顔貌 變形症 患者에 있어서 顎矯正 手術後 心理檢査 및 滿足度 評價에 關한 臨床的 硏究

이국엽,진우정 全北大學校 齒醫學硏究所 1991 전북치대논문집 Vol.9 No.1

The need to assess psychological characteristics of patients electing orthognathic surgery has recently been recognized. Systematic research on the relationship of personality predictors to patient recovery, postsurgical outcomes, and self-concept has not been reported widely in the clinical literature. This report examined the psychological responses and postsurgical outcomes in a clinical study of 37 patients who underwent orthognathic surgery for facial deformity. Each questionaire to assess a locus of control, Eysenck's personality dimension, self-concept, and postsurgical satisfaction was administered to the patients up to 11 months after surgery. Self-concept and postsurgical outcomes were compared according to age, sex, and operative technique And also the study was to determine the association among personality characteristics, postsurgical satisfaction, and self-concept. The results were as follows : 1. Males, tenages were significantly more improved with physical self-esteem than women, twenty-years old after surgery(P<0.01, P<0.05). 2. Total positive self-esteem was less improved in the groups with high scores of neuroticism, emotional dimension, and introversion(P<0.05). 3. Esthetic satisfaction with postsurgical results was more satisfied in the group of extroversion dimension, and there was a correlation with postsurgical satisfaction(P<0.05). 4. There was a correlation with self-concept in the group of introverion dimension(P<0.01).

구강 편평세포암종에서의 Microsatellite Instability

이국엽,손현진,최철영,조남표 대한구강악안면병리학회 2004 대한구강악안면병리학회지 Vol.28 No.3

To cletermine the role of mismatch repair in the clevelopment of oral squamolls cell carcinomas (OSCCs) , the prevalence of microsatellite instability (MSI), expression of I뼈LH1 ancll띠SH2 , ancl hypennethylation of I뻐LH1 ancl hMSH2 were explorecl. Bya panel of five markers (BAT25, BAT26 , 02S123, 05S346, ancl 017~‘250 , the so-callecl Bethescla markers) for screening of MSI, MSI was observecl in 5 of the 15 sqllamolls cell carcinomas (33.3%). As MSI is callsecl by the clysfllnction of MMR genes, this stucly examinecl the methylation status of CpG sites in the hMLH 1 ancl hMSH2 promoters ancl the expression hMLH1 ancl hMSH2. Becallse of inappr이)riate efficiency of fonnalin-frxecl ancl paraffin-embeclclecl samples for methylation-specific PCR (MS-PCR) of hMLH1 ancl hMSH2, the role of promoter hypelmethylation 띠 the clevelopment of MSI ancl expression of hMLH1 ancl hMSH2. meùlylation was failecl to clefìne. However, loss of nllclear staining of 1ψIILH 1 ancl hMSH2 were seen in nine (69.2%) ancl four (30.7%) of 13 OSCCs, while four ancl fìve all corresponcling normal epiùlelial tisslles showecl positive nllclear stι ining ofl마ILH1 and hMSH2. These data suggest that MSI anclloss of expression of hMLH1 ancl hMSH2 play a role in the carcinc핑enesis of oral sqllamolls cell carcinomas thollgh the role of promoter hypermethylation of hMLH1 ancl hMSH2 in MSI and their expresslon IS lIncertam

구강 편평세포암종 에서의 Microstellite Instability

이국엽,조남표,손현진,최철영 대한구강악안면병리학회 2004 대한구강악안면병리학회지 Vol.28 No.3

To determine the role of mismatch repair in the development of oral squamous cell carcinomas (OSCCs), the prevalence of microsatellite instability (MSI), expression of hMLH1 and hMSH2, and hypermethylation of hMLH1 and hMSH2 were explored. By a panel of five markers (BAT25, BAT26, D2S123, D5S346, and D17S250, the so-called Bethesda markers) for screening of MSI, MSI was observed in 5 of the 15 squamous cell carcinomas (33.3%). As MSI is caused by the dysfunction of MMR genes, this study examined the methylation status of CpG sites in the hMLH1 and hMSH2 promoters and the expression hMLH1 and hMSH2. Because of inappropriate efficiency of formalin-fixed and paraffin-embedded samples for methylation-specific PCR (MS-PCR) of hMLH1 and hMSH2, the role of promoter hypermethylation in the development of MSI and expression of hMLH1 and hMSH2. methylation was failed to define. However, loss of nuclear staining of hMLH1 and hMSH2 were seen in nine (69.2%) and four (30.7%) of 13 OSCCs, while four and five all corresponding normal epithelial tissues showed positive nuclear staining of hMLH1 and hMSH2. These data suggest that MSI and loss of expression of hMLH1 and hMSH2 play a role in the carcinogenesis of oral squamous cell carcinomas though the role of promoter hypermethylation of hMLH1 and hMSH2 in MSI and their expression is uncertain.

구내 절개법에 의한 악하선 적출

이국엽,진우정,백진아 大韓顎顔面成形再建外科學會 1994 Maxillofacial Plastic Reconstructive Surgery Vol.16 No.4

Surgical removal of the submandibular gland via intraoral approach was performed. The surgical procedure to be used for removal of submandibular gland had been performed via extraoral approach for many centuries. Disadvantages of extraoral technique are the esthetic distress due to an external scar, residual inflammation in Wharton's duct, and neurological complications. Indications of intraoral approach are unlimited in surgical cases of submandibular gland. Advantages of intraoral approach are esthetic satisfaction due to no remaining scars, preservation of adjacent anatomical structures and preservation of lower facial contour. This paper describes the surgical technique of the submandibular gland excision through an intraoral approach and variable incision lines tried. In 7 cases, excellentresults were obtained after removal of the submandibular gland through an intraoral approach.

顔貌 變形症 患者에 있어서 顎矯正 手術後 心理檢査 및 滿足度 評價에 關한 臨床的 硏究

이국엽(Kuk Yeop Lee),진우정(Woo Geong Jin),신효근(Hyo Jeun Shin) 대한구강악안면외과학회 1990 대한구강악안면외과학회지 Vol.18 No.4

The end to assess psychological characteristics of patients electing orthognathic surgery has recently been recognized. Systematic research on the relationship of personality pedictors to patient recovery, postsurgical outcomes, and self-concept has not been reported widely in the clinical literature. This report examined the psychological responses and postsurgical outcomes in a clinical study of 37 patients who underwent orthognathic surgery for facial deformity. Each questionaire to assess a locus of control, Eysenck s personality dimension, self-concept, and postsurgical satisfaction was administered to the patients up to 11 months after surgery. Self-concept and potsurgical outcomes were compared according to age, sex, and operative technique and also the study was to determine the association personality characteristics, postsurgical satisfaction, and self-concept. The results were as follows: 1. Males, tenages were significantly more improved with physical self-esteem than women, twenty-years old after swrgery (P<0.05). 2. Total positive self-esteem was less improved in the groups with high scores of neuroticism, emotional dimension, and introversion (P<0.05). 3. Esthetic satisfaction with postsurgical results was more satisfied in the group of extroversion dimension, and there was a correlation with postsurgical satisfaction (P<0.05). 4. There was a correlation with self-concept in the group of introverion dimension (P<0.01).

Traumatic carotid-cavernous sinus fistula accompanying multiple facial trauma

이국엽(Kuk Yeop Lee),진우정(Woo Geong Jin),신효근(Hyo Keun Shin) 대한구강악안면외과학회 1991 대한구강악안면외과학회지 Vol.17 No.2

경동맥 해면동루는 해면동과 내경동맥사이에 발생한 비정상적인 동정맥 교통관계를 말하고 발생원인은 이미 존재하는 정맥류 파열에 의해 자발적으로 형성되는 경우와 외상에 의한 경우로 나눌 수 있고, 보고된 문헌고찰에 의하면 모든 경우의 약 75-77%가 외상에 기인한다고 한다. 이 질환의 징후 및 증상은 주로 안구돌출증, 복시, 시력감소, 안검하수증, 결막부종, 두통 등이며 이 가운데 박동성 안구돌출증과 안구위 청진시 잡음이 이 질환에서만 흔히 관찰할 수 있는 증상이다. 또한 이 질환은 위해서 언급한 징후 및 증상을 나타내는 유사한 질환들과 감별진단을 해야하는데, 주요한 질환으로는 superior orbital syndrome, orbital apex syndrome, orbital hematoma or tumor, cavernous sinus thrombosis 등이다. 만일 이 질환의 정확한 진단과 적절한 치료가 이루어지지 않는다면, 비정상적인 혈행장애로 인해 망막내 저산소증을 초래해 영구적으로 시력을 상실할 수 있기에 안면 및 두경부 외상을 받은 환자에서 정확한 진단과 치료가 이루어져야 한다. 본 증례는 안면부 외상을 받은 31세 남자에서 하악골 및 협골 골절을 동반하고 서서히 진행되는 경동맥 해면동루를 detachable balloon embolization으로 치료한 치험례이다.

시상면 병행에 근거한 신개념의 하악상행지 시상분할 골절단술

백진아,이국엽,오향락,고승오,진우정 大韓顎顔面成形再建外科學會 2002 Maxillofacial Plastic Reconstructive Surgery Vol.24 No.6

Sagittal split osteotomy (SSRO) is an indispensable and most popular operation for correction of mandibular deformity. The procedure was considered of bony contact surface and nerve injury in the early stage. The procedure has undergone continuous surgical modifications for condylar displacement, relapse, psychologic analysis, functional & esthetic improvement, fixation method and postoperative evaluation of soft tissue change over time. In this article, we compared the contemporary operation method with new method which was designed through ramal computed tomography. Now we are going to introduce novel conceptual SSRO namely CNU-SSRO designed by Chonbuk National University and suggest the standardization of pre-existed SSRO.

顎矯正 手術 後 顎關節 障碍의 發現頻度에 關한 臨床的 硏究

백은호,이국엽,신효근,김정기 全北大學校 齒醫學硏究所 1992 전북치대논문집 Vol.10 No.1

The main purpose of the demanding surgical corrections aimed to improve esthetic appearance and masticatory function. But there are presumable etiologic factors in the development of T M symptoms after orthognathic surgery, that is, potential joint pathology due to different morphology of TMJ, hypombility after surgery, changes in condylar position, and changes in neuromuscular adaptation. These factors can influence on TMJ function. It is very important to find the etiological factors of TMD after surgery. Consequently, this survey was performed to evaluate TMJ function in 65 patients by questionaires, physical examination, radiogram after maxillofacial surgical corrections of the deformity patient. All patients were received pre- and post-operative orthodontic treatment. An acylic splint(wafer) was constructed prior to surgery with occlusal contacts in the anterior and posterior. The study group was consisted of 26 males and 39 females. The patients were evaluated at an average fellow-up period of 17.2 months with a range of 15 to 27 months. The results obtained were as follows: 1. The 65 patients were found to present preoperatively TMJ dysfunction symptom with an incidence of 18.5%(12 cases). 2. The patients with no TMJ dysfunction symptoms preoperatively, presented such symptom with an indicence of 26.4%(14 cases) postoperatively. 3. The main symptoms of TMJ dysfunction were 17 joints(15 clicking), TMJ pain(5 cases). 4. The mean preoperative MIO(maximal interincisal opening) of 49.7㎜ was reduced to 43.9㎜ postoperatively after sagittal split ramus osteotomy(n=38) with wire osteosynthesis(p<0.05).

하악지 시상분할 골절단술, 하악지 수직 골절단술, 하악지 기역자 골절단술 악교정술의 비교연구

백진아,이국엽,양명철,고승오,진우정 大韓顎顔面成形再建外科學會 2002 Maxillofacial Plastic Reconstructive Surgery Vol.24 No.6

The orthognathic surgery for esthetic and functional improvement has developed for 150 years. Today, we can expect the better prognosis which is based on the early trial & error and advanced analysis technique. However, conservatism which advocates upholding of traditions and passive changes has been obstacle to scientific modernization as a contemporary co-worker. IVRI, ILRO, IVSRO, IVRO-SSRO, SSRO have been used to orthognathic surgery variously. In this article, we are going to compare IVRO, ILO with SSRO and advocate superiority of SSRO.

Intra-oral vertico sagittal ramus osteotomy for treatment in habitual luxation

유준영(Jun Young You),이국엽(Kook Yeop Lee),윤현중(Hyun Hoong Yoon),고광희(Kwang Hee Ko),강명수(Myung Soo Kang) 대한구강악안면외과학회 1995 대한구강악안면외과학회지 Vol.21 No.4

악관절질환중 가장 오래전부터 인지되어왔고 치료되어졌던 악관절질환이며 그래서 그에 대한 치료방법도 많이 이루어져왔다. 습관성 악관절탈구의 원인은 악관절의 인대가 느슨해져서 악관절의 전방운동시 그의 제어가 불가능해져서 이루어진다. 이 악관절탈구의 치료방법은 느슨해진 인대에 Scleosing solution의 주입으로부터 악관절의 고정술, condylotomy까지 다양한 방법의 술식이 사용되어져왔다. 각각 술식의 장단점이 노출된 바 일종의 condylotomy로써 IVSRO를 이용하여 치료해본 결과 별다른 문제없이 치유되어 보고하는 바이다. Acute, recurrrent, and long-standing forward dislocation of the mandible are not common conditions compared with other conditions. Chronic recurrent dislocations of the mandible can be a significant problem. The understanding of the etiologic factors involved and the interrelations of the joint laxity to internal derangements of the disc are significant when considering the multiple factors of the TMJ disorders in general. A lot of literature shows that the treatment of painful condylar hypermobility, subluxation, and dislocation is approached in a rational conservative way utilizing surgical methods when nonsurgical treatment is not effective. In recurrent dislocation of the temporomandibular joint, many ways of treatment were reported such as eminectomy, eminence augmentation, and condylotomy. The final choice of the correct method(s) of tretment depends on a correct diagnosis and an understanding of the etiologic factors. Intra-oral vertical osteotomy is one of the widely used methods in correction of temporomandibular joint recurrent dislocation. But sagging of the TMJ after IVRO results in a bony step between the proximal segment and distal segment, and lateral rotation of the tempormandibular joint in a natural joint position. In this point of view, IVSRO has advantages. And healing is medular-to-medular minimum cortex-to-medular comparison with cortex-to-cortex healing in IVRO. The author thinks that IVSRO in correction of emporomandibular joint recurrent dislocation. The author performed the IVSRO(Choung s Osteotomy) in a habitual TMJ dislocation patient and it lead to good, and favorable post-pperative results in both function and esthetics.