TUMOR INDUCED OSTEOMALACIA : ASSOCIATED WITH GIANT CELL GRANULOMA ON THE GINGIVA

김여갑,류동목,이상철,Kim, Yeo-Gab,Ryu, Dong-Mok,Lee, Sang Chull Korean Association of Maxillofacial Plastic and Re 1991 Maxillofacial Plastic Reconstructive Surgery Vol.13 No.2

비내분비성 골종양이나 연조직종양에서 유래되는 구루병이나 골연화증은 매우 드문질환으로 1947 년 이래로 14 명의 환자만이 보고되고 있다. 이 질환의 본태는 아직 밝혀지지 않았으나 종양에서 생성하는 인산염뇨유발성 물질이 신세뇨관에 영향을 주고 저인산염혈증을 일으키며 골조직의 석회화에 장애를 일으키는 것으로 생각된다. 본 증례의 환자는 약 4 년 전부터 지속된 심한 전신동통과 근육위축, 현저한 신장의 감소를 주소로 내원한 41 세 남자로 상악우측 치은부의 종양에 의한 전신적 골연화증의 진단하에 종양의 외과적적출을 시행하였으며 술후 환자의 혈청과 뇨의 생화학적결과는 12 일 후에 정상으로 회복되었고 임상증상은 수술후 6 주에 회복되었으며 4 달후에 촬영한 치과 방사선상 놀랄만한 골재생과 새로 형성된 치조백선의 형성이 관찰되었다. 적출된 종물은 거대세포육아종의 조직소견을 보였으며 종물의 적출에 의하여 골연화증의 치유소견이 관찰 되었기에 종양에 의한 골연화증의 회유한 증례로 사료되어 이에 보고하는 바이다. Thr rickets or osteomalacia, that was induced by nonendocrine osseous or soft tissue tumor, is extremely rare disease and fourteen patients has been reported since 1947. The real nature of this disease is unknown, but postulated that unknown phosphaturic subtance which was elaborated from the tumor affect the renal tubule and produce hypophosphatemia and failure of calcification of osseous tissue. This case presented is that of 41-year-old man who suffered from severe generalized aching pain, severe muscular dystrophy, and shortening of the stature 4 years prior hospitalization. The causal coexisting tumor is walnut sized peripheral giant cell granuloma on the upper gingiva. After surgical removal of the tumor, patient's biochemical findings of the serum and urine were returned to the normal limits 12 days later, and clinical symptoms were marked relieved at 6 weeks later. The dental radiograms which were obtained 4 months later revealed remarkable bone regeneration and newly formed alveolar lamina dura.

악변형환자의 악교정수술시 합병증에 관한 연구

김여갑,이상철,이백수,김병주,Kim, Yeo-Gab,Lee, Sang-Chull,Lee, Baek-Soo,Kim, Byung-Ju 대한악안면성형재건외과학회 1994 Maxillofacial Plastic Reconstructive Surgery Vol.16 No.3

We got this conclusion from an investigation about complications from 144 cases of 130 patients who were to be searched their personal records, admission chart, clinical laboratory sheet, anesthetic record, consult sheet and radiographic opinion. They had orthognathic surgery for maxillofacial deformity treatment at the department of oral and maxillofacial surgery in dental school of Kyung Hee university for 4 years and 10 months, from March 1989 to December 1993. 1. In the intraoperative phase, by the frequency of complication, blood vessel injury was found the most-22%, and then soft tissue injury, unfavorable osteotomy split, and there were some cases of tooth injury and inappropriate osteotomy. In the mandibular segmental osteotomy, blood vessel injury was found the most frequently-20 cases (27%), soft tissue injury, unfavorable osteotomy split were the second frequent cases, and then unfavorable fragment position was found. In the extraoral vertical ramus osteotomy and Le Fort I osteotomy also, blood vessel injury and nerve injury were found the most. 2. In the postoperative hospitalization phase, by the frequency of complication, hematoma (23%) was happened the most, except for that, lkie the complication that can be happened by adverse reaction of medicine or long hospital life. In the case of SSRO, there were 21 cases (20%) of hematoma, and this wal the most frequently case. In the case of EVRO, hematoma wasn't happened that much-2 case (4%). 3. In the follow up phase, relaps, numbness and TMJ dysfunction were happened. In mandibular surgery, the forward relapse percentage of point B, was 27% when used wire fixation on SSRO, was 15% by miniplate fixation on SSRO and was 7% on EVRO. In the case of SSRO, numbness was kind of high, comparing to ordinary surgery-12 cases(16 There were many difficulties in analyzing this data accurately, Although orthognathic surgery is done many times, only available date is from the "success" stories and data is not consistently recorded for the cases with complications. In this manner, much essential informantion is lost and overlooked. When data is charted including those cases that are seemingly insignificalt, we can have a much clearer understanding and more accurate guide on treatment protocols.

소아 구강악안면 영역의 외상에 관한 임상적 연구

김학렬Hak-Ryeol Kim,김여갑Yeo-Gab Kim 대한구강악안면외과학회 2010 대한구강악안면외과학회지 Vol.36 No.1

Purpose: To research about maxillofacial traumatic injuries of children in aspects of gender difference, various incidence rates between age, trauma type, cause, monthly and daily incidence rate, type of tooth damage, gingival damage, soft tissue damage, and type of facial bone fracture. Materials and methods: Study group consisted of children under 15 years of age who visited Dental Hospital, School of Dentistry, Kyung Hee University from 2004/7/1 to 2007/6/30 with chief complaint of oral and maxillofacial traumatic injuries. 1,559 cases of traumatic injuries were studied from 1,556 (1,004 male, 552 female) children. Conclusion: 1. There were slightly more boys than girls, giving a male-to-female ratio of 1.82:1.0. The 1-3 year old boys and girls had the highest number of traumatic injuries. 2. Of the 1,556 patients, 68.63% had soft tissue injuries, 50.22% had periodontal injuries, 29.89% had teeth injuries, and 3.85% had maxillofacial bone fractures. 3. Falling down was the most common cause of injury in both sexes. 4. The months with the highest incidence rates were in order May (12.12%), June (11.74%), and October (11.13%). Most of the injuries occurred on weekends. 5. The most common tooth injury was uncomplicated crown fracture, and the most common periodontal injury was subluxation. The majority of traumatizes teeth were the upper central incisors. 6. The most common soft tissue injury was intraoral lacerations. 7. Mandibular fractures were most frequent in facial bone fractures; symphysis, condylar head, and angle fractures were most frequent in mandibular fractures; maxillary and nasal bone fractures were most frequent in midfacial bone fractures.

임프란트 식립시 이식된 탈회골기질을 함유한 이식재의 골형성에 대한 연구

김여갑(Yeo-Gab Kim),윤병욱(Byung-Wook Yoon),류동목(Dong-Mok Ryu),이백수(Baek-Soo Lee),오정환(Jung-Hwan Oh),권용대(Yong-Dae Kwon) 대한구강악안면외과학회 2005 대한구강악안면외과학회지 Vol.31 No.6

Purpose: The aim of the present study is to evaluate the effect of autogenous bone and allograft material coverd with a bioresorbable membrane on bone regeneration after a simultaneous installation of implant. Materials and methods: Twelve healthy rabbits, weighing about 3~4 kg, were used in this experiment. Following impalnt(with 3.25 mm diameter and 8 mm length) site preparation by surgical protocol of Oraltronics, artificial bony defect, 5mm sized in height and depth, was created on femoral condyle using trephine drill(with 5 mm diameter and 5 mm length). Then implant was inserted. In the experimental group A, the bony defect was filled with autogenous particulated bone and coverd with Lyoplant resorbable membrane. In the experimental group B, the bony defect was filled with allograft material(Orthoblast II) containing demineralized bone matrix and covered with Lyoplant. In the control group, without any graft materials, the bony defect was covered with Lyoplant. The experimental group A and B were divided into each 9 cases and control group into 3 cases. The experimental animals were sacrificed at 3, 6 and 8 weeks after surgery and block specimens were obtained. With histologic and histomorphometric analysis, we observed the histologic changes of the cells and bone formation after H-E staining and then, measured BIC and bone density with KAPPA Image Base system. Results: As a result of this experiment, bone formation and active remodeling process were examined in all experimental groups and the control. But, the ability of bone formation of the experimental group A was somewhat better than any other groups. Especially bone to-implant contact fraction ranged from 12.7% to 43.45% in the autogenous bone group and from 9.02% to 29.83% in DBM group, at 3 and 8 weeks. But, bone density ranged from 15.67% to 23.17% in the autogenous bone group and from 25.95% to 46.06% in DBM group at 3 and 6 weeks, respectively. Although the bone density of DBM group was better than that of autogenous bone group at 3 and 6weeks, the latter was better than the former at 8 weeks, 54.3% and 45.1%, respectively. Therefore these results showed that DBM enhanced the density of newly formed bone at least initially.

불소 및 수종 Hormone 이 악골결손부위의 골형성에 미치는 영향에 관한 조직화학적 연구

김여갑(Yeo Gab Kim) 대한악안면성형재건외과학회 1982 Maxillofacial Plastic Reconstructive Surgery Vol.4 No.1

N/A The purpose of this observation was to study fluoride, testosterone propionate and prednisolone acetate reaction and its effectiveness on new bone formation of mandibular bone defects. In order to carry out this experiment: 96 male rats were selected. Each was defected at a length of 3×3mm in the left mandibular angle portion and was divided into three experimental groups and a control group. Three experimental groups were then categorized as follows; a) 2.5%. NaF solution at m dose of 5mg/kg, b) testosterone propionate solution at a dose of 40mg/kg, c) predniso1one acetate solution at a dose of 20mg/kg, Control group was taken with the same method as experimenta1 groups with normal saline solution intraperitoneally injected three times during the week of experimentation. Experimental rats were sacrificed on 1st, 2nd, 4th, and on the 6th week consecutively producing block of bone by excising defective bone and normal bone. 10 % neutral formalin solution were fixed, decalcified by 5%, HNO3, which was embedded in paraffin in the normal routine manner. The histochemical techniques indulged were as follows; Hematoxylin-Eosin stain, Periodic acid schiff reaction for glycogen and mucopolysaccharide purposes, van Gieson`s stain reaction to detect collagen fiber, Aniline blue stain (Heidenhain`s method) reaction for osteoblaet and osteoid tissues. The following results were obtained from the microscopic studies; 1) Testosterone group revealed positive reaction to fibroblast and osteoblast in comparison to other experimental groups showing osteoid tissue and. chondroid tissue formation markedly. 2) Prednisolone group, However, showed slightly slow development reaction to fibroblast and osteoblast. Osteogenesis in bone tissue also indicated slow reacting process. 3) Rats injected with fluoride resulted in similar pattern to that of testosterone in showing fibroblast and osteoblast but initial stage indicated slower reaction to osteoid tissue and chondroid tissue compared to that of testosterone group. 4) PAS stain test showed positive reaction of connective tissues in the first initial state of the experiment to fluoride and testosterone injected species but indicated gradually reduction attitude in reaction. Prednisolone experiment resulted in a somewhat weaker positive reaction. 5) PAS stain study showed positive reaction to osteoid tissue and chondroid tissue in the beginning but showed slower reaction after new bone formation. 6) In the initial stage of van Gieson`s stain, collagen fiber in osteoid tissue was revealed. In the prednisolone group, delayed calcification was detected due to delayed remained fiber. 7) Testosterone group showed more or less increment of osteoid tissue formation compared to fluoride and prednisolone groups when experimenting aniline blue stain. However, the latter stage of fluoride injection was similar to testosterone group in the, new bone formation, prednisolone showed slightly decrement.

증례 : Basal Cell Nevus Syndrome 가족의 문헌고찰 및 임상 치험 예 ( Case Report : Basal Cell Nevus Syndrome is a Hereditary Disease with Multiple Defects Involving Organs and Systems of Both Ectodermal and Mesodermal Origin )

김여갑(Yeo Gab Kim),이상철(Sang Chull Lee),김효종(Hyo Jong Kim) 경희대학교 경희의료원 1986 慶熙醫學 Vol.2 No.3

악교정수술시 경조직 변화에 따른 연조직 변화에 관한 연구

김여갑(Yeo Gab Kim) 대한치과의사협회 1987 대한치과의사협회지 Vol.25 No.1

원저 : 하악골전돌증의 악교정수술 후 재발에 관한 연구 ( Original Article : Study on the Relapse after orthognathic Surgery for Mandibular Prognathism )

김여갑(Yeo Gab Kim) 경희대학교 경희의료원 1985 慶熙醫學 Vol.1 No.1

우리나라의 FDI 세계치과의사총회(FDI Annual World Dental Congress) 유치의 의미

김여갑(Yeo Gab Kim),김태훈(Tae-Hoon Kim) 대한치과의사협회 2010 대한치과의사협회지 Vol.48 No.9

FDI World Dental Federation is organization representing more than one million dentists worldwide with its more than 100 years of long history. Now FDI headquarter is located in Geneve, Switzerland and serves for developing health policy and continuing education programs, speaking as a unified voice for dentistry in international advocacy and supporting member association in oral health promotion activities worldwide. Korean Dental Association has been a member of FDI since 1959 and participated actively in the FDI’s worldwide activities. Past Dr. Heung-Ryul Yoon was a president of FDI from 2003 for 2 years and we also have an experience in 1997 of hosting FDI Annual World Dental Congress successively in Seoul. The image of a country reflects the country’s culture as well as affects to its economical and social development and it decides the national brand toward the world. Currently, Korean people realized that and put their efforts for promoting diverse aspects of Korea to the world such as multimedia culture called Han-Ryu, electric industry, automotive industry, sports represented by soccer. We have advanced technique and skill in various fields and now it’s time to show ourself better to the world. It’s same to the dentistry. It’s true that Korean dentistry is top-class in the world and the dental industry is prosperous and also has best technique in the world. I think and strongly hope that the 2013 FDI Seoul Annual World Dental Congress would be best opportunity for Korean dentistry and dental industry to promote ourselves and make a big step to the world. Not only for the dentistry, it will also be very good chance to all the Korean people to improve Korean national brand. I believe that we can accomplish if we, all dental societies, stand together and join our effort to use this good chance the best. I know we can make it.

만성 자극시 구강점막의 변성에 대한 병리조직학적 및 조직화학적 연구

김여갑(Yeo Gab Kim) 대한악안면성형재건외과학회 1983 Maxillofacial Plastic Reconstructive Surgery Vol.5 No.1

N/A The purpose of this observation was to study for the degenerative changes of the oral mucosa caused by chronic irritations with the histopathologic and histochemical studies in 45 cases of mandibular third molar opercula and 15 cases of epulis fissurata. These soft tissue specimens were obtained from 45 (18, male; 27, female) patients aged from 20 to 31 year-old in opercula and 15 (8, male; 7, female) patients aged from 17 to 63 year-old in equlis fissurata who came to the department of oral surgery, infirmary of dental college, Kyung Hee University. Specimens obtained were immediately fixed in the 10% neutral formalin solution, embedded in paraffin in the normal routine manner and then cut with a thickness of 4-6 micron. The histopathological and histochemical techniques applied were as follow; Hematoxylin-eosin stain, periodic acid shiff reaction (P.A.S) for glycogen and mucopolysaccharide purposes, van Gieson`s stain to detect collagen fiber, Ayoub-shklar stain for keratin, toluidine blue stein to study of the mast cells, and alcian blue stain, The following results were obtained from the microscopic studies: 1. The superficial epithelial cell of opercula was mainly composed stratified squamous epithelial cell with acanthosis and hyperparakeratosis and 9 cases of the 15 cases of epulis fissurata a1so showed acanthosis and hyperkeratosis. 2. In 4 cases of the 45 cases of opercular and 2 cases of the 15 cases epulis tissurata showed pseudoepitheliomatous hyperplasia with the thickening of the basal cell layer. 3. Hydropic degeneration at the granular layer and atypia of the epithelial cell were found in 5 eases of the 45 cases aperc0la. 4. Of 45 cases opercula, epithelial island was presented in 8 cases. 5. Focal osteoid tissue and cementum-like odontogenic calcified material in 6 cases 15 cases operula and 2 cases/5 cases epulis fissurata were observed. 6. Myxamatous degeneration in the connective tissue in 2 cases, and mucous minor salivary gland in 3 cases of the 45 cases opercula and, 1 case of the 15 cases epulis fissurata were presented. 7 Of the 45 cases opercula, lipoid degeneration in the connective tissue in 2 cases and nerve fiber in 3 cases were showed. 8. Capillary and vascular endothelial cell proliferation were observed in respectively 1 case of the opercula and epulis fissurata. 9. In PAS reaction, nearly all of the opercula and epulis fissurata revealed negative reaction in the epithelial cell layer. 10. Keratin layer with dark red stain in the Ayoub-shklar stain was observed in severely proliferated epithelial cell laryer, 11. In toluidin stain, minor salivary gland with positive reaction and mast cells with positive reacted granular type were presented. 12. In alcian blue stain, deep stained mucopolysaccharide showed with myxomatous degeneration abundantly.