낭종성 법랑아세포종 - 문헌고찰 및 증례 -

이의웅,박형식,차인호,김진,Lee, Eui-Wung,Park, Hyung-Sik,Cha, In-Ho,Kim, Jin Korean Association of Maxillofacial Plastic and Re 1991 Maxillofacial Plastic Reconstructive Surgery Vol.13 No.2

In 1977, Robinson & Martinez described a distinct varient of ameloblastomas in which the response to curettage was found to be favorable, with a recurrence rate of 25%. They referred to this varient as unicystic ameloblastoma. Unicystic ameloblastoma occur most commonly in the second and third decades of life, which is considerablly younger than the average age of discovery for the classical ameloblastoma. For the accurate histopathological diagnosis of the unicystic ameloblastoma, the specimen obtained the excisional biopsy, complete enucleation or incisional biopsy from the multiple site of the lesion. The purpose of this report is to review of the literature and to present three cases in which an unicystic ameloblastoma appear to be arising in the wall of a dentigerous cyst. 치성낭종과 법랑아세포종과의 조직학적 기준이 모호한 경우에 과거에는 병리학자들이 진단하는데 어려움이 많았으나 1970년 Robinson & Martinez가 조직학적 기준을 제시하면서 unicystic ameloblastoma라 명명하였다. Unicystic ameloblastoma는 conventional ameloblastoma 보다 젊은 연령인 10대, 20대에서, 하악 제3대구치부에서 호발하며 방사선학적으로 단방성 혹은 다방성의 비교적 경계가 뚜렷한 방사선 투과성 병소를 보인다. 이 병소는 적출술만으로 치료하였을 때 solid or multicystic ameloblastoma보다 현저히 낮은 재발율을 보인다. 임상적, 방사선학적으로 unicystic ameloblastoma가 의심되면 병소를 완전히 적출하여 정확한 병리조직학적 진단을 하여 solid or multicystic ameloblastoma일 때는 2차적으로 광범위한 수술 등을 고려하는 것이 타당할 것으로 사료되어 문헌고찰과 함께 3증례의 치료 경험을 보고하는 바이다.

한국인의 안면골 골절에 관한 임상적 연구

이의웅(Eui Wung Lee),박형식(Hyoung Sik Park) 대한구강악안면외과학회 1983 대한구강악안면외과학회지 Vol.9 No.1

This is a retrospective study on facial bone fractures of Koreans. The study was based on a series of 817 patients with facial bone fractures treated as inpatient at Severance Hospital of Medical and Dental College of Yonsei University during the period of Jan., 1971 through Dec., 1981. The results obtained are as follows: 1. Traffic accident was the most frequent cause of facial bone fractures (46.8%). 2. The ratio of Men to Women was 3.8: 1, and admissions for facial bone fractures have been increased year after year. 3. The age frequency was the highest in second decade (37.6%) and age distribution of patients ranged from 1½years to 83 years. 4. The most common location of facial bone fractures was Mandible (37.6%), and Zygoma complex (23.5%), Nasal bone (19.9%), Maxilla (9.3%) and Others (8.4%)were next in order of frequency. One location was fractured in 75% and multiple locations were involved in 35%. Among the 735 patients except for Others (82), one-location involvements were 610(83.0%), two locations were 96(13.1%), three-locations were 23(3.1%), and entire-locations were 6(0.8%). 5. In 380 patients of Mandible fractures, 310(83.8%) had fractures only in Mandible and 70(16.2%) had another facial bone fractures. The most frequent fx. site of Mandible was Symphyseal area (38.6/) and Simple fracture was the most frequent in type of fracture (63.4%). Teeth or alveolar bone trauma cases were 31% and Open-reduction with IMF was major method of treatment (51.4%) in Mandible fractures. 6. In 91 patients of Maxillary fractures, 21 (20%) had fractures only in Maxilla and 70(78%) had another facial bone fractures. Le Fort II and Unilateral fractures (22%) were two Major type of Maxillary fx., and Le Fort I II & III were 4 cases (4.4%). Teeth or alveolar bone trauma occured in 37.4% and Open-reduction was major method of tretment (37.8%) in Maxillary fractures. 7. In 230 patients of Zygoma complx fractures, 139(60.4%) had fractures only in Zygoma complex and 91(39.6%) had another facial bone fractures. Among these, Zygoma fx. were 105(45.7%), Zygomatic arch fx. were 94(40.9%) and Zygoma & Zygomatic arch fx. were 31(13.4%), and Left Zygoma was the most frequent site. Teeth or alveolar bone trauma occured in 15.2%, and Observation (32.4%) and Open-reduction (24.5%) were major methods of treatment in Zygoma complex fx. 8. In 194 patients of Nasal bone fractures, 141(72.7%) had fractures only in Nasal bone and 53(27.3%) had fractures on another facial bones. Closd-reduction (51.1%) and Observation (31.1%) were major methods of treatment. 9. In 817 patients of facial bone fractures, 21 patients(2.5%) were expired in Hospital and 12 of these were expired in 48 hours (1.5% ). Head (48.1%), Eye (12.2%) and Lower extremeties (12.1%) were injured commonly with facial bone fractures.

手術後 惹起된 開咬症 및 下顎骨後退症의 垂直 骨切斷術 및 腸骨移植術에 依한 治驗例

李義雄(Eui Wung Lee),金命來(Myung Rae Kim),尹仲鎬(Jung HoYoon),具箕書(Kee Seo Koo),李明淑(Myung Sook Lee) 대한치과의사협회 1975 대한치과의사협회지 Vol.13 No.2

口腔肉腫의 病理學的 硏究

李義雄(Eui Wung Lee) 대한치과의사협회 1969 대한치과의사협회지 Vol.7 No.1

한국인 치성종양의 역학적 연구

이의웅(Eui Wung Lee) 대한구강악안면외과학회 1998 대한구강악안면외과학회지 Vol.24 No.1

저자는 현재 새로이 제정된 WHO 조직분류법에 의한 국내의 치성종양에 대한 임상적 기초자료가 거의 없는 실정이므로 이에 대한 기초적 자료를 얻고자 1985년부터 1996년까지 12년간 연세대학교 치과대학 구강병리학교실에 접수된 총 4913예의 조직생검 기록지를 기초로 이중 1992년 WHO 분류법에 의한 치성종양으로 최종 진단된 총 156명의 환자의 조직표본을 재검경후 병록기록지와 수술전 방사선 사진 등을 이용하여 역학조사를 시행한바 다음과 같은 결론을 얻었다. 1. 양성종양 10종류만이 관찰되었고 악성으로 분류할 수 있는 치성종양은 1례도 관찰되지 않았다. 또한 총 4913례의 생체조직 검사 의뢰건수중 치성종양으로 확진된 증례수는 156례(3.18%)이었다. 2. 총 156례의 치성종양중 법랑아세포종이 66례(42.3%)로 가장 많았으며 다음이 치아종 64례(41.0%), 선종양치성종양 7례(4.5%), 골화성섬유종 6례(3.8%) 등의 순이었다. 3. 성별 빈도는 총 156례중 남자가 83명(53.2%)으로 여자 73명(46.8%)보다 다소 높았으나 치아종과 점액종에서는 여성에서 각기 53.1%, 75.0%로 높은 빈도를 나타냈다. 4. 연령별 빈도를 보면 총 156례중 대부분인 134례(85.9%)가 40세이전에 발생하였으며, 연령군별분포도를 살펴보면 10대가 60명(38.5%)으로 가장 빈발하였고 다음이 20대 37명(23.7%), 30대 22명(14%), 10세이전 15명(9.6%)의 순이었다. 5. 부위별로는 전체적으로 상악보다는 하악에서 약 2배가량(67.3%)빈발하였다. 법랑아세포종은 97.5%가 하악에서 발생하였으며 대구치부(45.5%), 우각부(28.1%), 하악지부(10.7%) 순으로 호발하였으나 치아종은 57.8%가 상악에서 발생하며 전치부(44.9%)에서 가장 높은 빈도를 보였다. 6. 법랑아세포종은 검사예의 62.1%에서 매복치와 연관된 것으로 관찰되었으며 주위치아의 변위(27.3%)보다는 치근흡수(53.0%)가 많이 관찰되었다. 치아종의 경우 종양으로 인한 영구치의 매복(62.5%)과 치아변위(75.0%)가 많이 발견되는 반면 치근흡수는 7.8%의 낮은 빈도를 나타냈다. 7. 법랑아세포종에서는 주소중 안면부종이 53례(80.3%)로 가장 많았고 다음이 동통 6례(9.1%)의 순이었다. There have been many different histological typing of odontogenic tumours and numerous reports on the epidemiological studies of the odontogenic tumours depending upon various these histological typing. Neoplasms and other tumours related to the odontogenic apparatus was classified into 21 entities by WHO in 1992 The purpose of this study is to get the clinically basic data of the odontogenic tumours in Korean according to this newly made WHO histological classification. The total of 4913 biopsied specimens were reviewed from the dept of Oral Pathology, College of Dentistry, Yonsei University for the period of Jan. 1985. to Dec. 1996. and among them 156 cases were diagnosed into the odontogenic tumours. The following results were obtained : 1. Odontogenic tumours were 156 cases(31.8%) of the total 4913 biopsy cases. Only the 10 different benign entities were observed in 156 cases of odontogenic tumour. 2. The most frequent odontogenic tumour was ameloblastoma(42.3%) and followed odontomas(41.0%), adenomatiod odontogenic tumours (4.5 per cent) and ossifying fibroma(3.8% ) in order. 3. Overall male to female ratio was 1.14(53.2%) to 1(46.8%), but female ratio is higher than male in odontoma(53.1%) and myxoma(75.0%) respectively. 4. 134 cases(85.9%) of all odontogenic tumours were observed under the age of forty. Age distribution showed 60 cases(38.5%) in the second decade, 37 cases(23.7%) in the third decade, 22 cases(14%) in the fourth decade and 15 cases(9.6%) in the first decade of life. 5. The ratio odontogenic tumours of the mandible to maxilla was about 2 : 1. Odontogenic tumour occured predominantly in the molar region(29.6%) and gonial region(17.08%) of the mandible and anterior region(18.8%) of the maxilla. Ameloblastoma occurred mostly in the molar region(45.5%), gonial region(28.1%), ascending ramus region(10.7%) and premolar region(9.1%) of the mandible, while odontomas predominated in the anterior region(44.9%) of the maxilla. 6. Most ameloblastomas were related with more the impacted teeth(62.1%) and root resorption(53.0%) than teeth migration(27.3%). In case of odontoma, teeth impaction(62.5%), teeth migration(75.0%) and root resorption(7.8%) were observed. 7. In the ameloblastomas, facial swelling was the most frequent chief complaint(80.3%) and followed by pain(9.1%)

하악골 부분 절제술후 metal plate와 PMMA를 복합 이용한 하악골 재건술의 치험례

이의웅(Eui Wung Lee),박형식(Hyung Sik Park),차인호(In Ho Cha) 대한구강악안면외과학회 1986 대한구강악안면외과학회지 Vol.12 No.1

This is a report of two cases of immediate reconstruction after partial mandibulectomy by using of metal plate and radiopaque polymethylmethacrylate (PMMA, Bone cements??) in the cases of an ameloblastoma and a dentigerous cyst with epithelial dysplasia on the mandible. We could get many advantages and the results are as follows. 1. It provided good esthetics and stress bearing area for partial denture reconstruction by the reconstruction of adequate volume and shape as its origin. 2. Because of the direct fusion of radiopaque PMMA to bone, the fixation and stability were more increased than used metal plate only. And so, IMF period was saved and masticatory function was returned in short period. 3. Alloplastic reconstruction was possible without any positional change of TMJ. 4. Post-op radiologic evaluation was easily possible in position and volume due to PMMA s radiopaque characteristics. 5. Long-term follow-up evaluation may be necessary in concerned with the histompatability of this alloplastic material.

하악골 양측성 과두돌기 및 정중부 골절상을 입은 4 세 남자환자의 치험예

이의웅(Eui Wung Lee),박형식(Hyung Sik Park),김형곤(Hyung Gon Kim),남일우(Il Woo Nam) 대한악안면성형재건외과학회 1982 Maxillofacial Plastic Reconstructive Surgery Vol.4 No.1

This is a case report about the conservative approach for the fractured bilateral condyles and symphysis of the 4-year old child`s mandible. The child sustained a facial trauma by a fell from the top of the slide. This case report could be summerized as follows. 1. Bilateral condyle fractures can cause a truma onto maodibular condyles where mandibular growth center is located. Because maindibular growth is a leading factor of the facial growth, it can cause facial deformities, bird jaw, ankylosis and pseudoarthrosis of the temporomandibular joint, open bite, and malocclusion. 2. Through conservative approach, functional reconstruction, normal facial growth pattern, and good alignment as well as good function resulted 8 months later. 3. Condyle fractures in children, including some which are displaced and dislocated, may be treated conservatively with good. result.

구강암 세포주의 c-Ki-ras 2 유전자 발현 및 점돌연변이에 관한 연구

이의웅(Eui Wung Lee) 대한구강악안면외과학회 1994 대한구강악안면외과학회지 Vol.20 No.3

Five oral cancer cell lines, FaDu, HEp-2 SCC-4, 1483, OEC-M1, and one epidermoid carcinoma cell line, A-431, were examined for their expression level of c-Ki-ras 2 gene and the presence of activating mutations. Northern blot analysis revealed that the expression level of c-Ki-ras 2 mRNA of FaDu cells was 4 times that of primary cultured normal human oral keratinocytes (NHOK). OEC-M1 cells expressed mRNA of a little smaller size than normal and the expression level was much higher than in NHOK. Other cells expressed c-Ki-ras 2 mRNA at comparable levels to NHOK. DNA sequencing of c-Ki-ras 2 gene exon 1 and exon 2 was performed using polymerase chain reactionamplified DNA fragments. OEC-M1 cells had three point mutations in their c-Ki-ras 2 gene exon 1 and exon 2 resulting in amino acid substitutions, asparagine to aspartic acid, phenylalanine to leucine, and glycine to arginine at 24the, 28th and 53rd residues respectively. However, other cells had no mutation in their c-Ki-ras 2 gene exon 1 and exon 2. This result shows that abberant expression of c-ki-ras 2 gene and the point mutations are quite often associated with oral cancer.

放射線照射가 白鼠唾液腺組織에 미치는 影響에 關한 實驗的 硏究

李義雄(Eui Wung Lee) 대한치과의사협회 1980 대한치과의사협회지 Vol.18 No.8

重合齒牙腫 一例

李義雄(Eui Wung Lee),金命來(Myung Rae Kim),尹仲鎬(Jung Ho Yoon),具箕書(Kee Seo koo) 대한치과의사협회 1975 대한치과의사협회지 Vol.13 No.3