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.

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.

치아회분-석고 혼합제와 생흡수성 차단막을 이용한 임플란트 주변 결손부 수복의 조직학적 평가

김영균,김수관 대한악안면성형재건외과학회 2002 Maxillofacial Plastic Reconstructive Surgery Vol.24 No.1

This study evaluated whether a particulate dentin-plaster of paris combination (PDPP) and bioresorbable membrane could be used to induce new bone to cover the partially exposed surface of titanium endosseous implants. Twelve AVANA (SooMin Synthesis Dental Materials Co., Korea) dental implants were placed in the ilium of mongrel dog. All implants were self-tapping screw implants, 10㎜ long and 4㎜ in diameter. A circumferential bony defect around the implant was made with surgical bur and the cervical 1/3 of the implant surface was exposed. Six implants were used as controls and the rest were covered with particulate dentin-plaster of Paris combination and Biomesh bioresorbable membrane (Samyang, Korea). The dogs were killed at 6 and 12 weeks. The defects treated with PDPP and Biomesh membrane were filled with newly formed bone and direct bone contact with the implant surface developed. Most of PDPP material was resorbed after 12 weeks. In histomorphometric study, there was a statistically significant difference in bone contact between two groups in 6 weeks (P < 0.05). This study showed that guided bony regeneration using PDPP and bioresorbable membrane induces new bone to form over the exposed portion of an implant.

레이저 치의학의 최근 연구동향

김수관,조세인,이상호 대한악안면성형재건외과학회 2002 Maxillofacial Plastic Reconstructive Surgery Vol.24 No.1

As the laser becomes more widely available in recent years, the oral and maxillofacial surgeon will have greater opportunity to use it for the treatment of soft tissue and hard tissue pathologies of the mouth. However, little information has been published on the bone. Dental lasers serve as an adjunct to regular treatments and enhancing outcomes in still others. The laser replaces conventional therapies with equal or improved results. Lasers offer new treatment options that heretofore were not available. Laser dentistry is capable of significantly minimizing discomfort, enhancing recovery times, and improving the overall efficiency of the dental office. We describe the basic researches and the developimg laser devices.

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.

치조제 증강을 위한 HTR 중합체 이식후 치유과정 : 증례보고

김수관,임성철 大韓顎顔面成形再建外科學會 2000 Maxillofacial Plastic Reconstructive Surgery Vol.22 No.1

The purpose of this study is to evaluate the effect of HTR?? (hard tissue replacement, Bioplant Inc, U.S.A) polymer on short-term healing as a grafting material for alveolar ridge augmentation. A 48-year-old female presented insufficient bone height and width for the placement of implants. HTR?? polymer was used for ridge augmentation. Bone biopsy was harvested 8 months after the ridge augmentation procedure. HTR?? polymer displayed rapid bone regeneration and mature lamellar and trabecular bone redevelopment. Clinical and histologic observation from the treatment of the patient presented suggest that HTR?? polymer seems to be a appropriate material for alveolar ridge augmentation.

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.

貯藏中인 쌀(벼, 玄米, 自米 Parboil米)의 脂肪成分의 化學的 變化

金關修,盧永姬,李熙鳳 충북대학교 농업과학기술연구소 1994 農業科學硏究 Vol.11 No.2

Rough rice(Chucheong) which had been harvested at the experiment station, Chung Buk National University on October 26, 1992, was used in this experiment. The rough rice was divided into two parts. A part of the rough rice was parbolied(B series) and another part was untreated(A series). Brown and polished rice was obtained from untreated and parboiled rice. Six different types of the rice stored at room temperature for about 10 months. During the storge time, moisture and crude lipid contents, free fatty acid values, peroxide values, TBA values and fatty acid compositions were investigated. The result was as follows. 1. The moisture contents of all the samples decreased remarkably during the storage periods. Polished rice showed the greatest decrease. The decreasing rate was pronounced between 3-7 mouth. 2. The crude lipid contents of the polished and brown rice increased during the storage periods. As the moisture contents decrease, the crude lipid contents was increased proportionally. The crude lipid contents of rough rice were rarely changed. 3. The free fatty acid values of all the samples increased during the storage periods. The increasing rate was pronounced between 5-9month. The free fatty acid values of polished rice was greater than those of brown and rough rice. 4. Peroxide values of all the samples increased during the storage periods. Especially, the increase in the peroxide values remarked between 5-9month. The peroxide values of untreated rice were greater than those of parboiled rice. 5. TBA values of all the samples increased during the storage periods. Its increase pattern were similar to the peroxide values. 6. Major fatty acids of the samples were oleic acid, and linoleic acrid, palmitic acid. A little of stearic acid, myristic acid, linolenic acid, and arachidic acid was found. The changes in fatty acid composition of the each samples were rarely noted during the storage periods.

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.

관상피판술 : 해부학, 수술시 고려사항, 병적인 상태

김영균,이기혁,여환호,김수관,박노승 大韓顎顔面成形再建外科學會 1996 Maxillofacial Plastic Reconstructive Surgery Vol.18 No.4

The coronal approach is a versatile surgical technique. This methos becomes particulary useful for exposure and internal fixation of midfacial fractures and the harvest of calvarial bone graft to manage the complex facial bone fractures. The rectrospective clinical study on the use of this technique in 10 patients was performes. The result shows that this technique provides the excellent exposure of fractures site, the ability to reduce the fragment accurately and good cosmetic results in incision area. We discussed with literatures review that anatomy, technique, indications, and potential complications of the coronal approach.