하악골 절제술후 재이식된 돌결자가골 재이식 : 치험 3례

김 식,김수관,김운규,김수민,류종희,이준길,조경안,김수흥,정태영,여환호 대한악안면성형재건외과학회 2001 Maxillofacial Plastic Reconstructive Surgery Vol.23 No.2

We described three cases of immediate reimplantation of a frozen-thawed autogenous mandible composed of a mixture of iliac bone, marrow, and particulate hydroxyapatite in tumors of the mandible. Acceptable outcomes were obtained in three patients who underwent immediate autogenous mandibular graft reconstruction. The conditions leading to successful outcome of the procedure are also discussed. Reimplantation of frozen autogenous lesioned mandible was performed in three patients with mandibular tumors. Two reimplanted grafts survived without complications following surgery. One case had postoperative infection that resolved with appropriate antibiotic treatment. There were no recurrences of the primary lesions. Satisfactory facial contour after surgery was achieved. These results are most promising, and we believe that, with further refinement, this technique will offer a new and acceptable modality for facial reconstruction in patients with cancer.

Medpor 매식후 치유과정에 Methylprednisolone이 미치는 영향

김수관,정성수 전남대학교 치과대학 1999 전남치대논문집 Vol.11 No.1

The purpose of this study is to evaluate the effect of methylprednisolone on the healing process and the effect on the contact surface of Medpor?? and bone after administering the methylprednisolone, and also the effect on the elapse of time in healing and on thickness after implantation of Medpor??. In this study, the middle part of the rat skull was exposed and Medpor?? was placed under the periosteum; the diameter : 8 mm, thickness : 1.5 mm (thin) and 4.5 mm (thick). Then coverage of the periosteum was performed. After the administeration of methylprednisolone, the light microscopic and scanning electron microscopic examinations and hardness measurements were performed after 2-, 4-, 8-weeks implantation. The results of this study were obtained as follows : 1. The inflammatory responses of the control group and the experimental group were reduced over time, especially of the experimental group. They almost disappeared at 8 weeks after surgery. 2. In light microscopic examination, 1.5 mm implants responded better than 4.5 mm and osteoid formation showed a slightly at 4 weeks after surgery. It showed increased findings at 8 weeks after surgery and the experimental group showed slightly decreased findings compared to the control group. 3. In scanning electron microscopic examination, a large number of osteoblasts came up through the observation, inflammatory reactions disappeared faster in the experimental group than the control group. The arrangement and the amount of deposition of bone matrix over time in the experimental group was more irregular and reduced than in the control group. These findings were more remarkable in 4.5 mm than in 1.5 mm. The fibrous connective tissue was shown in the thicker implant rather than the bony tissue. 4. In hardness measurement, bone adjacent to Medpor?? showed a statistical difference in the hardness depending on the time, the thickness, and the use of methylprednisolone : Hardness was decreased over time and in the thicker implant, and the use of methylprednisolone (P<0.001). It is concluded that the methylprednisolone is considered to suppress the inflammatory reaction, however, it could delay the wound healing because of the inhibition of osteoblastic activity. So, the use of methylprednisolone should be restricted except serious inflammatory response after the operation.

비강상악동 미분화암종

김운규,김수관,조세인,윤정훈 대한악안면성형재건외과학회 2002 Maxillofacial Plastic Reconstructive Surgery Vol.24 No.4

Sinonasal undifferentiated carcinoma(SNUC) is an uncommon aggressive malignancy of the nasal cavity and paranasal sinuses. Since the initial recognition of SNUC as a distinct clinicopathological entity, treatment regimens have evolved to include the current recommendation of combined radical resection, radio-therapy and chemotherapy. Despite this aggressive therapy, outcomes have remained dismal, with the mean survival time still being less than 1 year after diagnosis. SNUC present with locally advanced disease, with a tendency for the tumor to spread from the paranasal siuses to the orbit and anterior cranial fossa. A case of SNUC occurred in the left maxilla showing an unusual clinical manifestations and a fulminant course of disease, is described with literatures review. A 77-year-old female patient presented with rapidly growing tumor-like bulging of the left maxilla and slight ulceration of the right upper posterior vestibule. At the first biopsy, diagnosis was a radicular cyst, but SNUC was made subsequently by the second biopsy 6 month later. Rapid and wide extension from the maxilla to the orbit and nasal cavity developed with infection. Although the time relationship is not clear, local invasion could be developed from localized disease of SNUC. Despite combined therapy with chemotherapy and radiotherapy, She has been expired 13 months after the first biopsy. Focal positivity of immunohistochemical stain(CK, EMA), which is a specific characteristic of SNUC, may serve as a factor showing unfavorable prognosis.

구강점막섬유화에 의한 개구제한 : 증례보고 A CASE REPORT

김 훈,김수관,하정완 大韓顎顔面成形再建外科學會 2003 Maxillofacial Plastic Reconstructive Surgery Vol.25 No.2

Oral submucous Fibrosis(OSF) is an insidious chronic disease affecting the mucosa of the oral cavity and occasionally extending into the pharynx and esophagus. It is associated with a genetic predisposition and alterations, infectious and viral agents, carcinogens, nutritional and immunological factors. the etiology is obscure but it is correlated with a hypersensitivity to capsaicin, secondary to chronic iron and/ or vitamin B complex deficiencies or exposure to cashew kernel oil. We report a patient who had a month opening limitation caused by a fall when he was 8 years old despite several treatments at other hospitals. Excellent results were obstained by releasing the scar tissue using a standard split-thickness skin graft(STSG) which obtained from the thigh. It is important to recognize as a precancerous condition and to inspect the excision site and the remaining oral mucosa during long-term follow-up on a regular basis.

구강악안면 감염 환자에 관한 임상 통계학적 분석

김미성,남옥현,김수관,조세인 대한악안면성형재건외과학회 2002 Maxillofacial Plastic Reconstructive Surgery Vol.24 No.4

This is a clinico-statistical study of 532 oral and maxillofacial infected patients who were treated at Chosun University Dental Hospital during the period 1996-2001. The following results were obtained. The ratio of male to female ratio was 0.85:1. The highest monthly incidence was shown in June (10.15%) and July (9.77%), and the age distribution peaked in the 60s (15.60%), followed by 50s (14.29%) and 40s (13.53%). The most frequent cause was dental caries (43.05%), periapical abscess (13.72%), periodontal lesion (8.83%), and pericoronitis (8.27%). In terms of the delay time between onset of symptoms and visit, the highest incidence (56.20%) occurred at 1-3 days. In terms of the length of treatment, the highest incidence (36.65%) occurred at 7-9 days. Underlying medical problems were found in 161 patients, the most common being hypertension (27.33%) and diabetes (26.71%). The most common facial space involved was the buccal space (34.85%), followed by the submandiblular space (29.30%), canine space (17.17%), submental space (6.23%), and sublingual space (3.87%). In respect of antibiotics therapy, penicillin, aminoglycoside and metronidazole complex were most prevalent.

상악골 전방부 골절단술후 발생된 개방형 열개 : 증례보고 A CASE REPORT

김훈,김수관,이준길,정태영 大韓顎顔面成形再建外科學會 2003 Maxillofacial Plastic Reconstructive Surgery Vol.25 No.3

An anterior segmental osteotomy may be complicated by malpositioning,bleeding, perfusion deficiencies, periodontal defects(dehiscence), devitalized teeth, oronasal fistula, and nonunion(delayed union).If preiodontal defects occur after surgery, though hygiene and good nutrition are all that can be recommended until primary healing has occurred. However, a soft tussue graft might be needed at the defect site when the preiodontal defects do not heal properly. We reported a patient who showed an excellent prognosis after undergoing a palatal mucosa graft accompanied by laterally positioned flap as a result of a dehiscence that occurred after anterior segmental osteotomy.

쿠퍼씨 방법을 이용한 상악 전방부 골절단술

김소영,김수관,이상호,김수응,정태영,안태훈 대한악안면성형재건외과학회 2001 Maxillofacial Plastic Reconstructive Surgery Vol.23 No.5

Anterior segmental osteotomy were performed in 8 patients with Angle's II malocclusion or anterior maxillary protrusion. Cupar's method was used for operation. The period of follow up for patients were 15months by average. This study discussed the postoperative complications and soft tissue change after anterior segmental maxillary osteotomy. There are not specific major complications.

치아회분의 세포독성 및 과민성 검사

김영균,김수관,이장희 대한악안면성형재건외과학회 2001 Maxillofacial Plastic Reconstructive Surgery Vol.23 No.5

The purpose of this study was to determine the cytotoxicity and hypersensivity of toothash which we deloped. As a result of a cell toxicity experiment to use MTT assay, there were no differences between toothash group and control group. The cytotoxicity was thought to be absent. Particular allergic reaction did not appear compared with the control group in toothash group.

구강 연조직 병소의 Nd:YAG laser를 이용한 치료 : 임상 증례보고 CLINICAL CASE REPORTS

김수관,조세인,권병곤,이상호 대한악안면성형재건외과학회 2002 Maxillofacial Plastic Reconstructive Surgery Vol.24 No.4

The neodymium:yttrium-aluminum-garnet (Nd:YAG) laser is most widely used for treatment of lesions affecting the oral mucosa. A pulsed Nd:YAG laser (SDL-300EN, Samsung Electronics, Korea) with a wavelength of 1.32㎛ was used. In all cases, contact mode was used. Four cases of soft tissue oral lesions are presented to document the clinical aspects. Surgery proceeded without complication and healing was uneventful. This study indicate that the Nd:YAG laser can be used successfully for intraoral soft tissue applications are well tolerated and minimal bleeding.

변형 LeFort Ⅲ 골절단술을 이용한 중안면 성장부전을 동반한 하악전돌증의 치험례

김문수,김수관,류종회 대한악안면성형재건외과학회 2001 Maxillofacial Plastic Reconstructive Surgery Vol.23 No.2

Maxillary-malar deficiency is the most frequently occurring midface dentofacial deformity. Clinicaly patients with maxillary-malar deficiency exhibit malar and infraorbital rim deficiency and class III malocclusion. For treatment of these deformities, modified LeFort III osteotomy have been used. Modified LeFort III osteotomy advances maxilla with orbital rims and zygomatic bone anteroposteriorly. This is a case of patient who had severe mandibular prognthism with midface deformity. We performed modified LeFort III osteotomy for maxillary-malar advancement and simultaneous bilateral sagittal split ramus osteotomy for mandibular prognathism and autogenous iliac bone graft.