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자극성 섬유종, 구강백반증 및 구강편평세포암종에서 MMP-2 및 MMP-9 발현에 대한 면역조직화학적 연구
김문기(Moon-Key Kim),이은하(Eun-Ha Lee),김진(Jin Kim),이의웅(Eui-Woong Lee),차인호(In-Ho Cha) 대한구강악안면외과학회 2006 대한구강악안면외과학회지 Vol.32 No.4
MMP-2 and MMP-9, type IV collagenases which degrade basement membrane, have been known to play important roles in invasion and metastasis of tumor cells, In addition, they seem to be involved in cell differentiation, apoptosis, angiogenesis and immunity, etc. We immunohistochemically examined epithelial and stromal expressions of MMP-2 and MMP-9 in irritation fibroma, oral leukoplakia, and oral squamous cell carcinoma (OSCC) and have some results as follows: 1. Irritation fibromas, oral leukoplakias and OSCCs mostly showed increased expression of MMP-2 and MMP-9 in the epithelium and connective tissue compared with normal mucosa. 2. There was a significant difference in the epithelial expression of MMP-2 and MMP-9 between irritation fibroma and oral leukoplakia. 3. There was a significant difference in the epithelial and stromal expression of MMP-2 and MMP-9 between irritation fibroma and OSCC. 4. There was a significant difference in the stromal expression of MMP-9 between oral leukoplakia and OSCC. We concluded that rritation fibroma, oral leukoplakia and OSCC have somewhat different characteristics of MMP-2 and MMP-9 expressions, which perhaps result from different pathogenesis.
백지영(Ji Young Baek),최성원(Sung Won Choi),이의웅(Eui Woong Lee),최은창(Eun Chang Choi),차인호(In Ho Cha) 대한구강악안면외과학회 2000 대한구강악안면외과학회지 Vol.26 No.4
Malignant tumors of the maxilla represent about 3-4% of head and neck malignant neoplasm and the origins are maxillary gingiva, hard palate and maxillary sinus. We are to investigate clinical features and results according to various treatment modalities of maxillary malignant tumor to get information for better treatment results. Sixty patients with malignant maxillary tumors treated at Yonsei medical center from 1992 to 1997 were studied retrospectively. They are evaluated according to clinical signs & symptoms, stages at first diagnosis, primary site, histopathologic features, treatment method, recurrence and survival rate with clinical records, biopsy results and CT radiograph. The most common primary site was maxillary sinus and most common histopathology was squamous cell carcinoma. The local recurrence rate was 18% at 5 years, neck failure was 3% and distant metastasis was 18%. Overall survival rate was 78% at 2 years and 69% at 5 years. Failure at primary site is the main problem in the curative treatment. So, to improve survival in these patients efforts should be directed toward improvement of local control.
변성규(Seong Kyu Byun),최은창(Eun Chang Choi),박원서(Won Se Park),이의웅(Eui Woong Lee),차인호(In Ho Cha) 대한구강악안면외과학회 2000 대한구강악안면외과학회지 Vol.26 No.4
We reviewed 56 patients who received mandibulotomy at Yonsei medical center between 1989 and 1999. We also analysed the complications associated with mandibulotomy and its contributing factors. The complications occur in 16 patients(28.6%) and are classified into two categories; intraoperative and postperative complications. Nonunion was observed in 5 patients and osteoradionecrosis in 5. The patients who received preoperative radiation therapy were more tend to develop nonunion and osteoradionecrosis. This study suggests the benefits of mandibulotomy as a surgical approach to oral cancer: 1. Paramedian osteotomy was recommended for preservation of neurovascular bundle and ease of surgical access. 2. By using thin saw blade, reapproximation was improved with minimal bone loss. 3. osteotomy on anterior mandible which lies outside the usual portals of radiation therapy decreases the incidence of osteoradionecrosis.
악교정 수술시 유도저혈압 마취를 위해 사용되는 Esmolol과 Nitroglycerin의 효과에 대한 비교 연구
정영수(Young Soo Jeong),강정완(Jeong Wan Kang),박형식(Hyung Sik Park),이충국(Choong Kook Yi),이의웅,(Eui Woong Lee) 대한구강악안면외과학회 1998 대한구강악안면외과학회지 Vol.24 No.4
Induced hypotension is used to help control bleeding during procedures where surgical hemostasis is technically difficult to achieve. A mean arterial blood pressure(MABP) as low as 50-60 mmHg appears to be well tolerable in healthy patients. The present study was designed to compare the efficacy of Esmolol and Nitroglycerin as primary drug for hypotensive anesthesia during 22 cases of orthognathic surgery, and compare their effects on blood loss, duration of surgery, quality of the surgical field, hormonal response, and patient outcome. The results obtained are as follows. 1. During the induced hypotension, mean arterial blood pressure was similarly reduced in esmolol group and nitroglycerin group. And any significant difference was not seen in the time of inducing hypotension from starting the drug administration, preoperative mean blood pressure and mean blood pressure during the period of postoperative recovery. 2. Difficulty of the operation, quality of the surgical field and total operation time in 2 groups show no difference but the time during hypotension was significantly reduced in esmolol group. 3. Urine output, administered fluid volume, transfusion volume of autologous blood, preoperative and postoperative base excess, preoperative and postoperative hematocrit had no difference between 2 groups. 4. The change of the plasma renin activity was more lowered in esmolol group than in nitroglycerin group. Based on the above results, esmolol can replace the nitroglycerin as a new primary drug for hypotensive anesthesia. Especially, esmolol is more recommendable than nitroglycerin on the effect of stability in renin-angiotensin system and prevent rebound hypertension in posthypotensive period.
방사선조사 및 고압산소요법이 미세혈관 문합술에 미치는 영향
최성원(Sung Weon Choi),김병용(Byung Yong Kim),박정현(Jung Hyun Park),윤정훈(Jung Hoon Yoon),육종인(Jong In Yook),유재하(Jae Ha Yoo),이의웅(Eui Woong Lee),차인호(In Ho Cha) 대한구강악안면외과학회 2000 대한구강악안면외과학회지 Vol.26 No.5
Malignant tumors of the head and neck frequently require treatment with both radiotherapy and surgery. Reconstruction of the defect in previously irradiated field is a challenge to surgeon, who must produce both a functional and an esthetic result. Hyperbaric oxygen therapy(HBO) has been used in an attempt to reduce the deleterious effects of radiation. But the issue of whether prior irradiation and HBO of the recipient site of a free flap affects the result of reconstruction continues to generate controversy. So, the effects of irradiation and hypergbaric oxygen therapy on microvascular anastomosis was evaluated in an experimental study in femoral vessels of rats. The experimental groups were divided into 3 groups, contorol group, irradiation group, and irradiation and HBO group. Preoperative irradiation was delivered in the left groin field with single dose corresponding 2,000cGy and total 48 hours of HBO was given 100% oxygen at 2.4 atmosphere for 4 weeks. The femoral vessels of 60 rats were anastomosed after irradiation and HBO treatment. Three days, 1 week, 2 weeks and 4 weeks after surgery, the femoral vessels were evaluated for patency and histopathologic changes. There was no notable effect of irradiation on patency of femoral vessels in rats and the radiation effects were obvious on histological examination which showed the sloughing of the endothelial cells, subintimal hyperplasia and fibrosis on the media and adventitia of femoral arteries. The histologic changes of the femoral veins were mild and not typical. But the effects of hyperbaric oxygen therapy after irradiation was seen not marked difference in irradiation group.