방사선 조사받은 악골에서의 임플란트

김재환,현재훈,김용각,박형국 大韓顎顔面成形再建外科學會 1997 Maxillofacial Plastic Reconstructive Surgery Vol.19 No.2

Cancer therapy for the head and neck malignoncy by surgery, radiotherapy, or combined modalities may cause substantial aesthetic and functional problems for the patient. The placement of osseointegrated implants into irradiated bone should only be performed when the predictability of achieving and maintaining osseointegration is high and the risk of developing of osteoradionecrosis is low. There are many benefits that irradiated patients may gain from the use of implants. A successful implant-retained prosthesis is dependent upon the implants attaining osseointegraton and then sustaining it during functional loads. The use of implants in irradiated patients requires high implant success rates that are acceptable to warrant their use. We report a case and review the literatures about implants in irradiated bone. In that case, the patient were undergone tumor resection and inner-table mandiblectomy due to squamous cell carcinoma of lower posterior gingiva. But 5 year later, the tumor were recurred, we resected the tumor and applied the radiation therapy. After then, we installed four IMZ implants after hyperbaric oxygenation, and made prosthesis using those implants. Until now they don't have any complications.

구강저에 발생한 단독형 신경섬유종

김용각,유현석,곽재근,김규영,정붕희 大韓顎顔面成形再建外科學會 1990 Maxillofacial Plastic Reconstructive Surgery Vol.12 No.3

Benign neural sheath neoplasms are not common in the maxillofacial region. These lesions can occur as solitary tumors, or they can affect many sites in the form of multiple neurofibromatosis. A solitary neurofibroma is seldom undergo sarcomatous transformation, since solitary neurofibroma is relatively radioresistant and its recurrence rate seems to be low, the treatment of choice is surgical excision. This case showed a solitary neurofibroma in the left side of the floor of mouth which occurred in a 33 - year -old female. The tumor was excised. And there is no evidence of disease. She is satisfied in function and esthetic aspect.

항우식작용을 갖는 여러 향균물질의 조합에 따른 분할 저해 농도 (FIC ; Fractional inhibitory concentration)지수에 대한 연구

김영재,김종철,김각균 大韓小兒齒科學會 2002 大韓小兒齒科學會誌 Vol.29 No.4

임상에서 사용하고 있는 8종의 항우식 작용을 갖는 항균물질의 조합이 대표적 우식유발 세균인 Streptococcus mutans Ingbritt와 Streptococcus sobrinus 6715-7의 성장에 미치는 영향을 조사하고자 세균별로 28개 조합의 각 항균물질에서 최소 저해 농도와 분할 저해 농도 지수를 구하여 여러 기준에 따라 상승작용, 길항작용, 무관함, 부분적 상호작용 등을 각각 평가하였다. 미국 미생물 학회의 지침에 따라 분류하면 약 34%의 조합에서 상승작용이 관찰되었고 Berenbaum의 분류에 따르면 약 82%에서 상승작용을 갖는다고 해석할 수 있었다. 또한 Isenberg가 정의한 부분적 상승작용은 총 조합수의 절반에서 관찰되었다. 분류기준에 따라 다양한 결과를 얻을 수 있었으나 두 가지 항균물질의 조합이 우식유발 세균을 억제하는데 상승작용을 나타내는 경향이 존재함을 관찰할 수 있었고 따라서 우식유발세균을 억제하는데 있어서 항균물질이 단독 사용보다 세균의 생태와 대사의 여러 부분에 영향을 미치는 항균물질의 조합은 유용할 수 있다는 것을 알 수 있었다. The effect of combination of 8 antimicrobial agents on the growth of Streptococcus mutans and Streptococcus sobrinus was investigated with the minimum inhibitory concentration and fractional inhibitory concentration(FIC) and ∑FIC index. According to the ∑FIC values by The American Society for Microbiology and Berenbaum, Approximately 34% and 82% of the combinations were synergistic respectively. Partial synergy described by Isenberg was also observed in the half of the combinations. There was a tendency for additive antimicrobial effect against cariogenic bacteria though the test results showed difference according to the applied values. It may be beneficial to use combined antimicrobial agents that have various activities against an ecosystem and metabolism of bacteria than using individual agents.

口腔內 扁平上皮癌에 關한 臨床的 硏究

정붕희,김용각,김재승 大韓顎顔面成形再建外科學會 1990 Maxillofacial Plastic Reconstructive Surgery Vol.12 No.3

A clinical study of selected patients with intraoral squamous cell carcinoma which were managed in the Department of Oral Oncology of Korea Cancer Center Hospital from January 1982 to August 1989 was done. And following results were obtained. 1. Males were involved more than females by intraoral squamous cell carcinoma in a ratio of 4:1. and most of the cases occurred in the 7th and 6th decades (69%). 79% of total patients and 92.5% of males were. 2. The mean duration of symptomatic period was 5.9 months. 3. The common symptoms were swelling (63%), pain (40%), ulceration (33%), and trismus (23%) 4. In the histologic findings, well differentiation comprised 58.0%. 5. The primary sites were the upper alveolar mucosa (32%), the floor of the mouth (21%), the lower alveolar mucosa (19%), tongue (14%), retromolar trigone (8%), palate (7%) and buccal mucosa (3%). 6. According to TNM system, Stage I, Stage Ⅱ, Stage Ⅲ, and Stage Ⅳ comprised 4%, 15%, 32%, and 49% respectively. 7. In the management of intraoral squamous cell carcinoma, surgeries were done in the 32 cases, 23 cases of which were managed by radiation therapy or chemotherapy concurrently. And radiation therapy alone was received in 35 cases. 8. Overall 3 and 5-year survival rates without regarding to stage were 27.6% and 21.4%. 9. 3-year survival rate of female patients was 47.2% and that of male patients was 22.6%. 10. 5-year survival rate was 53.9% for “early”cancer (stage I and II) and 15.6% for “advanced”cancer (stage Ⅲ and Ⅳ). Survival rate of patients in the early stages of cancer appeared to be higher than that of patients with stage Ⅲ and Ⅳ(p<0.05).

치성낭종으로부터 유래된 편평상피세포암종 : Report of a Case & Review of Literatures

권혁진,현재훈,박형국,김용각 大韓顎顔面成形再建外科學會 1997 Maxillofacial Plastic Reconstructive Surgery Vol.19 No.2

Odontogenic cysts are relatively common pathologic lesions found in the oral and perioral structures, but the case of squamous cell carcinoma arising from those cysts are very uncommon. After first reported of that case in 1889 by Herman, Schwimmer collected 56 cases of previously reported squamous cell carcinoma arising in residual odontogenic cyst during about past one century. More than 60% of cases of carcinoma developing in odontogenic cysts arising in inflammatory periapical or residual cyst, and these tumors are usually well-differentiated with relatively good prognosis, and often are diagnosed as benign lesion in radiographic or clinical examination, therefore definitive diagnosis must be made by histologic examintation. We report a case and review the literatures, in our case, 78-year old woman were clinically and radiographically diagnosed as residual odontogenic cyst. But in histologic examination after enucleation of lesion, mass of squamous cell carinoma were observed, but in other area, typical cyst wall and lining epithelium were observed. And in some area, carcinoma in situ and invading squamous cell carcinoma into the lining epithlium were also observed.

골흡수 기전에 관한 연구 : 파골세포의 활성화 기전 MECHANISM OF OSTEOCLAST ACTIVATION

정동균,고재승,김관식,김각균,민병무,김세원 대한구강생물학회 1989 International Journal of Oral Biology Vol.13 No.1

Although the osteoclast has long been recognized to be the cell responsible for bone resorption, little is known of the mechanisms by which its activity is controlled. Recently, it has been suggested that osteoblasts ─ the bone-forming cells ─ seem to be the target cells of PTH, the bone-resorbing hormone, and mediate osteoclastic bone resorption by producing the coupling factor(s). Because bone tissue consists of several types of cells, isolation of distinct bone cell populations is prerequisite for studying the mechanism of bone resorption in cellular level. This experiment was performed ⅰ) to isolate the metabolically distinct bone cell populations from fetal rat calvaria by sequential enzyme digestion and biochemical characterization and ⅱ) to identify the factor(s) produced by osteoblast that stimulate resorption employing organ culture of bone. Calvaria from rat fetus at 19 day of gestation, were sequentially digested by enzyme solution consisted of collagenase, trypsin and EDTA for 10 (population I), 10(II), 10(III), 20(IV) and 20 minutes (V). Each bone cell population was primarily cultured for 6-7 days and effects of PTH, calcitonin and PGE_2 on acid and alkaline phosphatase activity and cAMP level were determined. Basal level of acid phosphatase in populations released early were higher than late population. In contrast, basal level of alkaline phosphatase was reversed. PTH(0.4 unit/ml) increased the acid phosphatase activity only in population I with no effect on alkaline phosphatase. Calcitonin(150ng/ml) had no effect on acid and alkaline phosphatase activity in all bone cell populations. cAMP level of population IV and V were increased by PTH significantly while CT had no effect in all bone cell populations at all. PGE_2 increased cAMP in all populations, the acid phosphatase activity in population I and alkaline phosphatase activity in population IV and V. Taken together, these results indicate that population IV and V express typical osteoblastic phenotype while population I revealed some characteristics of osteoclast. Bone cell population IV and V were incubated with fresh MEM or MEM containing 0.4U/ml PTH for 2 hours. After 2 hour-incubation, both the control-conditioned media(control-CM) or PTH-conditioned media(PTH-CM) were collected. Both conditioned media were lyophyllized and redissolved as 2 fold concentrate. Ulnae and radii were removed from 19-day old fetal rats, prelabelled by subcutaneous injection of 200μCi ^45CaCl_2 into their mothers on the 17th day of gestation. After 24 hours, media was changed with fresh BGJb media or BGJb media containing 300μl of control-CM or PTH-CM and cultured for 5 days. Effects of control-CM or PTH-CM were observed by the ratios of %-release of ^45Ca between paired control and experimental group. Control-CM obtained from population IV and V had no or very little effect on bone resorption but PTH-CM obtained from population IV and V increased the ^45Ca release significantly after 3 and 5 days of culture. This result provides the evidence indicating that osteoblastic cells mediate osteoclastic bone resorption stimulated by PTH.

한국인의 치아우식 조절에 관한 연구 : Ⅳ. 金堤郡 치문국교 학동의 尿中弗素濃度, 班狀齒指數 및 學童居住地域의 飮料水弗素濃度에 關한 硏究 Ⅳ. STUDY ON THE RELATION BETWEEN THE URINARY FLUORIDE CONCENTRATION, THE FLUOROSIS INDEX AND THE FLUORIDE CONCENTRATION OF DRINKING WATER IN BAIKKU-MYUN, KIMJAE-KUN

丁東均,李種昕,李孝宰,金各均,吳貴玉,鄭泰英 대한구강생물학회 1979 International Journal of Oral Biology Vol.3 No.1

The urinary fluoride concentration and the degree of dental fluorosis of all the schoolboys attending Chimoon primary school in Baikku-myun, Kimjae-kun and the fluoride concentration of drinking water of those areas were investigated in an effort to elucidate the relation between them. The urinary fluoride concentration and the fluoride concentration of driking water were measured by fluoride ion electrode, and dental fluorosis was surveyed and analysed by Dean and McKay's and Horowitz's method. 1) The mean urinary fluoride concentration and the mean fluorosis index of all the schoolboys were 1.89ppm (0.12-12.2ppm) and 0.79 (0-1.99). The mean fluoride concentration of drinking water of those areas was 0.61ppm (0.027-2.66ppm). 2) The mean urinary fluoride concentration and the mean fluorosis index of the schoolboys residing in Yookang-ri 5-ku, Baikku-myun (Dongja-po) were the highest (3.23ppm, 1.99) among the statistics for the schoolboys residing in different areas. Incidentally the fluoride concentration of drinking water for that area was also the highest (1.99ppm). 3) The urinary fluoride concentration was two to ten times as high as the fluoride concentration of drinking water regardless of the resident area of schoolboys. 4) There was no significant seasonal change in fluoride concentration of drinking water collected from the well in the resident area of schoolboys. 5) There showed a relatively parallel relationship between the urinary fluoride concentration and the fluorosis index of schoolboys. 6) The urinary fluoride concentration and the fluorosis index of schoolboys tend to increase with age increasing.

한국인의 치아우식 조절에 관한 연구 : Ⅲ. 白鼠우치痍患率에 미치는 數種 稀 有元素, 쌀 및 各種 양념의 影響 Ⅲ.EFFECTS OF SEVERAL TRACE ELEMENTS, RICE AND SPICES ON THE CARIES RATE IN RATS

鄭東均,鄭素英,李孝宰,金各均,吳貴玉,李種昕 대한구강생물학회 1979 International Journal of Oral Biology Vol.3 No.1

Two-part experiment was conducted to elucidate the effects of several trace elements, rice and spices on caries rate in Korean albino rats. Rats were selected into two large groups according to their weight ; one group (for part I experiment) consists of rats weighing 140-200gm and the other group (for part II experiment) consists of rats weighing 76-109gm, and the same experiment was conducted independently for both groups. Rats were fed standard cariogenic diet supplemented with rice (21, 53%), capsicum (1, 10%), garlic (0.5, 5 or 10%), phosphorus (2%), sodium chloride (3%, reagent grade), or table salt. Drinking water was tap water containing cold water extract of capsicum (0.1%) alcoholic extract of capsicum (0.1%), water extract of ginseng (2%), fluoride (10, 50 or 100ppm) or 50ppm of Mg, Zn, Mo, Sr, Mn of Fe. The results were as follows. 1. 24.9%, 51.0% and 54.3% decrease in caries score were recorded for rats which drank water containing 10, 50 and 100ppm of fluoride in part I experiment. In part II experiment caries score decreases 51.8% and 56.9% for 10ppm and 50ppm fluoride content. 2. Capsicum-fed rats showed 51.7% (capsicum 1%) and 58.1% (capsicum 10%) decrease in caries score in part I experiment. 21.5% and 33.6% decrcase were recorded for part II experiment. 3. Garlic-fed rats showed 44.5% (garlic 0.5%), 23.0% (garlic 5%) and 53.7% (garlic 10%) decrease in caries score. 4. Sodium chloride-fed rats showed 122.6% (NaCl 3%) increase in caries score. 5. Rats which were fed diet containing 2% Na_2HPO_4 showed 26.7% decrease in caries score and further 41.6% decrease when 10ppm fluoride was given simultaneously. 6. 28.4% and 31.5% decrease in caries score were recorded for rats which drank water containing 50ppm of Mg and Zn.

한국인의 치아우식 조절에 관한 연구 : Ⅱ. Streptococcus mutans strain B-13이 생산한 불용성 세포외 다당류와 dextransucrase 활성 Ⅱ. INSOLUBLE EXTRACELLULAR POLYSACCHARIDES AND ACTIVITY OF DEXTRANSUCRASE PRODUCED BY STREPTOCOCCUS MUTANS STRAIN B-13, IN VITRO

정태영,정동균,이효재,김각균,오귀옥,이종흔 대한구강생물학회 1979 International Journal of Oral Biology Vol.3 No.1

Insoluble extracellular polysaccharides synthesized by Streptococcus mutans type d strain B-13 were analysed in an effort to elucidate their chemical composition. Dextransucrase produced in supernatant was also studied for its activity. 1. The microorganism produced 2.10g of total insoluble fraction which contained 1.59g of insoluble polysaccharide and 0.41g of bacterial mass per 800ml of culture medium. 2. Insoluble fraction contained 26.1㎍/mg of nitrogen and 746.4㎍/mg of insoluble extracellular polysaccharides. Ketohexose content of polysaccharides was 7.12%. 3. Streptococcus mutans strain B-13 was capable of producing 4.10g insoluble extracellular polysaccharide per 1.0g of bacterial mass. 4. Dextransucrase liberated 5.11mg of hexose per 1ml of culture supernatant.

한국인의 치아우식 조절에 관한 연구 : Ⅰ. 만경·동진강유역 음료수내의 수종 무기질 함량 Ⅰ. THE CONTENTS OF SEVERAL ELEMENTS IN DRINKING WATER AROUND THE REGIONS OF THE MANKYUNG AND DONGJIN RIVERS

이종흔,정동균,김중수,이효재,김각균,오귀옥,정태영 대한구강생물학회 1979 International Journal of Oral Biology Vol.3 No.1

Mineral analyses of water samples from several areas of the Mankyung River and the Dongjin River regions in Chonrabukdo where dental fluorosis was observed, which had been conducted between June in 1978 and January in 1979, have shown the following results. In general, the mean calcium concentrations were high in the areas where the mean concentrations of phosphorus and fluoride were low. And in the same area where dental fluorosis was particularly observed, seasonally a few minerals were variable─namely, calcium, phosphorus, and fluoride. Those samples of high fluoride concentration have higher phosphorus concentration, but calcium concentrations were the opposite phenomenon. Particularly, fluoride concentrations were remarkably greater during the cold season(January) than during the rainy season(July).