백서의 피하조직에 Gelatin Matrix Implant (Fibrel^®) 매식시 조직변화에 관한 연구

김홍진,이종헌,김경욱,Kim, Hong-Jin,Lee, Chong-Heon,Kim, Kyung-Wook 대한악안면성형재건외과학회 1998 Maxillofacial Plastic Reconstructive Surgery Vol.20 No.4

GMI (Fibrel${(R)}$) is one of the dermal filling substances which have been successfully used for the treatment of depressed cutaneous scar and wrinkles. It's major components are; Gelatin powder, which provides a framework for the clot to form and remains stable under the scar, and ${\varepsilon}$-aminocaproic acid, which inhibits the production of fibrinolysin, and Plasma, which provides the necessary ingredients for collagen synthesis. GMI has advantages of low immunogenicity and increased longevity. It has been known to induce fibroblast activity and promote new collagen synthesis. We used 34 Sprague-Dawley rats which were bred under the same condition and duration. 18 of experimental animals were undergone cardiac puncture, and their blood were collected, centrifugated, and stored in freezer. Out of 16 animals, control group were injected with 2ml plasma into the subcutaneous tissue of Lt. scapular, while experimental group were implanted of 2 ml GMI into the Rt. same area. Experimental animals were sacrificed at the 3rd day, 5th day, 1st week and 2nd week respectively after implantation of GMI. To observe the histopathologic change of GMI and surrounding tissue reaction of GMI, we had examined with H&E staining, immunohistochemical staining with vimentin, ${\alpha}$-SMA, S-100 under LM and SEM. The obtained results were as follows ; 1. In LM study, the inflammatory cell infiltrations and granulation tissue formation were observed, and muscle tissues were well attached with adipose tissues in the control group. In the experimental group, inflammatory cell infiltrations had been observed by the 2nd week and irregular adipiose tissues and well differentiated mesenchymal tissues were examined. 2. In immunohistochemical study, the experimental group of ${\alpha}$-SMA study, there were a prominent positive response on endothelial development of granulation tissues and mesenchymal tissues compare with the control group. In vimentin study, positive response on mescenchymal fibroblast continued to 2nd week, but negative in the control group. In S-100 study, both groups were positively responded on irregular adipose tissues. 3. In SEM study, collagen fibers were embedded by the plasma by the 5th day in the control group, and in the 3rd day experiment GMI were resorved but communited with collagen fiber till the 1st week. Collagen fibers were infilt-rated into GMI at the 2nd week and the infilltrated GMI were conglomerated with the mature adipose cells and the collagen fibers. From the above results, GMI implantation in the subcutaneous tissue of Sprague-Dawley rat, the mild infiltration of inflammatory cells were showed till 2nd week and the granulation tissues were observed. GMI were nearly resorbed till 2nd week, but well attached with adipose tissue and collagen fibers. The endothelium and fibroblasts were actively proliferated. Adipose tissues and mesenchymal tissue cells were observed. As already expressed, GMI showed resorptive change in course of time without any early immune reaction, and seemed to induce fibroblast activity and promote new collagen synthesis.

백서 상복부 혈관의 동결시간에 따른 변화에 대한 연구

김우찬,이종헌,김경욱,김창진,Kim, Woo-Chan,Lee, Chong-Heon,Kim, Kyung-Wook,Kim, Chang-Jin 대한악안면성형재건외과학회 1999 Maxillofacial Plastic Reconstructive Surgery Vol.21 No.2

Vascular spasm which has been reported to occur in 25% of clinical cases continues to be a problem in microvascular surgery; When prolonged and not corrected, it can lead to low flow, thrombosis, and replant or free flap failure. Ischemia, intimal damage, acidosis and hypovolemia have been implicated as contributors to the vascular spasm. Although much work has been done on the etiology and prevention of vasospasm, a spasmolytic agent capable of firmly protecting against or reversing vasospasm has not been found. Therefore vascular freezing was introduced as a new safe method that immediately and permanently relieves the vasospasm and can be applied to microsurgical transfers. Cryosurgery can be defined as the deliberate destruction of diseased tissue or relief the vascular spasm in microvascular surgery by freezing in a controlled manner. 96 Sprague Dawley rats each weighing within 250g were used and divided into 2 group, experimental 1 and 2 group. In the experimental 1 group, right epigastric vessels (artery and vein) were freezed with a cryoprobe using $N_2O$ gas for 1 min. In the experimental 2 group, after freezing for 1 min, thawing for 30 secs and repeat freezing for 30 secs. Left side was chosen as control group in both group. We sacrified the experimental animals by 1 day, 3 days, 1 week, 2 weeks, 4 weeks & 5 months and observed the sequential change that occur during regeneration of epigastric vessels using a histologic, histomorphometric, immunohistochemical and SEM study after the vascular freezing. The results were as follows1. In epigastric arteries, internal diameters had statistically significant enlargement in 1 day, 3 days of Exp-1 group and 1 day, 3 days, 1 week & 2 weeks of Exp-2 group. Wall thickness had statistically significant thinning in 2 weeks of Exp-2 group. 2. In epigastric veins, internal diameters had enlargement of statistical significance in 1 day of Exp-1 and Exp-2 group. 3. The positive PCNA reactions in smooth muscle appeared in 1 week and increased until 2 weeks, decreased in 4 weeks. There was no statistical significance between Exp-1 and Exp-2 group. 4. The positive ${\alpha}$-SMA reaction in smooth muscles showed weak responses until 1 week and slowly increased in 2 weeks and showed almost control level in 4 weeks. 5. The positive S-100 reactions in the perivascular nerve bundles showed markedly decrease in 1 day, 3 days and increased after 1 week and showed almost control level in 4 weeks. Exp-1 group had stronger response than Exp-2 group. 6. In SEM, we observed defoliation of endothelial cell and flattening of vessel wall. Exp-2 group is more destroyed and healing was slower than Exp-1 group. To sum up, relief of vasospasm (vasodilatation) by freezing with cryoprobe was originated from the damage of smooth muscle layer and perivascular nerve bundle and the enlargement of internal diameter in vessels was similar to expeimental groups, but Exp-2 group had slower healing course and therefore vessel freezing in microsurgery can be clinically used, but repeat freezing time needs to be studied further.

치근면 처치시 결합조직 부착에 관한 초기효과의 조직병리학적 연구

문상준,이종헌,이재현,Moon, Sang-Joon,Lee, Chong-Heon,Lee, Jae-Hyun 대한치주과학회 1994 Journal of Periodontal & Implant Science Vol.24 No.1

An essential fact in the regeneration of new periodontal tissue after periodontal therapy is the reattachment of collagen fibers to the tooth. Two phenomena play a fundamental role in preventing new connective tissue attachment to the exposed root surface ; 1) The apical migration of the junctional epithelium 2) The contamination of cementum by toxic substances, especially endotoxins. Authors have used rat submucosal implantation of root sections to study the connective tissue healing to periodontally diseaed root, previously planed and demineralized with citric acid and tetracycline- HCl. The results were obtained as follows. 1. The connective tissue attachment was increased in tetracycline, citric acid, non disease, scaling and root planing order and inflammatory reaction was seen in the rat teeth, no treatment group. 2. Collagen fiber attachment at the dentin surface was more increased than cementum surface 3. In 2 week of citric acid and tetracycline-HCl specimens, osteoid was seen near the fibrotic band. 4. In the MT view, collagen fiber formation was increased with time and the numerous collagen fiber and connective tissue was more densly attached to the tooth surfaces in the tetracycline-HCl group than the citric acid group.

발치와의 혈소판 농축 혈장과 골 이식술 시행시 골 형성에 대한 임상 및 조직병리학적 연구

전영태,정진형,이종헌,임성빈,Jeon, Young-Tae,Chung, Chin-Hyung,Lee, Chong-Heon,Lim, Sung-Bin 대한치주과학회 2001 Journal of Periodontal & Implant Science Vol.31 No.2

The socket preservation procedure was a simple and effective technique, and has better prognosis for implantation. The socket preservation usually used barrier membrane in combination with/without alloplastic bone materials. A recently study had shown that a regenerative therapy to tooth extraction utilizing growth factors made better results. Platelet-rich plasma was clinically easy method that acquired the growth factors, and is known that accelerated new bone formation and mineralization of bone graft materials. The purpose of this study was to evaluate clinical and histopathologic results which occur following socket preservations using platelet-rich plasma and bovine bone powder. Twelve patients who required extraction of one or more teeth for implantation at the department of periodontics in Dankook University Dental Hospital were selected. Extraction sockets were treated by using platelet-rich plasma and bovine bone powder. 3 months later, we observed clinical and histopathological results as follows: 1. Internal vertical measurement was an average of 7.33mm preoperatively and statistically significantly decreased to an average of 1.42mm postoperatively(p<0.05). 2. External vertical measurement was an average of 3.33mm preoperatively and decreased to an average of 2.75mm postoperatively; therefore there was no significant difference. 3. Horizontal measurement was an average of 7.75mm preoperatively and statistically decreased to an average of 6.08mm postoperatively(p<0.05). 4. Osteocyte-like cells and new bone formation connected with bovine bone grafts were observed in histopathologic examination. This study implied that platelet-rich plasma and bovine bone powder grafts were effective treatment for socket preservation and regeneration of severe bony defect made by implantation failure.

Compomer와 Ketac Silver로 성견 상악 이개부 병소 충전시 조직반응에 미치는 영향

유제윤,임성빈,정진형,이종헌,Ryu, Jea-Youn,Lim, Sung-Bin,Chung, Chin-Hyung,Lee, Chong-Heon 대한치주과학회 2003 Journal of Periodontal & Implant Science Vol.33 No.4

Procedures for treatment of molar furcation invasion defects range from open flap debridement, apically repositioned flap surgery, hemisection, tunneling or extraction, to regenerative therapies using bone grafting or guided tissue regenerative therapy, or a combination of both. Several clinical evaluations using regenerative techniques have reported the potential for osseous repair of treated furcation invasions. Regenerative treatment of maxillary molars are more difficult due to the multiple root anatomy and multiple furcation entrances therefore, purpose of this study was to evaluated histologically compomer and Ketac Silver as a barrier in the treatment of a bi-furcated maxillary premolar. Five adult beagle dogs were used in this experiment. With intrasulcular and crestal incision, mucoperiostcal flap was elevated. Following decortication with 1/2 high speed round bur, furcation defect was made on maxillary premolar. 2 month later one premolar was filled with compomer and the other premolar was filled with Ketac Silver. After 4, 8 weeks, the animals were sacrificed by vascular perfusion. Tissue block was excised including the tooth and prepared for light microscope with H-E staining. Results were as follows. 1. Compomer & Ketac Silver restoration were encapsulated fine connective tissue. 2. In 4 weeks, compomer & Ketac Silver restoration slightly infiltrated inflammatory cells but not disturb the new bone or new cementum formation. 3. In 8 weeks, compomer & Ketac Silver restoration were less infiltrated iflammatory cell and encapsulated fine connective tissue. 4. Therefore, compomer & Ketac Silver filling to the grade III maxillary furcations with multiple root anatomy and multiple furcation entrances is possible clinical method and this technique is useful method for maxillary furcation involvement but it is thought that periodic maintenance should be needed

매식체 주위 열개형 골결손부에서 차단막과 골 이식술의 사용이 골 형성에 미치는 영향에 대한 임상 및 조직병리학적 연구

권칠성,홍기석,임성빈,정진형,이종헌,Kwon, Chil-Sung,Hong, Ki-Seok,Lim, Sung-Bin,Chung, Chin-Hyung,Lee, Chong-Heon 대한치주과학회 2005 Journal of Periodontal & Implant Science Vol.35 No.3

The purpose of this study is to examine the effect of non-resorbable membrane such as e-PTFE which was used with DFDB in bone regeneration on dehiscence defect in peri-implant area. Amomg the patients, who have recieved an implant surgery at the department of Periodontics in Dan Kook University Dental Hospital, 12 patients showed implant exposure due to the dehiscence defect and 15 implants of these 22 patients were the target of the treatment. Periodontists randomly applied $Gore-Tex^{(R)}$ to the patients and treated them with antibiotics for five days both preoperatively and postoperatively. Reentry period was 26 weeks on average in maxilla and 14 weeks on average in mandible. The results were as follows : 1. Dehiscence bone defect frequently appeared in premolar in mandible and anterior teeth in maxilla respectively. 2. Among 15 cases, 1 membrane exposure was observed and in this case, regenerated area was decreased. 3. In non-resorbable membrane, bone surface area $9.25{\pm}4.84$ preoperatively and significantly increased to $11.48{\pm}7.52$ postoperatively(0.05). 4. The increase of bone surface area in non-resorbable membrane was $2.23{\pm}3.38$. 5. As a result of histopathological finding, DFDB surrounded by new bone formation and lamellate bone, resorption of DFDB and bone mineralization was found. Also, fibrosis of connective tissue beneath the membrane was found. This study shows that the surgical method using DFDB and non-resorbable membrane on dehiscence defect in peri-implant area is effective in bone regeneration.

물리적 자극에 따른 사람 치은 섬유모세포에서 collagen I, elastin, matrix metalloproteinase-1 및 tissue inhibitor of metalloproteinase-1의 발현

차대식(Dae Sik Cha),이종헌(Chong Heon Lee),차경석(Kyung Suk Cha) 대한구강악안면병리학회 2007 대한구강악안면병리학회지 Vol.31 No.5

치조제 결손부에 매식체 식립 시 혈소판 농축 혈장과 골이식술의 사용이 골형성에 미치는 영향에 대한 임상 및 조직 병리학적 연구

정의영,임성빈,정진형,홍기석,이종헌,Jung, Ui-Young,Lim, Sung-Bin,Chung, Chin-Hyung,Hong, Ki-Seok,Lee, Chong-Heon 대한치주과학회 2005 Journal of Periodontal & Implant Science Vol.35 No.1

Alveolar ridge defects may limit or restrict placement of implants. The purpose of this study was to evaluate clinical and histopathologic results which occur following guided bone regeneration using platelet-rich plasma, bovine bone powder and e-PTFE membrane in the localized alveolar bone defects. Ten patients who required guided bone regeneration in implant placemnet, were slelected. Alveolar crest height and width were measured at baseline and, afer 2nd surgery 5 months later At 5 months , we obtained histopathological results as follows: 1. Alveolar crest height was an average of $8.20{\pm}3.74$ mm preoperatively and decreased to an average of $7.40{\pm}1.84$ mm postoperatively. There was no significant difference. 2. Alveolar crest width was an average of $4.25{\pm}2.03$ mm preoperatively and significantly increased to an average of $7.20{\pm}2.44$ mm postoperatively (P<0.01) 3. The change of Alveolar crest height and width were $0.80{\pm}1.40$ mm, $2.95{\pm}1.09$ mm 4. Histopathological evaluations revealed new bone formation with graft material and laminated bone containing the presence of osteocyte-like cell In conclusion, guided bone regeneration using platelet-rich plasma, bovine bone powder and e-PTFE membrane would provide a viable therapeutic alternative for implant placement in the localized alveolar defect or implant failure

두 종의 Bovine Bone Powder가 성견 발치와 치유에 미치는 영향에 관한 조직병리학적 연구

이상훈,임성빈,정진형,이종헌,Lee, Sang-Hun,Lim, Sung-Bin,Chung, Chin-Hyung,Lee, Chong-Heon 대한치주과학회 2002 Journal of Periodontal & Implant Science Vol.32 No.2

Recently the esthetic demands of clinicians and patients made the surgeon try to regenerate bone defects and gingival tissue after extraction. For that, many surgical methods were used and socket preservation have been evaluated simple, effective and good prognosis in the implant placement. Bone grafting was one of the methods for socket preservation. This study was to evaluate the histologic view of the effects on healing of the extraction sockets when deproteinized bovine bone mineral and tetracycline coated deproteinized bovine bone mineral was implanted 1. In control group, at 4 weeks after implantation, the extraction sockets were filled with connective tissue. And after 8 weeks, osteoblasts were observed in newly formed trabecular among the fibrous connective tissue in the extraction sockets. 2. In experimental 1 group, there was connective tissue and new bone trabecular around newly formed woven bone at 4 weeks. And many osteoblasts were observed in various direction at 8 weeks. 3. In experimental 2 group, there was a lot of new bone made around the bone powder after 4 weeks, and the thicker bone trabecular, lamellar bone and irregular osteoblasts arrangement were observed at 8 weeks. From the results of this study, tetracycline coated BBP would be better than the other groups in the lamellar bone formation and be faster in the bone formation rate.

성견 치근이개부 병소에서 Calcium Sulfate 차폐막이 치주조직 재생에 미치는 영향에 대한 조직 병리학적 연구

김영출,임성빈,정진형,이종헌,Kim, Young-Chool,Lim, Sung-Bin,Chung, Chin-Hyung,Lee, Chong-Heon 대한치주과학회 2003 Journal of Periodontal & Implant Science Vol.33 No.4

The present study evaluated the effects of guided tissue regeneration using xenograft material(deproteinated bovine bone powder), with and without Calcium sulfate membrane in beagle dogs. Contralateral fenestration defects (6 ${\times}$ 4 mm) were created 4 mm apical to the buccal alveolar crest of maxillary premolar teeth in 5 beagle dogs. Deproteinated bovine bone powders were implanted into fenestration defect and one randomly covered Calcium sulfate membrane (experimental group). Calcium sulfate membrane was used to provide GTR. Tissue blocks including defects with soft tissues which were harvested following four & eight weeks healing interval, prepared for histo-phathologic analysis. The results of this study were as follows, 1. In control group, at 4 weeks after surgery, new bony trabecular contacted with interstitial tissue and osteocytes lie cell were arranged in new bony trabecule. Bony lamellation was not observed. 2. In control group , at 8 weeks after surgery, scar-like interstitial tissue was filled defect and bony trabecule form lamellation. New bony trabecular was contacted with interstitial tissue but defect was not filled yet. 3. In experimental group, at 4 weeks after surgery, new bony trabecular partially recovered around damaged bone. But new bony trabecule was observed as irregularity and lower density. 4. In experimental group, at 8 weeks after surgery, lamella bone trabecular developed around bone cavity and damaged tissue was replaced with dense interstitial tissue. In conclusion, new bone formation regenerated more in experimental than control groups and there was seen observe more regular bony trabecular in experimental than control groups at 4 weeks after surgery. In control group, at 8 weeks after surgery, the defects was filled with scar-like interstitial tissue but, in experimental group, the defects was connected with new bone. Therefore xenograft material had osteoconduction but could not fill the defects. We thought that the effective regeneration of periodontal tissue, could be achieved using GTR with Calcium sulfate membrane.