정맥의 기계적 문합과 통상적 문합의 주사전자현미경적 비교

김창룡(Chang Lyong Kim),이종호(Jong Ho Lee) 대한구강악안면외과학회 1996 대한구강악안면외과학회지 Vol.22 No.2

The purpose of this experimental study was to compare scanning electron microscopically healing process of each anastomotic sites after mechanical or conventional microvascular anastomoses of the femoral vein in rabbit. Six rabbits weighed about 2.5kg were used. Mechanical microvascular anastomosis was done on left femoral vein, the opposite side, with the conventional method. The experimental animals were sacrificed at 3, 5, 7, 10, 14 and 28 days after anastomosis. Results obtained were as follows. Conventional method was presented that at 3 days, endothelial regeneration was not recognized and intima to intima contact was not achieved due to vessel overlapping. At 5 days, insertion site of the thread was partially covered with amorphous substance. At 7 days, endothelial regenration has begun but the thread was largely exposed. At 1 days, active regeneration of endothelium was observed over the anastomotic site and threads. At 14 days, active endothelial regeneration was observed but still the uncovered thread was seen. At 28 days, the thread was completely covered with normal endothelial cells. Mechanical method was presented that at 3 days, endothelial regeneration was not recognized but intima to intima contact was uniformal achieved. At 5 days, it was similar to 3 days appearance and regeneration was not observed on the anastomotic site. At 7 days, endothelial regeneration has begun but depression of anastomotic site was seen. At 10 days, half of the anastomotic site was covered with endothelial cell. At 14 days, the site of anastomosis was completely invisible and fully endothelialized and then at 28 days, it was similar to 14 days healing pattern and directions of endothelial cell was arranged with the flow of blood. By the above observation, because endothelial regeneration of the mechanical method was occured more evenly at the anastomotic site tan conventional, and exposure of suture material on the intimal vessel surface might carry the risk for thrombosis, it has been suggested that mechanical method be superior to conventional method.

치성감염에 의해 발생된 후측인두부 및 종격동 농양

이승호,정종철,김건중,정주성,유선열,박문성,김창룡 大韓顎顔面成形再建外科學會 1996 Maxillofacial Plastic Reconstructive Surgery Vol.18 No.4

Odontogenic infections are usually locally confined, self-limiting processes. However, under certain circumstances, they may break through the bony, muscular, and mucosal barriers and spread into contiguous fascial spaces or planes far from the initial site of involvement, resulting in severn life-threatening complications, such as retropharyngeal spread, suppurative mediastinal extension, airway obstruction, pleuropulmonary suppuration, and hematogenous dissemination to distant organs. The mortality arte for mediastinitis from odontogenic infection ranges from 40% to 60%. Therefore rapid evalution and treatment is essential with a combination of life support, antibiotic therapy, and surgical intervention. Recently, we experienced three cases of retropharyngeal and mediastinal abscesses secondary to odonogenic infections. In all patients, early diagnosis was possible by CT scanning and physical examination. The prognosis was good in all patients by using urgent aggressive surgical and antibiotic therapy.

악하부에 발생한 결핵성 경부 임파선염

김영운,정숭룡,이승호,이종호,김창룡,박문성,류선열 大韓顎顔面成形再建外科學會 1995 Maxillofacial Plastic Reconstructive Surgery Vol.17 No.4

Tuberculosis, a chronic infectious granulomatous disease, is preumed to be quite a rare entity. Because of the development of chemotherapy and the improvement of nutritional conditions, incidence of tuberculosis have reduced. For these reasons, tuberculosis may be overlooked in the differential diagnosis whenever dealing with a submandibular swelling. Diagnosis of tuberculous lymphadenitis consists of historical data, physical findings, laboratory tests and histologic examination. The treatment of choice seems to be surgical excision and long term antituberculosis chemotherapy. Surgery provides a rapid tissue diagnosis, because the histological examination of the excisional biopsy is the most reliable diagnostic test. This is the report of a case of tuberculous cervical lymphadenitis on left submandibular area with no evidence of the involvement of lung.

정맥의 기계적 문합과 통상적 문합의 주사전자현미경적 비교

김창룡,이종호 전남대학교 치과대학 1995 전남치대논문집 Vol.7 No.1

The purpose of this experimental study was to compare scanning electron microscopically healing process of each anastomotic sites after mechanical or conventional microvascular anastomoses of the femoral vein in rabbits. Six rabbits weighed about 2.5kg were used. Mechanical microvascular anastomosis was done on left femoral vein, the opposite side, with the conventional method. The experimental animals were sacrificed at 3, 5, 7, 10, 14 and 28 days after anastomosis. Results obtained were as follows. Conventional method was presented that at 3 days, endothelial regeneration was not recognized and intima to intima contact was not achieved due to vessel overlapping. At 5 days, insertion site of the thread was partially covered with amorphous substance. At 7 days, endothelial regeneration has begun but the thread was largely exposed. At 10 days, active regeneration of endothelium was observed over the anastomotic site and threads. At 14 days, active endothelial regeneration was observed but still the uncovered thread was seen. At 28 days, the thread was completely covered with normal endothelial cells. Mechanical method was presented that at 3 days, endothelial regeneration was not recognized but intima to intima contact was uniformly achieved. At 5 days, it was similar to 3 days' appearance and regeneration was not observed on the anastomotic site. At 7 days, endothelial regeneration has begun but depression of anastomotic site was seen. At 10 days, half of the anastomotic site was covered with endothelial cell. At 14 days, the site of anastomosis was completely invisible and fully endothelialized and then at 28 days, it was similar to 14 days' healing pattern and directions of endothelial cell was arranged with the flow of blood. By the above observation, because endothelial regeneration of the mechanical method was occured more evenly at the anastomotic site than conventional, and exposure of suture material on the intimal vessel surface might carry the risk for thrombosis, it has been suggested that mechanical method be superior to conventional method.

혈관화 두개골 외층골피판을 이용한 두개안면부 재건

정주성,김기영,김창룡,박문성,정숭룡,유선열,이승호 大韓顎顔面成形再建外科學會 1996 Maxillofacial Plastic Reconstructive Surgery Vol.18 No.4

Vscularized calvarial bone flaps have been useful tools in the reconstuction of different type of bone defects in craniofacial surgery Vascularized bone transfer are often preferred to nonvascularized bone grafts because nonvascularized bone grafts are less resistant to infection, mot as mechanically strong, and do not survive well in a poorly vascularized bed. Potential advantages of vascularized outer table cavarial bone flap include proximity to the operative feild, membranous origin similar to that of the facial skeleton, maleability which allows for a variety of shapes and sizes, inconspicous donor sit scar. The following are the case reports of two patients who underwent craniofacial reconstruction suing vasularized outer table calvarial bone flap.

연구개 및 구개수에 발생한 편평세포암종

이승호,이성훈,김기영,김창룡,박문성,류선열,조규승 大韓顎顔面成形再建外科學會 1996 Maxillofacial Plastic Reconstructive Surgery Vol.18 No.4

Carcinoma of the mouth accounts for approximately 5% of all carcinomas occurring in man. Carcinoma of the oral cavity develops as a result of invasion of malignant epithelial cells through the normally intact basal cell layer into subcutaneous and submucosal tissuse. The sofe palate and uvula may be involved in oral cancer but are not common sites. Early lesions of soft palate carcinoma appear as red, white, or mixed changes in the mucosa. The earliest symptom is mild sore throat. Advanced lesions interfer with swallowing and may cause a voice change. Although surgical method of soft palate carcinoma is successful, prognosis is relatively poor to swallowing and speech problem. Occasionally marginal recurrence may be developed. This article reports a case of squamous cell carcinoma occurred unusually in the soft palate and uvula. The case was treated with neoadjuvant chemotherapy, local radicalexcision and postoperative irradiation. Patient was followed up for 2 years. There was no tumor recurrence. The overall result including function was satisfactory.