얼굴신경의 해부학

곽현호(Hyun-Ho Kwak),박봉수(Bong-Su Park),김희진(Hee-Jin Kim) 대한치과의사협회 2012 대한치과의사협회지 Vol.50 No.10

This study examined the anatomical relationships along with the variability of the facial nerve trunk and its branches with an emphasis on the intraparotid connections between the divisions. And histomorphometric observations of the facial nerve branches and fascicles were performed on 40 Korean half-heads. The facial nerve trunk was bifurcated into two main divisions(35/40, 87.5%) and the other five cases were divided into a trifurcation pattern. According to the origin of the buccal branch, the branching patterns of the facial nerve were classified into four categories. Communications between the facial and auriculotemporal nerve branches were observed in 37 out of 40 cases(92.5%). In the histological observation, the buccal branch had the greatest number of branches(3.47), however the zygomatic branch had the largest diameters(0.93㎜). This detailed description of the facial nerve anatomy will provide useful information for surgical procedures such as a tumor resection, a facial nerve reconstruction, autonerve graft, and facelift.

Histomorphometric Characteristics of the Facial Nerve

Hyun-Ho Kwak(곽현호),Byung-Chan Koo(구병찬),Kyung-Seok Hu(허경석),Gyoo-Cheon Kim(김규천),Bong-Soo Park(박봉수),Hee-Jin Kim(김희진) 대한체질인류학회 2008 해부·생물인류학 (Anat Biol Anthropol) Vol.21 No.4

얼굴신경의 손상은 기능적인 장애뿐 아니라 심미적, 정신적으로도 심한 문제를 야기하기 때문에 얼굴신경의 결손 치료를 위한 다양한 자가신경의 이식술(autonerve graft)이 시행되고 있다. 자가신경이식의 성공을 위해서는 신경의 절단면적, 신경다발(fascicle)의 개수 등 얼굴신경의 미세해부학적 구조에 대하여 명확히 알고 있어야 한다. 그러나 한국인의 얼굴신경에 대한 미세해부학적 연구가 없다. 따라서 이 연구의 목적은 한국인 얼굴신경가지들의 각 부위에 대한 미세해부학적 구조를 확인하는데 있다. 한국인 시신의 머리 40쪽을 해부하여 얼굴신경을 노출시키고, 각 신경가지를 분류하였다. 신경가지의 수와 직경을 계측한 후, 조직염색을 하여 부위에 따른 신경다발의 수, 면적 등을 계측하였다. 얼굴신경가지의 개수는 볼가지가 평균 3.47개로 가장 많았으며, 관자가지 2.67개, 광대가지 2.03개, 턱모서리가지 1.57개, 목가지 1.27개였다. 얼굴신경가지의 평균직경은 광대가지가 0.93㎜로 가장 두꺼웠으며, 관자가지가 0.75㎜로 가장 얇았다. 신경다발의 수는 하나부터 아홉 개까지 다양하였으며, 얼굴신경줄기의 신경다발이 평균 4.36개로 가장 많고, 먼 곳으로 갈수록 적어지는 양상을 보였다. 신경다발의 총면적은 각각 얼굴신경줄기에서 2.72 ㎟, 관자얼굴가지에서 1.88㎟, 목얼굴가지에서 1.04㎟로 계측되었다. 얼굴신경의 미세해부학적 구조에 대한 이 연구결과는 얼굴신경의 결손 치료를 위한 기초자료로 활용할 수 있을 것이다. With the development of microsurgery, autogenous nerve grafting is being used widely in the treatment of the injured facial nerve. To use a donor graft for repair of the facial nerve, fascicular area and fascicular number should be considered in the selection of the donor site. This study demonstrated a detailed morphologic description of the facial nerve, including a microscopic assessment of nerve size and shape, and fascicular number and diameters. 40 embalmed hemi-sectioned head specimens from Korean adult cadavers were dissected to identify the facial nerve branches and nerve samples for histologic examination were cut from the anterior margin of the parotid gland. At the border of the parotid gland, the facial nerve specimens were found to have an average of 11 branches (ranging from 8 to 16). The branches were distributed among the five distinct branches, the buccal branch had the greatest number of branches (3.47), and the zygomatic branch had the largest diameters (0.93㎜), The number of fascicles varied from one to 9 over the course of the nerve, the trunk had the greatest number of fascicles (4.36), and averages indicated a tendency for fascicular numbers to decrease distally, from trunk (4.36) to upper division (3.72) to lower division (3.60) to marginal mandibular branch (2.37). The total fascicular area was averaging 2.72㎟, 1.88㎟, and 1.04㎟ at trunk, upper division, and lower division, respectively. However no significant differences of the fascicular diameter could be shown between five branches. This results of detailed facial nerve microanatomy should help in the treatment of the injured facial nerve.

한국인 위턱뼈동굴 아래벽의 국소해부학적 관계

곽현호(Hyun Ho Kwak),윤혜림(Hae Rym Yoon),허경석(Kyung Seok Hu),강민규(Min Kyu Kang),박현도(Hyun Do Park),고기석(Ki Seok Koh),박창서(Chang Seo Park),김기덕(Ki Deog Kim),김희진(Hee Jin Kim) 대한체질인류학회 2001 해부·생물인류학 (Anat Biol Anthropol) Vol.14 No.2

연구자들은 한국사람 시신 위턱뼈 24쪽의 절단표본을 제작하여 영상분석기 (Image-ProⓡPlus, Ver, 4.0, Media Cybernetics U. S. A.) 상에서 위턱 치아뿌리 끝과 위턱뼈동굴 벽 사이의 최단거리, 위턱뼈동굴 아래 벽 치밀뼈관의 두께, 볼 쪽과 입천장 쪽 이틀 뼈 치밀뼈관에서 치아뿌리까지의 거리 등 모두 21개 항목을 계측하고, 계측 값의 상관분석을 시행하여 다음과 같은 결과를 얻었다. 1. 위턱 첫째 작은 어금니에서 볼 쪽 치아뿌리 및 입천장 쪽 치아뿌리 끝에서 위턱뼈동굴 아래 벽까지 거리의 평균 수치는 각각 5.72mm, 6.27 mm이었으며, 위턱 둘째 작은 어금니의 경우, 치아뿌리에서 동굴아래 벽까지의 거리는 평균 4.82mm였다. 위턱 첫째 큰 어금니의 경우, 안쪽 볼 쪽 치아뿌리, 가쪽볼쪽 치아뿌리 그리고 입천장 쪽 치아뿌리 끝에서 위턱뼈동굴 아래 벽까지의 평균 거리는 각각 3.01mm, 3.53mm, 3.87mm였고, 위턱 둘째 큰 어금니의 경우, 안쪽 볼 쪽 치아뿌리, 먼쪽볼쪽 치아뿌리 그리고 입천장 쪽 치아뿌리 끝에서 위턱뼈동굴 아래 벽까지의 평균 거리는 각각 2.82mm, 2.74mm, 3.40mm였다. 2. 위턱뼈동굴 아래 벽의 치밀뼈관의 두께를 계측한 결과, 볼 쪽 및 입천장 쪽 치아뿌리 부위에서 위턱 첫째 작은 어금니 부위의 위턱뼈동굴 아래 벽 치밀뼈판의 두께가 가장 얇았고, 둘째 작은 어금니 치아뿌리 부위에서 두께가 가장 두꺼운 경향을 보였으며, 뒤쪽의 첫째 큰 어금니, 둘째 큰 어금니 부위로 갈수록 위턱뼈동굴 아래 벽 치멸뼈관의 두께는 다시 얇아지는 양상을 보였다. 3. 절단표본에서 위턱 큰 어금니의 치아뿌리 끝과 위턱뼈동굴 아래 벽 사이의 수직적인 위치관계를 확인한 결과, 위턱 첫째 큰 어금니 중 볼 쪽과 입천장 쪽 치아뿌리 끝을 연결한 선보다 위턱뼈동굴 아래 벽이 위쪽에 위치하는 경우(Type I)가 12예(54.5%)로 가장 많았으며, 위턱 둘째 큰 어금니 부위에서도 볼 쪽과 입천장 쪽 치아 뿌리 끝을 연결한 선보다 위턱뼈동굴 아래 벽이 위쪽에 위치하는 경우(Type I)가 11예(52.4%)로 가장 많았다. 4. 절단 표본에서 위턱 큰 어금니의 치아뿌리 끝과 위턱뼈동굴 아래 벽 사이의 수형적인 위치관계를 3가지 유형으로 분류하였으며, 위턱 첫째 큰 어금니 부위에서 위턱뼈동굴의 가장 아래 부분이 볼 쪽 치아뿌리와 입천장 쪽 치아뿌리 각각의 연장선 사이에 위치하는 경우(Type 2)가 8예 (80%) 있었으며, 위턱 둘째 큰 어금니 부위에서도 위턱뼈동굴이 Type 2인 경우가 8예 (80%)로 대부분이었다.

인천 국제 공항에서의 CAT-I 착륙을 위한 GPS 확장 시스템 설계

곽현호(Hyun-Ho Kwak),원유두(Yu-Doo Won),오병주(Byung-Ju Oh),정지웅(Ji Ung Jeong),이은성(Eun-Sung Lee),조완희(Wan-Hee Cho),이영재(Young Jae Lee) 한국항공우주학회 1998 韓國航空宇宙學會誌 Vol.26 No.5

인천 국제 공항에서의 CAT-I 착륙을 위한 GPS 확장 시스템 설계

곽현호(Hyun-Ho Kwak),원유두(Yu-Doo Won),오병주(Byung-Ju Oh),정지웅(Ji Ung Jeong),이은성(Eun-Sung Lee),조완희(Wan-Hee Cho),이영재(Young Jae Lee) 한국항공우주학회 1998 韓國航空宇宙學會誌 Vol.26 No.7

Synthetic Chenodeoxycholic Acid Derivative HS-1200-Induced Apoptosis of Human Oral Squamous Carcinoma Cells

김인령,손현진,곽현호,김규천,박봉수,최원철,고명연,안용우,Kim, In-Ryoung,Sohn, Hyeon-Jin,Kim, Gyoo-Cheon,Kwak, Hyun-Ho,Park, Bong-Soo,Choi, Won-Chul,Ko, Myung-Yun,Ahn, Yong-Woo Korean Academy of Orofacial Pain and Oral Medicine 2007 Journal of Oral Medicine and Pain Vol.32 No.3

Bile acids and synthetic its derivatives induced apoptosis in various kinds of cancer cells and anticancer effects. Previous studies have been reported that the synthetic chenodeoxycholic acid (CDCA) derivatives showed apoptosis inducing activity on various cancer cells in vitro. It wasn't discovered those materials have apoptosis induced effects on YD9 human oral squamous carcinoma cells. The present study was done to examine the synthetic bile acid derivatives(HS-1199, HS-1200) induced apoptosis on YD9 cells and such these apoptosis events. We administered them in culture to YD9 cells. Tested YD9 cells showed several lines of apoptotic manifestation such as activation of caspase-3, degradation of DFF, production of poly (ADP-ribose) polymerase(PARP) cleavage(HS-1200 only), DNA degradation(HS-1200 only), nuclear condensation, inhibition of proteasome activity, reduction of mitochondrial membrane potential(HS-1200 only) and the release of cytochrome c and AIF to cytosol. Between two synthetic CDCA derivatives, HS-1200 showed stronger apoptosis-inducing effect than HS-1199. Therefore HS-1200 was demonstrated to have the most efficient antitumor effect. Taken collectively, we demonstrated that a synthetic CDCA derivative HS-1200 induced caspases-dependent apoptosis via mitochondrial pathway in human oral sqauamous carcinoma cells in vitro. Our data therefore provide the possibility that HS-1200 could be considered as a novel therapeutic strategy for human orall squamous carcinoma from its poweful apoptosis-inducing activity.

자신경 깊은가지가 새끼두덩근육에 분포하는 양상

윤관현(Kwan-Hyun Youn),김희진(Hee-Jin Kim),곽현호(Hyun-Ho Kwak) 대한체질인류학회 2021 해부·생물인류학 (Anat Biol Anthropol) Vol.34 No.4

고정된 사체의 손 40쪽을 해부하여 새끼두덩근육으로 가는 자신경 깊은가지의 분포양상을 자세히 살펴보았다. 자신경 깊은가지에서 일어나 새끼두덩근육에 분포하는 근육가지는 한 개부터 다섯 개로 다양했다. 모두 40개의 표본 중 하나의 근육가지로 일어난 뒤 나뉘어 새끼두덩근육에 분포하는 경우는 두 쪽 (5%)이었으며, 두 개의 근육가지가 분포하는 경우는 10쪽 (25%)이었다. 자신경 깊은가지에서 일어나 새끼두덩근육에 분포하는 근육가지가 세 개인 경우가 22쪽 (55%)으로 가장 흔하였으며, 네 개의 근육가지를 갖는 경우는 두 쪽 (5%), 다섯 개의 근육가지가 분포하는 경우는 네 쪽 (10%)이었다. 새끼벌림근에 분포하는 근육가지는 일반적으로 자신경 깊은가지에서 일어났으며 (36쪽, 90%), 이 근육가지가 자신경 깊은가지와 얕은가지가 나뉘는 분기점에서 일어나는 경우가 두 쪽이었고, 얕은가지에서도 일어나는 경우가 한 쪽 관찰되었다. 자신경 얕은가지와 정중신경이 교통가지로 연결된 경우는 35쪽 (87.5%)에서 관찰되었다. 자신경 깊은가지가 새끼두덩근육에 분포하는 양상에 대한 자세한 우리의 연구결과는 외과의사가 새끼두덩의 외상, 자신경굴 압박, 관련 부위의 종양 등 손의 자쪽면에 영향을 미치는 다양한 병증상태를 진단 및 치료하는 데 도움이 될 것으로 기대한다. Although some studies have examined the course of the deep branch of the ulnar nerve into the hypothenar muscles, the anatomic descriptions of the courses of the deep branch of the ulnar nerve are vary and the precise patterns of innervation to muscles is not well defined. A total of 40 hands from 26 preserved Korean cadavers were dissected. Branching patterns from the deep branch of the ulnar nerve into the hypothenar muscles ranged from one main branch to five main branches. In two of 40 specimens (5%), only one main branch from the deep branch of the ulnar nerve innervated into all the hypothenar muscles. 10 specimens had two main branches to supply the hypothenar muscles (25%). The most common number of main branches was three (22 specimens, 55%). The muscular branch to the abductor digiti minimi usually arose from the deep branch of the ulnar nerve (36 specimens, 90%). In three specimens, this branch arose from the furcation spot between the deep and superficial branches of the ulnar nerve, and the remaining one specimen had the branch arising from the superficial branches of the ulnar nerve. These results of the present study will provide a useful reference for clinical applications and surgical procedures of the hypothenar region.

다중 기준국 DGPS를 이용한 위치측정

오병주(Byung-Ju Oh),곽현호(Hyun-Ho Kwak),정지웅(Ji Un Jeong),이은성(Eun-Sung Lee),원유두(Yu-Doo Won),조완희(Wan-Hee Cho),이영재(Young Jae Lee),지규인(Gyu-In Jee),이장규(Jang Gyu Lee),오종택(Jong Taek Oh) 한국항공우주학회 1998 韓國航空宇宙學會誌 Vol.26 No.6

Mechanism Underlying a Proteasome Inhibitor, Lactacystin-Induced Apoptosis on SCC25 Human Tongue Squamous Cell Carcinoma Cells

백철중,김규천,김인령,이승은,곽현호,박봉수,태일호,고명연,안용우,Baek, Chul-Jung,Kim, Gyoo-Cheon,Kim, In-Ryoung,Lee, Seung-Eun,Kwak, Hyun-Ho,Park, Bong-Soo,Tae, Il-Ho,Ko, Myung-Yun,Ahn, Yong-Woo Korean Academy of Orofacial Pain and Oral Medicine 2009 Journal of Oral Medicine and Pain Vol.34 No.3

Lactacystin, a microbial natural product synthesized by Streptomyces, has been commonly used as a selective proteasome inhibitor in many studies. Proteasome inhibitors is known to be preventing the proliferation of cancer cells in vivo as well as in vitro. Furthermore, proteasome inhibitors, as single or combined with other anticancer agents, are suggested as a new class of potential anticancer agents. This study was undertaken to examine in vitro effects of cytotoxicity and growth inhibition, and the molecular mechanism underlying induction of apoptosis in SCC25 human tongue sqaumous cell carcinoma cell line treated with lactacystin. The viability of SCC25 cells, human normal keratinocytes (HaCaT cells) and human gingiva fibroblasts (HGF-1 cells), and the growth inhibition of SCC25 cells were assessed by MTT assay and clonogenic assay respectively. The hoechst staining, hemacolor staining and TUNEL staining were conducted to observe SCC25 cells undergoing apoptosis. SCC25 cells were treated with lactacystin, and Western blotting, immunocytochemistry, confocal microscopy, FAScan flow cytometry, MMP activity, and proteasome activity were performed. Lactacystin treatment of SCC25 cells resulted in a time- and does-dependent decrease of cell viability and a does-dependent inhibition of cell growth, and induced apoptotic cell death. Interestingly, lactacytin remarkably revealed cytotoxicity in SCC25 cells but not normal cells. And tested SCC25 cells showed several lines of apoptotic manifestation such as nuclear condensation, DNA fragmentation, the reduction of MMP and proteasome activity, the decrease of DNA contents, the release of cytochrome c into cytosol, the translocation of AIF and DFF40 (CAD) onto nuclei, the up-regulation of Bax, and the activation of caspase-7, caspase-3, PARP, lamin A/C and DFF45 (ICAD). Flow cytometric analysis revealed that lactacystin resulted in G1 arrest in cell cycle progression which was associated with up-regulation in the protein expression of CDK inhibitors, $p21^{WAF1/CIP1}$ and $p27^{KIP1}$. We presented data indicating that lactacystin induces G1 cell cycle arrest and apoptois via proteasome, mitochondria and caspase pathway in SCC25 cells. Therefore our data provide the possibility that lactacystin could be as a novel therapeutic strategy for human tongue squamous cell carcinoma.

두경부재건을 위한 전외측 대퇴유리피판: 해부학적 연구

박주용,박현도,윤관현,곽현호,허경석,강현주,김회진,최성원,Park, Joo-Yong,Park, Hyun-Do,Youn, Kwan-Hyun,Kwak, Hyun-Ho,Hu, Kyung-Seok,Kang, Hyun-Joo,Kim, Hee-Jin,Choi, Sung-Weon 대한악안면성형재건외과학회 2005 Maxillofacial Plastic Reconstructive Surgery Vol.27 No.4

The anterolateral thigh flap was originally described in 1984 as a septocutaneous flap based on the descending branch of the lateral circumflex artery. This flap has some significant advantages for reconstruction of the head and neck. It can be raised as a subcutaneous flap, a fasciocutaneous flap, or a myocutaneous flap and can resurface large defects in the head and neck. In addition, it has a large and long vascular pedicle, and because of the distance of the donor site from the head and neck, it can easily be harvested with a 2-team approach. However, the number and locations of cutaneous perforators vary individually, and thus, it is not widely used because flap elevation is often complicated and time-consuming owing to unexpected anatomical variations. The purposes of this study are to classify the vascular anatomy and to assess the suitability of anterolateral thigh flap for head and neck reconstruction in Korean. We performed an anatomic study on cadavers and analyzed the anatomic pattern of the lateral circumflex femoral arterial system and the perforators nourishing the anterolateral thigh flap. This study suggest the characteristics of vascular anatomic patterns of anterolateral thigh flap of Korean and utility of this flap for head and neck reconstruction.