顎顔面成形再建外科學會 1990 Maxillofacial Plastic Reconstructive Surgery Vol.12 No.1

The cememtomas are derived from the periodontal ligament and a diversified group of nonrelated lesions poducing cementum-like material. The diagnostic term, Cementoma, has encompassed several unrelated lesions : periapical cemental dysplasia, benign (true) cementoblastoma, cementifying fibroma and familial multifle (gigantiform) cementoma. The authors treated one case of benign cementoblastoma & the other of cementifying fibroma by conservative enucleation & curettage. By follow up check of the patient. We obtained of good result without any signs of recurrence of the lesions.

구강내 치료시 연하나 흡입된 이물질의 처치에 관한 치험례

류수장,전종후 大韓顎顔面成形再建外科學會 1996 Maxillofacial Plastic Reconstructive Surgery Vol.18 No.3

The practice of oral surgery or other dentistry possesses the danger of causing the loss of foreign bodies used within the oral cavity. If such foreign bodies would be lost, they could enter the viscera through the esophagus or tracheobroncheal tree. Ingestion is four times as frequent as aspiration and 80% to 90% of ingested foreign bodies will pass through the body spontaneously. Once the aspiration or ingestion of foreign bodies is happened, a dental procedure should be discontinued immediately. If symptoms of respiratory distress, including coughing, wheezing, or stridor, are present, a patent airway should be maintained, oxygen administered, and ventilation supported if necessary. The PA chest radiograph will identify the objects in the lung, esophagus, or stomach. Ingested gastrointestinal foreign bodies may be managed by observation, endoscopy, and or surgical intervention and aspirated tracheobroncheal foreign bodies may be managed by bronchoscopy, and or surgical intervention. This case report describes the management of ingested or aspirated foreign bodies happened to the three patients during intraoral treatment. we recommend that the preventive method of ingestion or aspiration of the dental foreign bodies should be performed prior to intraoraltreatment and the immedieate measures should be carried out after ingestion or asipiration of it.

관골 골절의 양상 및 정도에 관한 임상적 연구

류수장(Soo Jang Ryu),김미숙(Mi Sook Kim),노기문(Ki mun Ro) 대한구강악안면외과학회 2000 대한구강악안면외과학회지 Vol.26 No.2

This is a retrospective study on the nature and severity of zygomatic bone fractures. This study was based on a series of 358 patients with zygomatic bone fractures who treated as in-patient at Soonchunhyang Chonan Hospital during the period of Jan. 1993 through Dec. 1996. The results obtained are as follows : 1. The ratio of men to women was 4.41:1. The age frequency was highest in the second, third decade. The yearly distribution was the highest in 1993. The monthly distribution was highest in Feb. and Jun. 2. The most frequent cause was the traffic accident.(66.2%) 3. The most frequent type of fractures was the class Ⅰ(undisplaced fx.).(25%) 4. The most frequent associated oral and maxillofacial injuries was soft tissue.(46.9%) 5. The most frequent associated systemic injuries was upper, lower extremity.(38%) 6. In A.I.S of oral and maxillofacial area, the mean score of A.I.S was 2.5~3. In I.S.S, the highest mean score was in the ped TA.(19) 7. In respect of treatment, the most common method was open reduction with rigid fixation on fronto-zygomatic suture area.(47.8%) 8. The incidence of complication was 12% and the most common complication was malunion.(6.1%)

당뇨병을 가진 LUDWIG'S ANGINA 환자에 대한 치험례: 증례보고

류수장,양영철 大韓顎顔面成形再建外科學會 1997 Maxillofacial Plastic Reconstructive Surgery Vol.19 No.3

Ludwig's angina has been defined as a potentially lethal, rapidly spreading cellulitis, involving the sublingual and submandibular spaces, and is manifesed by a brawny, suprahyoid induration, tender swelling in the floor of mouth, elevation and posterior displacement of tongue. This paper is of interest not only because of severity of infection but also because of associated diabetic mellitus. Diabetes mellitus is a complex syndrome of disordered metabolism and elevated blood glucose, it results from deficiency of insulin secretion of combination of insulin resistance and inadequate insulin secretion. The effects of diabetic mellitus include neuropathy, vascular insufficiency, decreased leukocytic function, hematologic change etc. Clinically this may be refelected by the increased severity of infections seen in diabetics. The treatment of infections in diabetics are reduction of number of microbes through the use of appropriated antimicrobial agents and proper surgical drainage and improvement of the host factors by tight control of insulin replacement and immediate intervention to correct abnormalities of the local factors by drainage, debriment, and removal of avoidance of foreign bodies. The authors present the report of the Ludwig's angina in patient with diabetic mellitus, with literature review and good clinical result.

사고원인별 구강 악안면손상의 양상 및 정도에 관한 임상적 연구

류수장(soo Jang Ryu),윤중호(Jung Ho Yoon) 대한구강악안면외과학회 1991 대한구강악안면외과학회지 Vol.17 No.2

This is a retrospective study on the nature and severity of oral & maxillofacial injuries by cause Thhe study was based on a series of 811 patients with oral & maxillofacial injuries treated as in-patient at Wonju Christian Hospital of Wonju medical College during the period of Jan. 1984 through Dec. 1988 The results obtained are as follows ; 1. The ratio of men to women was 3.9:1. in yearly distribution, the number of patients have been increased year after year. 2. The most frequent cause of oral and maxillofacial injuries was the traffic accident(57.3%). In the traffic accident, autobicycle accident was the most frequent cause(24.6%). 3. The age frequency was the highest in the third decade(33.8%). 4. The most common location of oral and maxillofacial injuries was mandible(37.7 % ), zygoma and zygomatic arch(24.3%), nasal bone(21.9%) and maxilla(l6.1%) were next in order of frequency. the classification by the location of fracture, the frequency of singel fracture was 79.2% and combined fracture was 47.5%. In these patientsm,m one-location involvements were 79.2%, two 15.5%, three 4.7%, entire location were 9.6%. 5. In the case of tooth and alveolar bone injuries, tooth fracture was the most frequent case(27%). 7. In the type of mandible, simple fracture(59.2%) was the most frequent, type and autobicycle accident was the most frequent cause(19.6%). In proportional ratio, out-car accident(75%) was the most frequent type of simple fracture and others(40%) was the most frequent type of compound fracture. The most frequent fracture site of mandible was symplhyseal area(56.6%). 8. In the frequency of combined fracture of mandible by cause, symphysis or body with condyle fracture was the highest frequency(l7.8%). 9. In cases of maxilla and zygoma fracture, Lefort Ⅱ fracture was the major type of fracture(26.3%). The most frequent cause(39.4%) was the autobicycle accident. 10. In 811 patients of oral and maxillofacial injuries, the frequency of associated injuries was head & neck 63.9%, chest 15.4%, extremities 14.0%, abdomen 6.7% were next in order of frequency. 11. In A.I.S. of oral and maxiillofacial area, the highest score of A.I.S. in the every cause was 4 except the sllipdown case. the mean score of autobicycle and industrial accident was 3 and it meant the severiousness of injury. 12. The highest score of L.S.S. by cause was the autobicycle accident(56). In the mean score of I.S.S., 26(industrial accident) was the highest score.

하악골 골절의 양상 및 정도에 관한 임상적 연구

류수장(Soo Jang Ryu),양영철(Young Cheol Yang) 대한구강악안면외과학회 1996 대한구강악안면외과학회지 Vol.22 No.4

This is retrospective study about nature and severity of mandibular fractures based on a series of 349 patients with mandibular fractures who treated as in-patient at Soonchun-hyang Cheonan Hospital during the period of Jan. 1990 through Dec 1994. The results obtained are as follows: 1. In respect of incidence, there was highest frequency in 1992 and there were high frequency may and September. The ratio of man to momen was 3.57 : 1 By age, the second decade was the top of all group. 2. The most frequent cause was the traffic accident. 3. The most common location was symphsis and follwed by angle, body, condyle. 4. The most frequent type of fracture was simple and follwed by compound-commuited, compound simple. 5. The most frequent associated oral and maxillofacial injuries was tooth and alveolar bone injuries. and the most frequency associated injuries was extremity injuries. 6. In A.I.S. of oral and maxiilofacial area, the mean score of A.I.S. was 3 in the autobicycle, bicycle, other traffic accident. In I.S.S. the high mean score in the autobicycle, bicycle, passenger, pedestrian traffic accidnet 7. In respect of treatment, the frequency of open reduction was 236 patients The most common method of open reduction was CR+OR-RIF. 8. The incidence of complication was 16.8% and most common complications was neuromuscular disturbance and infection. 9. The most frequent mental state at the time of vist was alert and the frequency of death was 20 patients. The most common treatment of emergency room was wound closure.

Garre s 경화성 골수염의 치험례

류수장(Soo Jang Ryu),노기문(Ki Mun Ro) 대한구강악안면외과학회 1997 대한구강악안면외과학회지 Vol.23 No.4

Garre s Sclerosing Osteomyelitis is seen primarily in children and young adult and occasionally in older individuals. It is also known as chronic nonsupprative sclerosing osteomyelitis, proliferative periositis of Garre, periostits ossificans. It is commonly associated with carious molar and a history of past toothache. Radiogrphically, a focal area of well-calcified bone proliferation may be seen that is smooth and often has a laminated apperance. This disease is thought to occur because of a low-grade infection or irritation that influence the potentially active periosteum of young individuals to lay down new bone. Its treatment is directed toward removing identifiable source of inflammation. Following successful treatment of dental pathology, remodeling of the mandible generally occurs naturally but the deformity may remain and surgical recontouring may be required. We report a case of Garre s sclerosing osteomyelitis, treated by surgical recotouring and antibiotic therapy, in 9-year old female with literature review.

악하선 타석증의 치험례

김미숙,류수장 대한악안면성형재건외과학회 2000 Maxillofacial Plastic Reconstructive Surgery Vol.22 No.4

The Sialolithiasis is one of the most common disease that is found in the submandibular gland and they can be usually observed in the extra glandular area. As the lumen of Wharton's duct is larger and more expandable than that of Stensen's duct, the symptom of them is initially painless. As increasing their size, the sign and symptom are pain and sudden enlargement of gland. It can be observed with clinical exam and the scintigraphy. After removal of sialoliths, the majority of them can get the recovery of function. Our department performed the transoral sialolithotomy and the extraoral sialoadenectomy for three patients of sialolithiasis and all of them showed no complication after operation.