구강암 연구를 위한 동물실험모델의 개발 ( 1 )

박형국(Hyung Kook Park),김용각(Yong Kack Kim) 대한악안면성형재건외과학회 1997 Maxillofacial Plastic Reconstructive Surgery Vol.19 No.3

편평상피세포암종은 악성종양 중 가장 중요한 비증을 차지하고 있는 암종이다. 하지만 편평상피세포암종의 세포주는 다른 악성종양에 비하여 아직까지 많이 개발되어지지 않았다. 또한 동물실험모델을 만들기 위한 이종이식에 있어서 편평상피세포암종은 매우 낮은 생착율을 보이고 있다. 구강암 중에서도 편평상피세포암종은 가장 많은 부분을 차지하나. 개발된 세포주는 그리 많지 않으며, 더 더욱이 동물실험 모델의 제작은 쉽지 않아, 새로운 치료 약제의 개발이나 치료 방법 개발등에 많은 제약이 있어왔다. 본 실험에서는 수종의 구강 편평상피세포종의 세포주를 배양하였고, 특별히 고안된 사육시설을 이용하여 BALB/C nude mice 를 사육하였다. 여러 농도의 구강암 세포주를 nude mice 의 등에 피하로 이식하였다. 어떤 세포주는 계속적인 성장을 보였으나 어떤 세포주는 완전히 흡수되기도 하였다. 5주 이상을 관찰하였으며, 이식된 종양의 크기를 측정하고, 부피를 계산하였다. 또한 또다른 동물모델의 제작 방법으로서 특별히 고안된 cap nude mice 의 등에 이식하고, 그 안에 구강암 세포주를 배지와 함께 이식하였으며, 1주후에 cap을 제거하였고, 4주이상을 관찰하였으며, 성장하는 종양의 모습과 크기를 관찰하였다. 본 연구는 구강암 연구에 적절한 동물실험모델을 개발하여 다른 악성종양에 비해 동물실험적으로 연구할 기회가 적었던 구강암 영역의 연구를 활발히 하며, 향후 한국인의 구강암 연구에 가장 적절한 도움실험모델을 개발하여, 보다 진보된 구강암 치료방법의 개발 및 신약 등의 개발에 이용하기 위함이다.

한국여자프로골프(KLPGA Tour)의 서비스품질 요인이 갤러리 만족도에 미치는 영향

박형국 ( Park Hyung-kook ),신상현 ( Shin Sang-hyun ) 인천대학교 스포츠과학연구소 2017 스포츠科學硏究誌 Vol.30 No.0

In this study, focused on analysis of influence of KLPGA Tour gallery satisfaction factors on willingness to revisit. The empirical analysis using a statistical methodology is conducted to diagnose the adhesion to regions and improvements of service quality. The findings show the relationship of service quality factor-gallery’ satisfaction-intention to revisit-intention to recommend. It is determined that this should be importantly deal with, in order to enhance their satisfaction and intention to revisit and recommend. Moreover, from the path analysis, it is found that there are effects of co-prosperity among regions, golf course and Tour. The KLPGA Tour has been held while making Tour across golf course that meet certain requirements. In the process, gallery usually visit golf course including round that they have never experienced, or necessarily visit some regions to which they have never went. This results in increase of influx of outsiders who do not reside in the regions, which is favorable for local Tourism. From the empirical analysis, it is also found that the gallery who are satisfied with the KLPGA Tour are willing to revisit the regions. Thus, the KLPGA Tour is can be determined to have positive effects on related industries and also contribute to local effects such as local tourism and publicity. In conclusion, the KLPGA Tour have positive effects on regions, golf course and gallery, which is supported by various results of the empirical analysis.

전측방 “S”자상 도달법을 이용한 인공고관절 전대치술

박형국(Hyung Kook Park),박상원(Sang Won Park) 대한정형외과학회 1981 대한정형외과학회지 Vol.16 No.2

FIBRIN SEALANTS IN MAXILLOFACIAL SURGERY : A INTRODUCTORY REPORT

김명진,박형국,Kim, Myung-Jin,Park, Hyung-Kook Korean Association of Maxillofacial Plastic and Re 1991 Maxillofacial Plastic Reconstructive Surgery Vol.13 No.2

Fibrin Sealants 는 과거 간, 비장, 신장등의 일반외과 수술에서 단순한 외과적 봉합으로는 해결하지 못하는 넓은 면적의 조직의 유착을 위하여 1940 년경 부터 개발되기 시작한 것으로 악안면 영역에서는 1970 년대 중반부터 미세신경접합술과 피부이식을 위하여 사용되기 시작한 후, 현재, 골이식후의 골세편의 고정, 혈관봉합술, 연조직에서 조직들의 유착과 지혈, 그리고 혈관종의 치유등을 목적으로도 광범위하게 연구되고 사용되고 있다. 이것은 인체에서 채취한 혈액응고인자 XIII 을 포함하는 Fibrinogen 성분과, 소에서 추출한 Thrombin 의 두가지 주요 성분으로 구성되며, Fibrinogen 용해제인 Aprotinin 액과 Thrombin 용해제인 염화칼슘액과 함께 네부분으로 구성된다. 각제품에 따라 그리고 사용된 농도에 따라 차이는 있으나, 대개 수분후에 조직이 응고되어 달라붙기 시작하고, 수시간후에 최대접착효과에 도달하며, 응고된 접착효과는 12 일에서 15 일간 유지되고 그후 정상적인 섬유소분해작용과 식세포활동에 의하여 분해된다. 저자는최근 6 개월간 서울대학교병원 구강악안면외과에서 28 명의 각종 질환 및 기형 환자에서 미세신경봉합술, 피부이식, 악교정성형술과 구개파열 또는 하악골 재건을 요하는 환자의 골이식후의 골세편의 고정, 경부곽청술이나 종양제거술후 각종 피부판 또는 근피판을 이용한 연조직의 적합, 혈관종의 처치, 후이개접근 법에 의한 악관절수술후의 외이도의 접합등 다양한 목적을 위하여 적용된 Fibrin Sealants 를 사용하여 양호한 결과를 얻었기에 보고하는 바이다. The fibrin sealant was first designed as an alternative to surgical suture for the purpose of surface-to-surface union especially in parenchymal organs like the liver, spleen and kidney. The clinical application of currently used fibrin sealant was first introduced in 1972. The fibrin sealant consists of principal two components; lyophilized human fibrinogen and bovine thrombin. The fibrinogen component also contains coagulation factor XIII. A solution of aprotinin, an inhibitor of fibrinolysis is used to dissolve the fibrinogen and to provide the first component, and a solution of calcium chloride is also used to provide the second component. From July to December in 1990, during 6 months, we used fibrin sealant in the 28 patients of 33 various cases, in the following ways; supportive application of fibrin sealant after free autogenouse nerve graft for the repair of inferior alveolar nerve, facial nerve or accessory nerve, treament of hemangioma or lymphangioma to thrombosize and lead to the tumor shrinking, skin grafting to stimulate the adhesion and tissue repair, bone grafting in the patients of cleft alveolus, mandibular reconstruction or orthognathic surgery to facilitate the knitting of bone chips, tissue adhesion after tumor resection, radical neck dissection or flap reconstructions, and supportive adhesion of external auditory cannal after TMJ surgery via postauricular approach. No adverse effects were observed, none of the patients developed hepatitis or other blood transmitted disease, and the wound healing were acceptable.

구강악안면영역의 선양낭성암종환자의 생존율 등에 관한 임상적 연구

김용각,박형국,Kim, Young-Kack,Park, Hyung-Kook 대한악안면성형재건외과학회 1997 Maxillofacial Plastic Reconstructive Surgery Vol.19 No.1

Adenoid cystic carcinoma is characterized by sloe growth, multiple recurrence, a long clinical course and late metastasis. It is less than 1% of all head and neck malignancy, but most prevalent malignancy in salivary gland origin. During 14 years(from 1982 to 1995), 24 patients were diagnosed as adenoid cystic carcinoma in oral and maxillfacial area, in department of Oral and Maxillofacial Surgery, Korea Cancer Center Hospital. We studied clinically about their age and sex distribution, primary site distribution, TNM staging, treatment modalities, overall survival rates, survival rates according to stages. The age range were from 15 years to 79 years, average age weas 51 years. 15 were men and 9 Were women. Maxilla and palate were the most prevalent primary site. The most cases were in stage III(37%) and stage IV(46%). The 3 year and 5 year overall survival rate were 65.0% and 58.5%. The 5 year survival rate of the stage III cases was 66.7%, and that of the stage IV cases was 38.4%.

상악골 악성종양절제술환자의 생존율 및 상악폐쇄보철물 등에 관한 임상적 연구

김용각(Yong Kack Kim),박형국(Hyung Kook Park) 대한구강악안면외과학회 1997 대한구강악안면외과학회지 Vol.23 No.1

During 10 years (from 1986 to 1995), 54 patients were diagnosed as maxillary cancer and undergone maxillectomy in department of Oral and Maxillofacial Surgery, Korea Cancer Center Hospital. We studied clinically about their age and sex distribution, TNM staging, histopathologic diagnoses, treatment modalities, overall survival rates, survival rates according to stages and treatment modalities. In them, 23 patients were delivered maxillary obturators, we also studied clinically about them and their obturators. The overall 3-year and 5-year survival rates of these maxillectomized patients were 59.0% and 55.0%. The 5-year survival rates of stage II and stage III patients was 63.0%, and that of stage IV patient was 50.0%. According to treatment modalities, The 5-year survival rates in cases of surgery only was 66.7%, in cases of preoperative chemotherapy and/or radiaiotherapy was 63.5%, in cases of postoperative radiotherapy and/or chemotherapy was 50.4%. The 5-year survival rate of obturator delivered patients was 56.8%, and that of no-obturator delivered patients was 51.8%. The using rates of obturator were 70.5% at 1 year, 59.7% at 2 years, and 53.0% at 3 years.

치령 및 치아상실에 관한 임상적 연구

김수경(Soo Kyung Kim),박형국(Hyung Kook Park) 대한구강악안면외과학회 1991 대한구강악안면외과학회지 Vol.17 No.2

Many studies about tooth loss have been reported, but until recent years, no great effects in the prevention of tooth loss has been achieved. We hoped this study served as data to help prevent the loss of tooth and to design the future dental treatment plan. We studied the 14,953 cases of tooth extractions except deciduous and supernumerary teeth, of the 7,782 patients (3,846 males and 3,936 females), over 10 years old, during 1987 to 1989, at the department of oral surgery, Seoul National University Hospital. We analysed the cases according to tooth type, age, sex and reason for extraction and obtained the data about to the tooth mortality and the cause of tooth loss. The categories selected as reasons for extraction were dental caries, periodontal disease, impaction, prosthetic reason and other reasons, and the results of comparisons were as follows : 1. The average of tooth loss in male patients were ranged from 31.8 to 56.3 years and the mean age was 40.0 years, and in female patients, ranged from 29.6 to 59.7 years and the mean age was 38.2 years. Thus, the tooth loss in females was earlier than in males (P<0.01). 2. The average ages of tooth loss in maxillae were ranged from 31.8 to 49.3 years and the mean age was 41.6 years, and in mandibles, ranged from 30.7 to 56.9 years and the mean age was 38.2 years. Thus, the tooth loss in mandible was earlier than in maxilla (P<0.01). 3. The percentage of tooth loss by dental caries was 26.9% in male patients and 32.5% in female patients therefore, the tooth loss by dental caries were more common in female (P<0.01). And 37.6% in maxilla, and 24.1% in mandible, therefore, the tooth loss by dental caries were more common in maxilla than in mandible (P<0.01). 4. The percentage of tooth loss by periodontal disease was 37.8% in male patients and 31.0% in female patients, therefore, the tooth loss by periodontal disease were more common in male (P<0.01). And 32.0% in maxillae, and 36.0% in mandibles, therefore, the tooth loss by periodontal disease were more common in mandible than in maxilla (P<0.01). 5. The percentage of tooth loss by impaction or malposition was 23.6% in male patients and 25.0% in female patients, therefore, the tooth loss by impaction or malposition were more common in female (P<0.05). And 11.4% in maxillae, and 33.6% in mandibles, therefore, the tooth loss by impaction or malposition were more common in mandible than in maxilla (P<0.01). 6. The percentage of tooth loss by prosthetic reason was 4.2% in male patients and 5.0% in female patients, therefore, the tooth loss by prosthetic reason were more common in female (P<0.05). And 5.2% in maxillae, and 4.2% in mandibles, therefore, the tooth loss by prosthetic reason were more common in maxilla than in mandible (P<0.01).

방사선 조사받은 치아의 발거에 대한 임상적 연구

김용각(Yong Kack Kim),박형국(Hyung Kook Park),권혁진(Hyuk Jin Kwon),현재훈(Jae Hoon Hyun) 대한구강악안면외과학회 1997 대한구강악안면외과학회지 Vol.23 No.2

Radiation therapy, in addition to its therapeutic effects, cause several complications in oral region. As a result of radiation, the blood supply to bone is decreased, and large areas of hypcellular, hypovas-cular, hypoxic tissue arc created that are devoid of functioning fibroblasts and osteoblasts. Therefore, the extraction of teeth after irradiation to the jaws has generally been regarded as a potentially hazardous procedure because of the possible initiation of osteoradionecrosis. Hyperbaric oxygen therapy appears to assist in salvaging irradiated tissue by tissue angioneogenesis in marginally viable tissue induced by high oxygen tissue level. Hyperbaric oxygen therapy is beneficial for patients at risk for the development of osteoradionecrosis, such as irradiated patients requiring tooth extraction We obtained good results when extraction is performed with hyperbaric oxygen therapy in 17 cases with head & neck malignancy and present results with review of literatures.

구강악안면 암환자의 초진시와 추적검사시 양전자 방출 단층촬영의 임상적 유용성

김용각(Yong Kack Kim),박형국(Hyung Kook Park),현재훈(Jae Hoon Hyun),김재환(Jae Hwan Kim),조병호(Byung Ho Cho) 대한구강악안면외과학회 1999 대한구강악안면외과학회지 Vol.25 No.3

BACKGROUND : Positron Emission Tomography(PET) with [18F]-fluorodeoxyglucose (FDG) is a new imaging technique that has the advantage of imaging metabolic changes linked to malignancy. PET-FDG can provide a functional image of the regional biochemistry which may be more sensitive and accurate for detecting the presence of tumor in early stage. Recently, the clinical use of PET scan has been studied in many cancers but, there is a few clinical reports in oral and maxillofacial cancers. We have evaluated the ability of PET-FDG for initial diagnosis and detection of early subclinical recurrent malignancies in follow up check. PATIENTS AND METHODS : PET-FDG studies were performed in 33 patients from october, 1997 to september, 1998. 14 patients underwent PET-FDG evaluation for initial diagnosis and 19 patients for follow up check. RESULTS : Evaluated for initial diagnosis, PET-FDG was found to have an overall accuracy of 79%, sensitivity of 90%, specificity of 60%, positive predictive rate of 80% and negative predictive rate of 75%. Evaluated for follow up check, PET-FDG demonstrated accuracy of 84%, sensitivity of 91%, specificity of 75%, positive predictive rate of 83% and negative predictive rate of 86%. CONCLUSION : These data indicate that PET-FDG scan appears to be effective in initial diagnosis and detection of early recurrent oral and maxillofacial malignancies. The informations gained with PET-FDG can be included for essential treatment planning because of possibility of detection for early subclinical malignancies and distant metastases.

구강악안면 영역의 악성 종양에 있어서 양전자방출 단층촬영의 이용

김용각(Yong Kack Kim),박형국(Hyung Kook Park),현재훈(Jae Hoon Hyun),김재환(Jae Hwan Kim),조병호(Byung Ho Cho) 대한구강악안면외과학회 1998 대한구강악안면외과학회지 Vol.24 No.2

Positron emission tomography(PET) is a diagnostic method that creates high resolution, 3-Dimentional tomographic images of the distribution of positron emitting radionuclides in human body. Computed tomography(CT) and magnetic resonance imaging(MRI) are routinely used to delineate the presence and extent of primary and metastatic oral and maxillofacial malignancy. Because the CT and MRI criteria for malignancy depend upon morphology, these imaging techniques have limitations in their ability to identify malignant tissue when fascial planes are distorted or destroyed. PET has the advantage of imaging metabolic changes that appear to be linked to malignancy. Recently, PET has shown promise in the early detection of primary and metastatic oral and maxillofacial canter and has been used to evaluate the tumor response to chemotherapy and radiotherapy. We report cases of diagnosis of oral and maxillofacial cancers and review the literatures to determine whether PET is effective in identifying oral and maxillofacial tumors.