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말초신경 재건을 위한 인회석 박막 코팅 미세공성 신경재생관(nerve conduit)의 개발
이종호(Jong-Ho Lee),황순정(Soon-Jeong Hwang),최원재(Won-Jae Choi),김성민(Soung-Min Kim),김남열(Nam-Yeol Kim),이은진,안강민(Kang-Min Ahn),명훈(Hoon-Myung),서병무(Byoung-Moo Seo),최진영(Jin-Young Choi),정필훈(Pill-Hoon Choung),김명진(Myu 대한구강악안면외과학회 2003 대한구강악안면외과학회지 Vol.29 No.3
This study was performed to develop a useful nerve conduit which provides favorable environment for Schwann cell viability and proliferation. Milipore membrane of 0.45μm pore size was selected because it permits nutritional inflow from the outside of the conduit and prevents from invading the fibrotic tissue into the conduit. The membrane was rolled and sealed to form a conduit of 2mm diameter and 20mm length. To improve the axonal regeneration and to render better environment for endogenous and exogenous Schwann cell behaviour, the microgeometry and surface of conduit was modified by coating with thin film of calcium phosphate. Cellular viability within the conduit and attachment to its wall were assessed with MTT assay and SEM study. Milipore filter conduit showed significantly higher rate of Schwann cell attachment and viability than the culture dish. However, the reverse was true in case of fibroblast. Coating with thin film of low crystalline calcium phosphate made more favorable environment for both cells with minimal change of pore size. These findings means the porous calcium phosphate coated milipore nerve conduit can provide much favorable environment for endogenous Schwann cell proliferation and exogenous ones, which are filled within the conduit for the more advanced strategy of peripheral nerve regeneration, with potential of reducing fibrotic tissue production
이종호(Jong-Ho Lee),홍순민(Soon-Min Hong),이은진(Eun-Jin Lee),안강민(Kang-Min Ahn),김성민(Sung-Min Kim),명훈(Hoon Myoung),황순정(Soon-Jung Hwang),서병무(Byoung-Moo Seo),최진영(Jin-Young Choi),정필훈(Pill-Hoon Choung),김명진(Myung-Ji 대한구강악안면외과학회 2003 대한구강악안면외과학회지 Vol.29 No.1
The incident of false aneurysm of internal maxillary artery in the oral and maxillofacial region is known to be very rare. One case of false aneurysm in the internal maxillary artery is presented, which was experienced in our department. The etiology of this case is regarded as the mandibular condyle fracture, and/or iatrogenic trauma during open reduction. Clinically, there were systolic bruit on auscultation, pulsation and massive bleeding during operation. The lesion was finally diagnosed with angiography and treated by embolization procedure. False aneurysm can cause so massive bleeding as to threat the life of the patients. Therefore accurate diagnosis and treatment is very important. Angiography enables the solid diagnosis for the clinical one. And as the embolization has many advantages over the ligation, it can be a good treatment method.
폐쇄성 수면무호흡환자에서 확대 구개수구개피판을 이용한 치험례
김지연(Ji-Youn Kim),김성민(Soung-Min Kim),명 훈(Hoon Myoung),황순정(Soon-Jung Hwang),서병무(Byoung-Moo Seo)이종호(Jong-Ho Lee),정필훈(Pill-Hoon Choung),김명진(Myung-Jin Kim),최진영(Jin-Young Choi) 대한구강악안면외과학회 2011 대한구강악안면외과학회지 Vol.37 No.1
The uvulopalatal flap (UPF) technique is a modification of uvulopalatopharyngoplasty (UPPP) for the surgical treatment of obstructive sleep apnea. In the UPF technique, an uvulopalatal flap is fabricated and sutured to the residual mucosa of the soft palate to expand the antero-posterior dimensions of the oropharyngeal inlet. In the extended uvulopalatal flap (EUPF) technique, an incision at the tonsillar fossa is added to the classical UPF technique followed by the removal of mucosa and submucosal adipose tissue for additional expansion of the lateral dimension. The EUPF technique is more conservative and reversible than UPPP. Therefore, complications, such as velopharyngeal insufficiency, dysphagia, dryness, nasopharyngeal stenosis and postoperative pain, are reduced. In the following case report, the patient was diagnosed with obstructive sleep apnea and treated with the EUPF technique. The patient’s total respiratory disturbance events per hour (RDI) was decreased to 15.4, the O 2 saturation during the sleep was increased, and the excessive daytime sleepiness had disappeared after the surgery without complications. The authors report this case with a review of the relevant literature.
구개점막과 협점막의 절개에 사용되는 칼의 개선을 위한 기초 연구
서병무,최진영,이종호,김명진,정필훈,Seo Byoung-Moo,Choi Jin-Young,Lee Jong-Ho,Kim Myung-Jin,Choung Pill-Hoon 대한구순구개열학회 2001 대한구순구개열학회지 Vol.4 No.1
Disposable blade is widely used for palatal and oral mucosal incision in oral and maxillofadal surgery nowadays, But its design and durability need for improvement, Especially, there are so many hard tissues intraoral area, such as bone and tooth, therefor the sharpness of the surgical blade was easily destroyed, The purpose of this study was to make basic data for developing new design of surgical blade using in oral and maxillofacial area including for the patients who have cleft lip and palate deformities, Some questionnaires about the usefulness of currently used surgical blades were sent to 150 dentists, the 54 of them made a reply, Secondly, The used-once blade and fresh new blade were examined under the scanning electron microscope with the 4000-times magnification, Lastly, the tissue reaction following the surgical incision with a fresh-new and a used blade on rat buccal cheek mucosa and hard palate was evaluated with light microscope with hematoxilin-eosin staining, The time interval from the surgical trauma to taking a sample were 1 day, 3 days, 7 days, and 14 days, At each time schedule, 2 Sprague-Dawley rats were sacrificed, Many dentists were agreed to need for changing the design of the surgical blades and also demand to improve the durability of the blades, They were also eager to adopt the new design of blade if it was available, The blade used in surgical extraction procedure was heavily damaged in its sharpe edge of number 15 blade, The histological differences were not prominent, but the delayed healing was detected in buccal mucosal defects especially in the surgical group with used blade, There are slight different changes in hard palatal defects between a used and a new blade group, In this study, we could find that there are imperative demanding on improvement of surgical blade design and durability for oral and maxillofadal area, The blade currently using in surgical extraction was easily damaged, The animal model of this study was not perfect for the purpose of this study.
구강암 환자에서 방사선 조사에 따른 타액의 세균학적 조성변화에 대한 연구
이종호(Jong Ho Lee),김명진(Myung Jin Kim),정필훈(Pill Hoon Choung),최진영(Jin Young Choi),서병무(Byoung Moo Seo),송노헌(Ro Heun Song),안강민(Kang Min Ahn),김종원(Jong Won Kim),남일우(Il Woo Nam),김수경(Soo Kyung Kim) 대한구강악안면외과학회 2000 대한구강악안면외과학회지 Vol.26 No.1
The changes of the microorganism composition after therapeutic radiation for oral cancer patients are not well known and the longterm follow-up data are not reported. To obtain basic data for understanding of pathogenesis and prevention and treatment of dental caries and mucositis occuring after radiation therapy, 7 of the oral cancer patients presented at the Seoul National University Oral & Maxillofacial Department between 1997 and 1998 whose treatment plan included radiation therapy were recruited to investigate the changes in bacterial composition(total aerobic count, Candida, Staphylococci, Lactobacilli, S.mutans, and S.salivarius(mitis, sanguis)) of the saliva before, during, and after radiation therapy. The basic data obtained from this study on identification and composition change of the bacteria in saliva of patients treated with radiation therapy can be used (1) as a reference for deciding on the ideal anti-microbial spectrum of the oral rinsing agent to be used in patients treated with radiation therapy for malignant tumor of the head and neck region. (2) to enhance the understanding of increase of opportunistic infection after immunochemical changes of the saliva and its relation to specific bacterial infection. (3) as a reference in prescribing prophylactic antibiotics in immunodepressed patients after radiation therapy.
이종호(Jong-Ho Lee),안상철(Sang-Cheol Ahn),이은진(Eun-Jin Lee),서병무(Byoung-Moo Seo),최진영(Jin-Young Choi),정필훈(Pill-Hoon Chung),김명진(Myung-Jin Kim) 대한구강악안면외과학회 2002 대한구강악안면외과학회지 Vol.28 No.5
Pigmented villonodular synovitis(PVNS) usually presents as a benign proliferative monoarticular arthritis that affects the knee in 80% of cases, followed in frequency by the hip, ankle, and calcaneocuboid joint. PVNS rarely affects temporomandibular joint area. Patients typically complain of pain, locking, and recurrent swelling. Tumor progression limits the range of movement of the joint and causes it to become stiff and firm. Sometimes a palpable mass can be appreciated. Aggressive form of PVNS invades into adjacent bones and soft tissues, is confused with other types of neoplasia. Here we report 2 cases of the PVNS on a temporomadibular
분층피부와 분말골로 이식 전 처리된 유리견갑골근피판과 임플란트 보철을 이용한 경구개와 상악골의 기능적 재건
이종호(Jong-Ho Lee),김명진(Myung-Jin Kim),박종철(Jong-Chul Park),김영수(Yung-Soo Kim),안강민(Kang-Min Ahn),팽준영(Jun-Young Paeng),김성민(Sung-Min Kim),명훈(Hoon Myoung),황순정(Soon-Jung Hwang),서병무(Byoung-Moo Seo),최진영(Jin-Youn 대한구강악안면외과학회 2004 대한구강악안면외과학회지 Vol.30 No.4
The flap considered at first for the reconstruction of large maxillary defect, especially mid-face defect, is scapular free flap, because it provides ample composite tissue which can be designed 3-dimensionally for orbital, facial and oral reconstruction. In case of maxillary defect involving hard palate, however, this flap has some limitations. First, its bulk prevents oral function and physio-anatomic reconstruction of nasal and oral cavity. Second, mobility and thickness of cutaneous paddle covering the alveolar area reduce retention of tissue-supported denture and give rise to peri-implantitis when implant is installed. Third, lateral border of scapula that is to reconstruct maxillary arch and hold implants is straight, not U-shaped maxillary arch form. To overcome these problems, new concept of step prefabrication technique was provided to a 27-year-old male patient who had been suffering from a complete hard palate and maxillary alveolar ridge defect. In the first stage, scapular osteomuscular flap was elevated, tailored to fit the maxillary defect, particulated autologous bone was placed subperiosteally to simulate U-shaped alveolar process, and then wrapped up with split thickness skin graft(STSG, 0.3mm thickness). Two months later, thus prefabricated new flap was elevated and microtransferred to the palato-maxillary defect. After 6 months, 10 implant fixtures were installed along the reconstructed maxillary alveolus, with following final prosthetic rehabilitation. The procedure was very successful and patient is enjoying normal rigid diet and speech.
팽준영,명훈,황순정,서병무,최진영,이종호,정필훈,김명진,Paeng, Jun-Young,Myoung, Hoon,Hwang, Soon-Jung,Seo, Byoung-Moo,Choi, Jin-Young,Lee, Jong-Ho,Choung, Pill-Hoon,Kim, Myung-Jin 대한악안면성형재건외과학회 2006 Maxillofacial Plastic Reconstructive Surgery Vol.28 No.4
Objectives: Distraction osteogenesis has recently evolved a challenging technique to overcome the limitations of conventional augmentation procedures. The aim of this report was to evaluate the clinical result of alveolar distraction osteogenesis for implant installation. Methods: Twenty five patients with alveolar ridge deficiencies were treated with vertical alveolar distraction osteogenesis by intraoral device (total 27 devices: 25 extraosseous and 2 intraosseous devices). After the latency periods of 5-7 days, activation of the device was started. The distraction rhythm and rate was 0.75-1.0 mm a day with 2 or 3 times a day. After 3-4 months, dental implants were placed with removing the distractor simultaneously. Results: On average, a vertical gain of $9.8{\pm}3.4\;mm$ was obtained by distraction osteogenesis. Total 84 implants were installed. Average follow up period was $13.5{\pm}7.5$ months. No implant was removed during the follow up period. Three patients showed infection during the distraction osteogenesis. Three devices were broken and 2 devices among them were replaced with new one. Conclusion: Relatively larger amount of alveolar bone augmentation could be obtained with distraction osteogenesis. For the ideal anatomically and functionally ideal regeneration of alveolar bone to install dental implant, the complication of distraction should be controlled.
구순구개열 환자의 상악골 열성장에서 골신장술을 위한 Internal distraction device와 Rigid external distraction의 비교
팽준영,명훈,황순정,서병무,최진영,이종호,정필훈,백승학,김명진,Paeng, Jun-Young,Myoung, Hoon,Hwang, Soon-Jung,Seo, Byoung-Moo,Choi, Jin-Young,Lee, Jong-Ho,Choung, Pill-Hoon,Baek, Seung-Hak,Kim, Myung-Jin 대한악안면성형재건외과학회 2005 Maxillofacial Plastic Reconstructive Surgery Vol.27 No.4
Distraction osteogenesis for the advancement of hypoplastic maxilla of cleft patients has shown successful results. In this report, rigid external distraction(RED) system and internal distraction device were used for maxillary advancement. Each system has its advantages and disadvantages. Larger amount of advancement can be achieved with RED system. But complex external device may give patients psychological stress. Internal device is invisible. However its distraction amount have limitation for the advancement (< 20mm) and the vector cannot be changed freely during distraction. The authors treated five cleft patients with maxillary hypoplasia(three with RED system and two with internal distractor). Their results were clinically satisfactory. We present the pros and cons of RED and internal system for maxillary distraction osteogenesis.
하악골 재건시 사용된 유리비골피판에서 임플란트 식립을 위한 수직적 골신장술
팽준영,이진용,명훈,황순정,서병무,최진영,이종호,정필훈,김명진,Paeng, Jun-Young,Lee, Jin-Yong,Myoung, Hoon,Hwang, Soon-Jung,Seo, Byoung-Moo,Choi, Jin-Young,Lee, Jong-Ho,Choung, Pill-Hoon,Kim, Myung-Jin 대한악안면성형재건외과학회 2006 Maxillofacial Plastic Reconstructive Surgery Vol.28 No.6
Introduction: The fibular free flap is now considered as the first choice for long mandibular discontinuity defect. In spite of its good bone quality for implant installation, its diameter is too narrow to rehabilitate the masticatory function with implant installation. In this report, distraction osteogenesis was used for the augmentation of bone to install the dental implant in the mandible which was reconstructed with a vascularized fibular free flap. Patients and Methods: Three patients undertook the vertical augmentation of grafted fibular bone and dental implants were installed. On the day 8 post-surgery, the activation of the distractor was started at the rate of 1 mm twice a day. The total amount of distraction was 15 mm in two patients and 12.5 mm in one patient. Twelve implants were installed in three patients. Dental implants were simultaneously installed during removal of the distraction device in two patients. In one patient, the implant installation was delayed after device had been removed. All three patients showed the symptoms of mild to severe postoperative infection during the activation and consolidation. However, the distracted site showed undisturbed bone regeneration. Conclusion: The distraction osteogenesis showed the reliable results for the vertical augmentation of fibular bone which was used for the mandibular reconstruction. However, the great tendency of postoperative infection must be considered and clinically controlled.