조직확장술을 이용한 두경부 연조직 재건

정종철,박준아,김영운,정숭룡,이종호,류선열,Jeong, Jong-Cheol,Park, Jun-Aa,Kim, Young-Woon,Jung, Soong-Rhyong,Lee, Jong-Ho,Ryu, Sun-Youl 대한악안면성형재건외과학회 1994 Maxillofacial Plastic Reconstructive Surgery Vol.16 No.3

Tissue expansion has now been widely used in various soft tissue defects and deformities. It is to reconstruct the lesion site by providing donor tissue of the same color, texture, and similar thickness and sensation with minimal scar formation and minor donor site morbidity. It is achieved through using a temporary expander capable of accumulating normal saline. Internal pressure from expander exerts its force on the flap, which gradually expands to provide additional tissue for reconstruction. We have applied tissue expander in three patients. The first case was soft tissue loss on the left forehead. The second case was multiple scar formation on the left mandibular angle and upper cervical area. The third case was scar contraction on the right cheek. All cases have been successfully reconstructed without complications. 저자들은 1예의 전두부 연조직 결손과 2예의 경부와 안면에 형성된 다발성의 반혼구축 환자에서 조직확장술올 이용하여 양호한 두경부의 연조직 재건을 얻을 수 있었다. 다양한 연조직의 결손이나 변형에서 적절한 증례를 선택하여 올바르게 적용할 경우 조직 확장술은 유용한 재건방법이 될 수 있을 것으로 생각된다.

미맹출치를 동반한 Calcifying Odontogenic Cyst

류선열,정중재,정종철,박준아,최홍란,Ryu, Sun-Youl,Chung, Jung-Jae,Chung, Jong-Chull,Park, Jun-Ah,Choi, Hong-Ran 대한악안면성형재건외과학회 1993 Maxillofacial Plastic Reconstructive Surgery Vol.15 No.2

좌측 상악 구치부와 협부의 무통성 종창을 주소로 내원한 16세 여자의 좌측 상악동에서 다량의 석회화 침착과 미맹출지를 포항한 COC 1예를 구내 접근법을 통해 외과적으로 제거하였다. 적출물은 $50{\times}40{\times}35mm$의 크기였고 낭종벽으로 잘 피낭되어 있었다. 조직학적으로는 잘 발달된 상피 내벽과 ghost cell이 나타나 COC의 소견을 보였으며 석회화물은 complex odontoma의 양상을 보여 COC의 type IB로 분류되었다. 술후 1년이 지난 현재 안모의 개선을 나타내고 있으며 재발의 증상 없이 양호한 경과를 보여주고 있다. A case of calcifying odontogenic cyst associated with an unerupted tooth which appeared in the left maxillary sinus of a 16-year-old woman, was reported. Clinical examination revealed painless swelling on the left maxillary posterior region and the cheek. Radiographically, this lesion showed a monolocular radiolucent shadow with calcified materials and unerupted maxillary second premolar. Histological examination revealed cystic structure with presence of the ghost cells, calcified tissue and unerupted tooth. This lesion was classified as Type IB of COC according to classification of the Praetorius. After surgical removal of the cyst, the wound healed uneventfully and the lesion is now free of symptoms.

안면부에 발생한 괴사성 근막염

김영운(Young Woon Kim),정숭룡(Soong Rhyong Jung),박준아(Jun A Park),정종철(Jong Cheul Jung),오희균(Hee Kyun Oh),이종호(Jong Ho Lee),류선열(Sung Youl Ryu) 대한구강악안면외과학회 1994 대한구강악안면외과학회지 Vol.20 No.4

Necrotizing fasciitis is a rapidly progressing necrotizing process which affects subcutaneous tissue and fascia and is accompanied by severe systemic toxicity. Although necrotizing fasciitis can affect any part of the body including the back and neck, it is rather a rare entity in the head and neck. The rate of spread is remarkably rapid, with the tendency towards systemic toxicity related to delayed initiation of treatment. The infection process may be caused by any type of trauma. The infectious process usually begins 2 to 4 days after the initial insult. The skin becomes smooth, tense, and shiny: no sharp demarcation is seen between normal and affected skin. As the disease progresses, the pathognomonic sign of necrotizing fasciitis appears: a dusky discoloration of the skin as small purplish patches with ill-defined borders. An early exploration and drainage of all the involved fascial planes is important. We have had much difficulty in differentiating necrotizing fasciitis from other infections diseases. When infection is present in the oral & maxillofacial area, we thin abscess and cellulitis first of all. With failure of the lesion to respond to conventional treatment, we have to rule out the necrotizing fasciitis due to its alarming toxicity. Successful treatment of necrotizing fasciitis is bases on the early recognition of the infection process, aggressive surgical intervention systemic medical and supportive therapy, and intensive antibiotic therapy, with emphasis placed on early surgical care. The early exploration and drainage of al the involved fascial planes is critical. We experienced two cases of necrotizing fasciitis of the face. With early recognition of the infection process, aggressive fasciotomy and various medically supported therapy, we resolved the edema and exudate with offering the best chance for core. The patient was treated successfully.

구개부에 발생한 다형성선종

정숭룡(Soong Rhyong Jung),김영운(Young Woon Kim),박준아(Jun Ah Park),정종철(Jong Cheol Cheong),오희균(Hee Kyun Oh),이종호(Jong Ho Lee),류선열(Sun Youl Ryu),최흥란(Hong Ran Choi) 대한구강악안면외과학회 1994 대한구강악안면외과학회지 Vol.20 No.4

Pleomorphic adenoma is a circumscribed tumor characterized microscopically by its pleomorphic or mixed apprearance, and its clearly recognizable epithelial tissue intermingled with areas of mucoid, mixed, or chondroid appearance. Pleomorphic adenoma, the most common tumor of the salivary glands, is now generally accepted as epithelial and benign adenoma, The palate is the most common location for minor salivary gland tumor. The neoplasm has been found in all age groups, the majority being in the fifth decade with an age ranged from 30 to 50. Minor salivary gland lesions appear a decade later, ranging in age from 40 to 60. We experienced three cases of pleomorphic adenoma occuring in the palate. They were treated with complete local exicision and reconstructed with pedicled temporal fascial, flap, pedicled buccal fat pad, and palatal islands flap each.

파상풍과 저작근 강직

이종호(Jong Ho Lee),정중재(Jung Jae Jeong),박준아(Jun Ah Park),윤정한(Jeong Han Yoon) 대한구강악안면외과학회 1993 대한구강악안면외과학회지 Vol.19 No.3

Tetanus is a rare disease which is caused by the exotoxin produced by Clostridium tetani. The exotoxin affects the central nervous system and its main site of action is the interneuronal synapses of the inhibitory pathways where it induce a blockade of spinal inhibition resulting in muscular rigidity. Tetanus may occur when the microorganisms are introduced not ony through wouds that provide anaerobic conditions but also without obvious portal of entry. The incubation period of tetanus varies from three days to four weeks(usually about seven days). Generally, patients with tetanus show early trismus due to the masseteric spasm with varying degree of hypertonicity of the muscles in the neck, back, abdomen and limbs. The spasms of the facial muscles result in risus sardonicus and spasm of spinal musculature causes opisthotonus. Spasms can by precipitated by all forms of stimuli such as noise, light and touch. Recently we encountered three cases of tetanus in 35-, 40-, and 54-year-old male. Their initial presentations were trismus with or without dyspnea. Subsequently, they developed muscular spasm which led to the diagnosis of tetanus, This paper reports these relatively unusual cases with the general description about tetanus and the management of the condition.

하악골 과두부의 유한요소법에 의한 이차원 응력해석

박준아,류선열 전남대학교 치과대학 1993 전남치대논문집 Vol.5 No.1

The purpose of this study was to investigate the stress distribution and the biomechanism of mandibular condylar fracture, because the condyle is one of the sites predisposed to fracture. Clinical and experimental studies on the fracture mechanism have so far been undertaken by a number of our precedessor. It's possible that fracture pattern of condylar process was influencend by the morphological characteristies of the condylar head. In this analysis, loading was applied to four directions in the model of the mandibular body, and three directions in the model of the condylar head. The results obtained were as follows: 1. Lange stress arised on the condylar head in simulated model with the loading on the mandible symphysis rather than mandible angle, and maximal principal stress arised on the articular eminence. 2. It were supposed that fracture arised on the condylar neck with tendency of the maximal stress on the condylar neck with the all 4 types when the 45 degree and horizontal loading was directed into condylar head. Especially, the tendency was remarkable on the horizontal load of convex type. The stress was remarkable on the pole area in the vertical loading. 3. With the same loading these were supposed that comminuted fracture on the condylar head arised on convex and round type. Especially, the tendency was remarkable in the convex type. 4. The size of displacement was observed in the direction of horizontal, 45 degree and vertical to the descending parameter. The direction of displacement was observed on the upper area of the mandibular head to the internally to the horizontal and 45 degree loading with the all cases, and externally to the vertical loading with the flat and angled cases. Especially, the internal displacement tendency was observed on the condylar head to the all derectional loading with the convex type. Above results suggest that condylar fracture is supposed with the loading on the mandible. Especially, frequency of the fracture is remarkable on the condylar neck area.

악골에 발생한 악성 섬유성조직구종 2례

정종철,최홍란,오희균,박준아,류선열,이종호,김영운,정숭룡 大韓顎顔面成形再建外科學會 1995 Maxillofacial Plastic Reconstructive Surgery Vol.17 No.3

Malignant fibrous histiocytoma rarely occurs in the jaws. Although the histogenesis of this tumor remains controversal, it is best regarded as a primitive and pleomorphic nature reflected by collagen production and occasional phagocytosis. It is common for metastatic foci to appear in lung and regional lymph node. There are variable treatments such as radiotherapy, surgical excision or combination, therapy of surgical excision, chemotherapy and radiotherapy. With the review of literatures, the authors report the clinical study of two cases of malignant fibrous histiocytoma of the jaw.