자가장골이식을 이용한 하악골 결손의 치험4례

류선열(Sun Youl Ryu),김일규(Il Kyu Kim),김종철(Jong Chull Kim),오희균(Hee Kyun Oh),박재관(Jae Kwan Park) 대한구강악안면외과학회 1986 대한구강악안면외과학회지 Vol.12 No.1

This is to report four cases of autogenous corticocancellous iliac bone graft for reconstruction of mandibular defects occurred by traumatic comminuted fractures and surgical removal of ameloblastoma. In only one case, infection developed shortly with suppuration on the 7th postoperative day and was well treated with adequate antibiotic therapy and drainage. In all cases, pain and paresthesia on donor site were complained but disappeared within a few days. All cases were satisfactorily treated with proper masticatory function and esthetic improvement.

연골성 및 막성 탈회골기질과 탈회상아질기질에 의한 골유도 과정에 대한 연구

류선열(Sun Youl Ryu),신형철(Hyung Chul Sin),김선헌(Sun Hun Kim),김백윤(Baik Yoon Kim) 대한구강악안면외과학회 1995 대한구강악안면외과학회지 Vol.21 No.2

Bony tissue develops via two different preocesses : endochondral ossification and intramembanous ossification. This study tests the hypothesis that each type of bony tissue contains unique inducing factors for the promotion of cartilage and direct bone formation. Previous studies suggest that both of implants of intramembranous and endchondral bone matrix can induce bone formation through endochondral bone formation, which means that the bone growth properties of the bone matrices are similar. This study was done to know whether the osteoinductive property of intramembranous bone matrix is identical to that of endochondral matrix and that property of demineralized dentin matrix. Endochondral and intramembranous demineralized bone matrices and demineralized dentin matrices were implanted in pectoral muscles of rats. At the 5 days of implantation many spindle shaped mesenchymal cells aggregated around 3 kinds of the matrices. At the 10 days of implantation osteoid tissue formed adjacent to the matrices. At the 14 days implants of endochondral bone and dentin matrices induced bone formation via endochodral and intramembranous ossification in contrast to implsants of intramembranous bone matrix which did not induce endochondral ossification. At the 60 days of implantation, the matrices were absorbed and mature bone formation with trabeculae was proceeded. The matrices were aborbed by macrophages and multinucleated giant cells and osteoclasts which resorb the calcified bone at the same time. These findings suggest that endochondral ossification is not a necessity in the processes of bone formation by demineralized hard tissue matrix and the matrix of endochondral bone differs qualitatively from that of intramembranous bone.

가토 하악골에 Proplast I과 II 이식후 주위 조직반응 및 골형성

류선열,김건중,Ryu, Sun-Youl,Kim, Geon-Jung 대한악안면성형재건외과학회 1991 Maxillofacial Plastic Reconstructive Surgery Vol.13 No.3

The purpose of this study was to compare the response of adjacent tissue and new bone formation after implantation by different methods of subperiosteal using using Proplast I and II in rabbit mandible. Microstructure of Proplast I and II was observed by scanning electron microscope. And the implantation procedure was carried out by dividing into tow groups, A and B. a group consisted of subperiosteal graft on the cortex, and the other B group was made up onlay graft following artificial decortication in the madibular body of rabbit. The experimental animals were sacrificed on the 1st, 2nd, 4th and 8th week after grafting for macroscopic and histopathologic examination. The samples extracted at the 6th postgrafting week were also used for biometric test. The result ere as follows : 1. By scanning electron microscopic observation, pore size was $50{\sim}180{\mu}m$ in the Proplast I and $100{\sim}220{\mu}m$ in Proplast II. 2. Macroscopically, infection of the graft site, deformation and displacement of the implanted materials were not observed in all experimental groups. 3. In the tissue response, infiltration of inflammatory cells and multinucleated giant cells were observed from the 2nd to the 8th week in Proplast I. Inflammatory cells decreased in number from the 2nd week in Proplast II suggesting that Proplast II is better than Proplast I. 4. Bone formation was not observed until the 8th week in the group A, but new bone formation from the surrounding graft bed and the periostium was appeared from the 4th week in the group B. 5. The maximum mean values of shear stress mere serially $65.5gf/mm^2$ in Proplast II of group B, $32.9gf/mm^2$ in Proplast I of group B, $17.0gf/mm^2$ in Proplast II of group A, and $15.7gf/mm^2$ in Proplast I. of group A.

당뇨백서(糖尿白鼠)의 대퇴동맥(大腿動脈) 미세혈관문합(微細血管吻合) 후(後) 내피세포(內皮細胞)의 재생(再生)에 관한 연구(硏究)

류선열,김영재,Ryu, Sun-Youl,Kim, Young-Jae 대한악안면성형재건외과학회 1992 Maxillofacial Plastic Reconstructive Surgery Vol.14 No.1

Recently, diabetic patients are increasing in the field of microvascular surgery. Diabetes melltius is known to be related to arterial damage, platelet malfunction and thrombus formation. After microvascular anastomosis, delayed repair and vascular occlusion occurred more frequently in diabetic state. This study was performed to investigate the patency rate and process of endothelial healing after microvascular anastomosis of femoral artery in diabetic rat by scanning electron microscope. The animals were divided into two groups, 20 diabetic-induced and 20 non-diabetic groups. Diabetes was induced with a injection of Streptozotocin(50mg/kg b.w., Sigma Chemical Co.) to tail vein. The results obtained were as follows: 1. Macroscopically, anastomotic site was intact except a few cases showed minimal inflammatory sign around the wound site. But the inflammatory change was frequently occurred in diabetic-induced group. 2. The patency rate was 95% (19/20) in non-diabetic group and 65% (13/20) in diabetic-induced group. 3. In the non-diabetic group, anstomotic region was mostly endothelized by the alignment along the long axis of vessel but stitchs were not covered with endothelial cells. The thichkening of vessel wall was not observed. 4. In the diabetic-induced group, anastomotic region was not endothelized but covered with blood cellular components and connective tissue instead of endothelial cells. The thickening of the vessel wall was prominent in some diabetic-induced rats. These results suggest that diabetes was related to delayed regeneration of endothelium of vessels after microsurgical anastomosis.

상악골에 발생한 악성섬유성조직구종

류선열,박석인,이진환,정무강,정종철,최홍란,Ryu, Sun-Youl,Park, Suk-In,Lee, Jin-Hwan,Chung, Mu-Gang,Chung, Jong-Chull,Choi, Hong-Ran 대한악안면성형재건외과학회 1992 Maxillofacial Plastic Reconstructive Surgery Vol.14 No.1

우측 협부의 종창과 압통을 주소로 내원한 59세의 여자 환자에서 방사선 소견상 우측 상악골의 광범위한 골파괴상이 나타났고 조직생검에서 MFH로 진단되었다. 치료는 술전과 술후에 SWOG외 CY-VA-DIC요법을 변형시킨 화학요법과 총 40Gy의 $^{60}Co$ 방사선요법 그리고 우측 상악골전적출술의 삼자병용요법을 시행하였다. 술후 2년이 경과된 현재까지 재발이나 전이 등의 소경은 관찰되지 않고 있으며 환자의 예후에 대하여 주의 깊은 관찰을 계속하고 있다. Malignant fibrous histiocytoma rarely occurs in the jaws. A case of malignant fibrous histiocytoma originated from the maxillary sinus is reported with review of literature. A 59-year-old woman visited the Chonnam University Hospital in March, 1990, with chief complaint of swelling and tenderness in the right cheek. Radiographic findings revealed wide destruction of the maxilla. The biopsy taken from the maxilla showed histopatholgic findings of malignant fibrous histiocytoma. Accordingly the patient received preoperative and postoperative anticancer chemotherapy by the modified CY-VA-DIC protocol of the Southwest Oncology Group (SWOG). Preoperative and postoperative radiotherapy were also given to her in total 40Gy of $^{60}Co$ And she underwent radical resection of the maxilla. No evidence of recurrence or metastasis was shown for 2-year period of postoperative follow up.

Kirschner線을 이용한 하악과두골절 치험2례

류선열(Ryu Sun Youl),오희균(Oh Hee Kyun),김건중(Kim Geon Jung),윤영수(Yun Young Soo),박재관(Park Jae Kwan) 대한구강악안면외과학회 1987 대한구강악안면외과학회지 Vol.13 No.1

This report dealed with a simplified method for the internal fixation of fractures of the mandibular condyle. We have presented 2 cases of the displaced condylar fractures of the mandible treated by Kirschner wire for internal fixation. Advantages over previous surgical methods were as follows: 1. This method provided ease access and lack of danger to the facial nerve and the articular capsule by submandibular approach. 2. It allowed ease manipulation, accurate alignment, and rigid fixation of fragments. 3. No special equipment was required and drilling was carried out in a safe area. 4. Follow up studies revealed good function and no remarkable post-operative complication.

Post 형태에 따른 치근 내부와 지지 조직의 응력 분산에 관한 2차원적 연구

류선열(Sun-Youl Ryu),양홍서(Hong-So Yang),조규종(Kyu-Zong Cho) 대한치과의사협회 1988 대한치과의사협회지 Vol.26 No.8

개에서 임프란트의 골유착에 미치는 탈회상아질기질의 영향

류선열(Sun Youl Ryu),박석인(Suk In Park),김선헌(Sun Hun Kim) 대한구강악안면외과학회 1996 대한구강악안면외과학회지 Vol.22 No.1

The purpose of this study was to investigate the effect of demineralized dentin matrix on osseointegration of implants. Seven mongrel dogs of either sex, weighing about 15kg, were used. The lower 1st, 2nd, 3rd, and 4th premolars of both sides were extracted under general anesthesia. Implants were inserted 3 months after extraction of the teeth. In the control group, socket wall around the implant was sutured without any graft material. The experimental groups were divided into the two : the DDM group was filled with demineralized dentin matrix into the hole of the implant and the DDCM group filled with demineralized dentin and collagen matrix. The animals were killed 1, 2, 4, 8, and 12th weeks after the implantation. Tissue specimens obtained were processed for light and fluorescent microscopic examination. Results obtained were as follows: 1. At one week after the implantation fibrous connective tissue from the surrounding periosteum was observed at the superior portion of the alveolar bone-implant interface and blood clot was formed within the hole of the implant in control group. Endosteal proliferation from the cut surface of the compact bone was observed in the both experimental groups. 2. At two weeks after the implantation the interspace between the alveolar bone and implant became narrow, and endosteal proliferation and woven bone formation from trabecular bone was blended with demineralized dentin matrix in the both experimental groups. 3. At four weeks after the implantation some fibrous tissues were still observed in the interspace between the alveolar bone and implant in control group. However, with osteoinduction and osteoconduction by demineralized dentin matrix, osseointegration without intervening of fibrous tissue was observed in the both experimental groups. 4. At eight and twelve weeks after the implantation a complete osseointegration was noted and demineralized dentin matrix was almost resorbed in all groups. 5. By fluorescent microscopic examination, bone formation and osseointegration were noted earlier in the experimental groups than in the control group. 6. Bone healing of the DDCM group was similar to that of the DDM group. These results suggest that demineralized dentin matrix can be used as a useful material for early fixation of implants by promoting new bone formation and osseointegration of implants.

미맹출치를 동반한 Calcifying Odontogenic Cyst

류선열,정중재,정종철,박준아,최홍란,Ryu, Sun-Youl,Chung, Jung-Jae,Chung, Jong-Chull,Park, Jun-Ah,Choi, Hong-Ran 대한악안면성형재건외과학회 1993 Maxillofacial Plastic Reconstructive Surgery Vol.15 No.2

좌측 상악 구치부와 협부의 무통성 종창을 주소로 내원한 16세 여자의 좌측 상악동에서 다량의 석회화 침착과 미맹출지를 포항한 COC 1예를 구내 접근법을 통해 외과적으로 제거하였다. 적출물은 $50{\times}40{\times}35mm$의 크기였고 낭종벽으로 잘 피낭되어 있었다. 조직학적으로는 잘 발달된 상피 내벽과 ghost cell이 나타나 COC의 소견을 보였으며 석회화물은 complex odontoma의 양상을 보여 COC의 type IB로 분류되었다. 술후 1년이 지난 현재 안모의 개선을 나타내고 있으며 재발의 증상 없이 양호한 경과를 보여주고 있다. A case of calcifying odontogenic cyst associated with an unerupted tooth which appeared in the left maxillary sinus of a 16-year-old woman, was reported. Clinical examination revealed painless swelling on the left maxillary posterior region and the cheek. Radiographically, this lesion showed a monolocular radiolucent shadow with calcified materials and unerupted maxillary second premolar. Histological examination revealed cystic structure with presence of the ghost cells, calcified tissue and unerupted tooth. This lesion was classified as Type IB of COC according to classification of the Praetorius. After surgical removal of the cyst, the wound healed uneventfully and the lesion is now free of symptoms.

구강암 환자에 대한 후향적 연구

류선열(Sun Youl Ryu),박문성(Mun Seong Park) 대한구강악안면외과학회 1996 대한구강악안면외과학회지 Vol.22 No.4

Retrospective study of 89 oral cancer patients from Jan. 1987 to Dec. 1994, who have been treated at the Department of Oral and Maxillofacial Surgery, Chonnam University Hospital, was performed to assess or, if needed, to revise our present treatment protocol. The analysis was focused on the clinical and histopathological findings, treatment methods and their results. The results obtained were as follows: The histologic diagnosis of oral cancer was mostly squamous cell carcinoma followed by malignant melanoma, malignant fibrous histiocytoma. Tie lapse from the recognition of initial symptoms to the first visit was mostly less than 3 months. T4 was the most frequent followed by T3, T2, T1. The situation was the same for the clinical stage. The degree of histopathological differentiation of oral squamous cell carcinoma was in the order of well, moderate, poor differentiated type. T4 was common at maxillary sinus, maxillary and mandibular alveolus and T2 was common at mouth floor. Most cases were treated by combined therapy consisted of presurgical chemotherapy. Surgical resection and postoperative radiation therapy. In 35 cases. Surgical resection was performed. Immediate reconstruction was done in 22 cases and secondary reconstruction was done in 8 cases. The periods between primary surgery and reconstruction were 12.4 months in average. In 26 cases out of 89 cases, recurrence or metastasis was confirmed. The latest follow-up revealed that 33 patients were still alive while 35 were expired due to the malignancy.