백서에서 자가 구강점막세포와 혈소판 농축 혈장의 이식에 의한 점막 근 피판의 조직공학적 제작

이부규(Bu Kyu Lee),황진혁(Jin Hyuk Hwang) 대한구강악안면외과학회 2007 대한구강악안면외과학회지 Vol.33 No.4

Backgrounds: To overcome limited amount of autogenous mucosa for the reconstruction of various mucosal defect including oral mucosal defect, tissue engineered mucosa has been recently introduced. However, introduced conventional technique of tissue engineered mucosa still have serious pitfalls such as long fabrication time, fragility of the reconstructed mucosa, and complexity of the technique. Aim of the study: To examine whether the complex of preconfluent autologous keratinocytes and autologous PRP (Platelet rich plasma) can reconstruct oral mucosa on the muscular flap with easier and faster way compared to conventional mucosal tissue engineering technique. Materials and methods: One day before the operation, oral mucosa (3mm in diameter) were taken and treated for extraction of oral keratinocytes according to the routine manner. The day of operation, oral keratinocytes were prepared in the laboratory and then moved to the operating theater. Autologous PRP was also prepared and then mixed with oral keratinocytes just before grafting on the prepared muscular flap. After keratinocyte-PRP complex was seated, then a sterilized rubber sheet was placed on the graft and the elevated skin flap was replaced and sutured. Biopsies were proceeded at 3,5,7,14 and 21 days. Tissue samples were evaluated clinically, histologically, and immunohistochemically. Results: All of the oral keratinocyte-PRP complexes were successfully grafted on the recipient sites (100%). On 3 days after the operation, 1-2 continuous epithelial layer and many inflammatory cells were observed. On 5 days after the operation, increase of layers of keratinocyte was observed with less inflammatory response. Thickness of the layers was gradually increased from 7 to 21 days after the operation. Cytokeratin confirms epithelium in every specimen. Conclusions: Preconfluent graft of autogenous oral keratinocytes mixed with autogenous PRP have successfully reconstructed myo-mucosal flap. This technique could be a useful alternative for oral mucosal reconstruction in the near future.

중국 덕주 지역의 구순구개열 의료 봉사 활동 보고 및 치험례 발표

이원덕,이부규,최진영,김종렬,오용석,민병일,김명진,Lee, Won-Deok,Lee, Bu-Kyu,Cho, Jin-Young,Kim, Jong-Ryul,Oh, Yong-Seok,Min, Byoung-Il,Kim, Myung-Jin 대한악안면성형재건외과학회 2009 Maxillofacial Plastic Reconstructive Surgery Vol.31 No.5

Il Woong Cleft lip and palate foundation was founded in 1968 by Professor emeritus Byoung-Il Min. Since then the foundation has operated numerous cleft lip and palate patients not only in Korea but also in under-developed countries such as Vietnam, China, and Cambodia. In December 2005, the foundation was allowed as an incorporated association by Ministry of Foreign affairs and Trade, so that it could have official status. From March 6th 2009 to March 14th 2009, we conductp,d charity cleft lip and palate operations of 23 patients in areas of Deozhou, China. Hereby we present the results of operations.

폐와 하악골에 다발성으로 발생한 Histiocytosis X

황진혁(Jin-Hyuk Hwang),이부규(Bu-Kyu Lee) 대한구강악안면외과학회 2005 대한구강악안면외과학회지 Vol.31 No.3

Hitiocytosis X, recently termed Langergans cell histiocytosis, is a rare disease histologically characterized by an abnormal proliferation of histiocytes, and of which the pathophysiology is still ambiguous. The clinical presentation is highly varied. Typically, there is a solitary or multiple bony involvements, and less frequently, lesions are found in other organs such as the lungs, liver, lymph nodes, skin, and mucosae. Interestingly, so far, there has been no report which shows multiple developments in both soft and hard tissues. In this report, we present a case of hitiocytosis X in both mandible and lung. This may provide some information for understanding the pathophysilogy of the histiocytosis X.

백서에서 혈소판 풍부 혈장의 제작과 유효성에 대한 실험적 연구

이상훈,조영욱,지현숙,안강민,이부규,Lee, Sang-Hoon,Cho, Young-Uk,Chi, Hyun-Sook,Ahn, Kang-Min,Lee, Bu-Kyu 대한악안면성형재건외과학회 2007 Maxillofacial Plastic Reconstructive Surgery Vol.29 No.2

Purpose: Platelet-rich plasma (PRP) is known to accelerate and/or enhance hard and soft tissue healing and regeneration. As such, PRP has been used in various clinical fields of surgery. Recently there have been several attempts to use PRP in the field of tissue engineering. However, some controversies still exist on exact mechanism and benefits of PRP. Therefore various animal experiments are necessary to reveal the effect of the PRP. However, even if animal experiment is performed, the efficacy of the experiment could not be validated due to absence of an animal PRP model. The purpose of this study is to establish rat PRP model by comparing several PRP fabricating methods, and to assay growth factor concentration in the PRP. Materials and methods: Rat blood samples were collected from nine SD rat (body weight: 600-800g). PRP was prepared using three different PRP fabricating methods according to previously reported literatures. (Method 1: 800 rpm, 15 minute, single centrifuge; Method 2: 1000 rpm, 10 minute, double centrifuge; Method 3: 3000 rpm, 4min and 2500 rpm, 8 min, double centrifuge). Platelet counts were evaluated in an automated machine before and after PRP fabrications. In terms of growth factor assay, prepared PRP were activated with 100 unit thrombin and 10% calcium chloride. Growth factor (PDGF-BB, VEGF) concentrations on incubation time were determined by sandwich-ELISA technique. Results: An average of 3ml (via infraorbital venous plexus) to 15ml (via celiac axis) the rat blood could be collected. By using Method 3 (3000 rpm, 4 min and 2500 rpm, 8 min, double centrifugation), around 1.5ml of PRP could be prepared. This method allowed us to concentrate platelet 3.77-fold on average. PDGF-BB concentration (mean, 1942.10 pg/ml after 1 hour incubation) and VEGF concentration (mean, 952.71 pg/ml after 1 hour incubation) in activated PRP were higher than those in untreated blood. Also PDGF-BB showed constant concentration during 4-hour incubation, while VEGF concentration was decreased after 1 hour. Conclusion: Total 11,000 g minute separation and condensation double centrifuge method can produce efficient platelet-rich plasma. Platelet-rich plasma activated with thrombin has showed higher concentrations of growth factors such as PDGF-BB and VEGF, compared to the control group. Platelet-rich plasma model in a rat model was confirmed in this study.

하악골에 발생한 동정맥 기형의 혈관 색전술에 의한 치험례

이승호(Seung-Ho Lee),서대철(Dae-Cheol Seo),장현호(Hyun-Ho Chang),이부규(Bu-Kyu Lee) 대한구강악안면외과학회 2003 대한구강악안면외과학회지 Vol.29 No.6

Mandibular arteriovenous malformations(AVM) are relatively rare and potentially life threatening lesions. Surgical treatment consists of wide resection of the mandible, which is difficult and potentially hazardous due to significant blood loss during surgery. Therefore, some authors advocate that transvenous embolization may be a safer and more effective method in the treatment of mandibular AVM. We report a treatment case of mandibular AVM in a 9-year-old-girl for episodes of spontaneous bleeding for 6 days using by selective transarterial embolization ,direct puncture embolization and microcoil embolization.

치성 협부 봉와직염의 증상으로 발현된 Sweet 증후군; 증례 보고

김용진,변수환,김준영,안강민,전주홍,이부규,Kim, Yong-Jin,Byun, Soo-Hwan,Kim, Jun-Young,Ahn, Kang-Min,Jeon, Ju-Hong,Lee, Bu-Kyu 대한악안면성형재건외과학회 2007 Maxillofacial Plastic Reconstructive Surgery Vol.29 No.6

Sweet syndrome is characterized by acute onset of fever. neutrophilic leukocytosis, painful erythematous plaque on the face and extremities, infiltration of mature neutrophils in the dermis. Cutaneous lesion and clinical symptoms rapidly improve after treatment with systemic corticosteroids. The cause of sweet syndrome is unknown but the associations with hypersensitivity to bacteria, virus, or tumor antigen have been reported. Sweet syndrome itself can be a premonitory manifestation of malignancy, so diagnostic work up for other internal malignancy is recommended. Because of fever and leukocytosis, cutaneous infections are important differentials. Sweet syndrome can be divided into 4 categories according to associated disease and symptom. (Idiopathic Sweet syndrome, Parainflammatory Sweet syndrome, Paraneoplastic Sweet syndrome, Pregnacy associated Sweet syndrome.) Sweet syndrome is relatively rare disease and the association with myelodisplastic syndrome has been reported. We report a case of Sweet syndrome associated with myelodisplastic syndrome which has initial manifestation of odontogenic buccal cellulites.

골격성 제3급 부정교합환자의 하악지 시상분할 골절단술후 하안면 폭경 및 고경의 변화에 대한 두부계측 방사선학적 연구

장현석,임재석,권종진,이부규,손형민 대한악안면성형재건외과학회 2000 Maxillofacial Plastic Reconstructive Surgery Vol.22 No.3

Purpose : The purpose of this study was to analyze the lower third facial changes in frontal view after mandibular setback surgery. Materials and Methods : In this study, fifteen subjects(6 males and 9 females) with class III dental and skeletal malocclusions who were treated with BSSRO(Bilateral Sagittal Split Ramus Ostetomy) were used. Frontal cephalometric radiographs were taken preoperatively and more than 6 months postoperatively, and hard tissue(H2-Hl) and soft tissue changes (S2-S1) were measured on vertical and horizontal reference lines. In 15 cases, changes which developed more than 6 months after surgery were studied. Results : The results were as follows. 1.In the facial height, hard tissue decreased(2.46±2.76mm) with statistical significance(P<0.01), and soft tissue also decreased(1.64±3.66mm). As a result, the facial height generally becomes shorter after sagittal split ramus osteotomy. 2.In the mandibular width, hard tissue decreased(2.08±3.59mm) with statistical sgnificance(P<0.05), but soft tissue increased (2.14±5.73mm) without statistically significant difference (P>0.05) postoperatively. 3.In the facial index, hard tissue decreased(0.23±2.21%), but soft tissue increased(2.41±3.46%) with statistical significance. Conclusion : One of the main purpose of orthognathic surgery is to achieve facial esthetics and harmony. In order to fullfill this purpose, it is important to carry out a precise presurgical treatment planning by estimating the changes of frontal profile after surgery.