POSTOPERATIVE TOXIC SHOCK SYNDROME: REPORT OF A CASE

장현석,권종진,임재석,이갑재,Jang, Hyon-Seok,Kwon, Jong-Jin,Lim, Jae-Seok,Lee, Kab-Jae Korean Association of Maxillofacial Plastic and Re 1999 Maxillofacial Plastic Reconstructive Surgery Vol.21 No.1

Toxic Shock Syndrome(TSS)은 1978년 Todd등에 의해 처음 보고된 이래 젊은 여성에서 월경과 연관된 질환으로 생각되어 왔으나 최근에는 코수술을 비롯한 두경부수술 및 기타 소수술후 합병증으로 많은 증례가 발표되고 있다. 이의 진단은 주로 임상적 진단, 즉 갑작스런 술후 고열, 설서, 저혈압 및 홍피증과 혈액배양등에서 검출되는 포도상구균등으로 가능하다. TSS은 대부분 수액공급 및 혈압의 유지, 전신적인 항생제 투여등으로 쉽게 치료가 가능하지만, 경과가 좋지 않은 경우 면역글로불린의 사용도 시도되어 좋은 결과를 얻고 있으며 조기 발견 및 처치가 가장 중요하다고 할 수 있다. 이에 저자는 상악골 및 비골, 안와근심벽 골절을 지닌 48세 남자환자에서 골절부에 대한 관혈적 정복고정술후 발생된 TSS의 처치에 대해 문헌고찰과 함께 보고하는 바이다. Toxic shock syndrome is an acute disease involving multiple organs. I described here a case of TSS associated with intranasal packing. Four major criteria, which are involvement of multiple organ systems, fever, hypotension or shock, and rash with subsequent desquamation should be fulfilled for the diagnosis. The exact pathogenesis is not well understood, however it is thought to be due to the effects of an enterotoxin produced by certain strains of staphylococcus aureus.

피브로넥틴, I형 콜라겐과 비트로넥틴이 조골세포의 이동에 미치는 영향에 대한 연구

장현석 ( Hyon Seok Jang ),임재석 ( Jae Suk Rim ),이의석 ( Eui Seok Lee ),윤정주 ( Jung Ju Yoon ) 한국조직공학과 재생의학회 2004 조직공학과 재생의학 Vol.1 No.2

Osteoblast migration as well as adhesion is important aspect of bone formation. While the significance of extracellular matrix protein cell interactions are generally appreciated, the specific relationship osteoblast interactions with adhesive extracellular matrix proteins to cell motility is not well defined. We investigated effects of adhesive extracellular proteins on the motility of ROS 17/2.8 cells. Recombinant fibronectin domain 4 (+RGD) and type I collagen promoted cell motility in a dose-dependent manner. Recombinant fibronectin domain 4 - dependent motility was inhibited by anti-1 integrin antibody and GRGDSK peptide. Type I collagen - dependent motility was inhibited anti-2 integrin antibody, demonstrating that the migration supported by these proteins is specifically regulated by their receptors. Surprisingly, vitronectin, a major adhesive protein among serum components, repressed motility. This study demonstrates that diverse mechanisms of osteoblast migration on extracellular matrices exist.

악안면 골절의 임상적 연구

장현석(Hyon-Seok Jang),남일우(Il-Woo Nam) 대한치과의사협회 1987 대한치과의사협회지 Vol.25 No.10

백서 두개골 결손부의 골재생에 fibrin glue가 미치는 영향에 관한 실험적 연구

임재석,장현석,윤정주,이의석,박은용,서제덕,Rim, Jae-Suk,Jang, Hyon-Seok,Eune, Jung-Ju,Lee, Eui-Seok,Park, Eun-Yong,Suh, Je-Duck 대한악안면성형재건외과학회 2005 Maxillofacial Plastic Reconstructive Surgery Vol.27 No.5

Fibrin glue is composed of fibrinogen and thrombin and used in various regions for multiple use. Basic principle is that thrombin converts fibrinogen to fibrin in the presence of $Ca^{2+}$. The structure of fibrin is loose at the beginning, but after about 5 minutes a tight structure is formed under the influence of factor VIII which changes fibrin monomer into fibrin polymer. Fibrin glue is used for tissue adhesive, suture, local hemostasis, wound healing, closure of subdural space. Fibrin adhesive has been used in oral and maxillofacial surgery for hemostasis after tooth extraction in patients with coagulation disorders, skin graft fixation, reattachment of periodontal flaps, in combination with autogenous bone chips to fill the bony cavities following cyst removal, and for securing the hydroxyapatite granules for maxillary alveolar ridge augmentation. This study was designed for researching influence of fibrin glue during healing phase after making artificial bone defect.

지방조직 유래 줄기세포의 조골세포로의 분화에 대한 실험적 연구

이의석,장현석,권종진,임재석,Lee, Eui-Seok,Jang, Hyon-Seok,Kwon, Jong-Jin,Rim, Jae-Suk 대한악안면성형재건외과학회 2008 Maxillofacial Plastic Reconstructive Surgery Vol.30 No.2

Stem cells have self-renewal capacity, long-term viability, and multiline age potential. Adult bone marrow contains mesenchymal stem cells. Bone marrow-derived mesenchymal stem cells (BMSCs) are progenitors of skeletal tissue components and can differentiate into adipocytes, chondrocytes, osteoblasts, and myoblasts in vitro and undergo differentiation in vivo. However, the clinical use of BMSCs has presented problems, including pain, morbidity, and low cell number upon harvest. Recent studies have identified a putative stem cell population within the adipose tissue. Human adipose tissue contains pluripotent stem cells simillar to bone marrow-derived stem cells that can differentiate toward the osteogenic, adipogenic, myogenic, and chondrogenic lineages. Human adipose tissue-derived stem cells (ATSCs) could be proposed as an alternative source of adult bone marrow stem cells, and could be obtained in large quantities, under local anesthesia, with minimal discomfort. Human adipose tissue obtained by liposuction was processed to obtain ATSCs. In this study, we compared the osteogenic differentiation of ATSCs in a specific osteogenic induction medium with that in a non-osteogenic medium. ATSCs were incubated in an osteogenic medium for 28 days to induce osteogenesis respectively. Osteogenic differentiation was assessed by von Kossa and alkaline phosphatase staining. Expression of osteocyte specific bone sialoprotein, osteocalcin, collagen type I and alkaline phosphatase, bone morphogenic protein 2, bone morphogenic protein 6 was confirmed by RT-PCR. ATSCs incubated in the osteogenic medium were stained positively for von Kossa and alkaline phosphatase staining. Expression of osteocyte specific genes was also detected. Since this cell population can be easily identified through fluorescence microscopy, it may be an ideal source of ATSCs for further experiments on stem cell biology and tissue engineering. The present results show that ADSCs have an ability to differentiate into osteoblasts. In the present study, we extend this approach to characterize adipose tissue-derived stem cells.

PLLA/HA Composite Scaffold와 골수 줄기세포를 이용한 조직공학적 골재생에 대한 연구

김병렬,장현석,임재석,이의석,김동현,Kim, Byeong-Yol,Jang, Hyon-Seok,Rim, Jae-Suk,Lee, Eui-Seok,Kim, Dong-Hyun 대한악안면성형재건외과학회 2008 Maxillofacial Plastic Reconstructive Surgery Vol.30 No.4

Aim of the study: Scaffolds are crucial to tissue engineering/regeneration. Biodegradable polymer/ceramic composite scaffolds can overcome the limitations of conventional ceramic bone substitutes such as brittleness and difficulty in shaping. In this study, poly(L-lactide)/hydroxyapatite(PLLA/HA) composite scaffolds were fabricated for in vivo bone tissue engineering. Material & methods: In this study, PLLA/HA composite microspheres were prepared by double emulsion-solvent evaporation method, and were evaluated in vivo bone tissue engineering. Bone marrow mesenchymal stem cell from rat iliac crest was differentiated to osteoblast by adding osteogenic medium, and was mixed with PLLA/HA composite scaffold in fibrin gel and was injected immediately into rat cranial bone critical size defect(CSD:8mm in diameter). At 1. 2, 4, 8 weeks after implantation, histological analysis by H-E staining, histomorphometric analysis and radiolographic analysis were done. Results: BMP-2 loaded PLLA/HA composite scaffolds in fibrin gel delivered with osteoblasts differentiated from bone marrow mesenchymal stem cells showed rapid and much more bone regeneration in rat cranial bone defects than control group. Conclusion: This results suggest the feasibility and usefulness of this type of scaffold in bone tissue engineering.

HA/TCP 골이식재상에 이식된 지방유래 줄기세포의 골모세포로의 분화 및 골형성에 대한 연구

임재석,권종진,장현석,이의석,정유민,이태형,박정균,Rim, Jae-Suk,Gwon, Jong-Jin,Jang, Hyon-Seok,Lee, Eui-Seok,Jeong, You-Min,Lee, Tai-Hyung,Park, Jeong-Kyun 대한악안면성형재건외과학회 2010 Maxillofacial Plastic Reconstructive Surgery Vol.32 No.2

Aim of the study: An alternative source of adult stem cells that could be obtained in large quantities, under local anesthesia, with minimal discomfort would be advantageous. Adipose tissue could be processed to obtain a fibroblast-like population of cells or adipose tissue-derived stromal cells (ATSCs). This study was performed to confirm the availability of ATSCs in bone tissue engineering. Materials amp; Methods: In this study, adipose tissue-derived mesenchymal stem cell was extracted from the liposuctioned abdominal fat of 24-old human and cultivated, and the stem cell surface markers of CD 105 and SCF-R were confirmed by immunofluorescent staining. The proliferation of bone marrow mesenchymal stem cell and ATSCs were compared, and evaluated the osteogenic differentiation of ATSCs in a specific osteogenic induction medium. Osteogenic differentiation was assessed by von Kossa and alkaline phosphatase staining. Expression of osteocyte specific BMP-2, ALP, Cbfa-1, Osteopontin and osteocalcin were confirmed by RT-PCR. With differentiation of ATSCs, calcium concentration was assayed, and osteocalcin was evaluated by ELISA (Enzyme-linked immunosorbant assay). The bone formation by 5-week implantation of HA/TCP block loaded with bone marrow mesenchymal stem cells and ATSCs in the subcutaneous pocket of nude mouse was evaluated by histologic analysis. Results: ATSCs incubated in the osteogenic medium were stained positively for von Kossa and alkaline phosphatase staining. Expression of osteocyte specific genes was also detected. ATSCs could be easily identified through fluorescence microscopy, and bone formation in vivo was confirmed by using ATSC-loaded HA/TCP scaffold. Conclusions: The present results show that ATSCs have an ability to differentiate into osteoblasts and formed bone in vitro and in vivo. So ATSCs may be an ideal source for further experiments on stem cell biology and bone tissue engineering.

Pleiotrophin이 골수 줄기 세포의 부착 및 골형성에 미치는 효과에 대한 연구

윤정호,윤정주,장현석,임재석,이의석,김대성,권종진,Yoon, Jung-Ho,Eune, Jung-Ju,Jang, Hyon-Seok,Rim, Jae-Suk,Lee, Eui-Seok,Kim, Dae-Sung,Kwon, Jong-Jin 대한악안면성형재건외과학회 2006 Maxillofacial Plastic Reconstructive Surgery Vol.28 No.2

An area of current research is investigating the app1ication of human mesenchymal stem cells or hMSCs as a cell-based regenerative therapy. In order to achieve effective bone regeneration, appropriate matrices functioning as cell-carriers must be identified and optimized in terms of function, efficacy and biocompatibility. Two methods of approaching optimization of matrices are to facilitate adhesion of the donor hMSCs and furthermore to facilitate recruitment of host progenitor cells to osteoblastic differentiation. Pleiotrophin is an extracellular matrix protein that was first identified in developing rat brains and believed to be associated with developing neuronal pathways. A recent publication by Imai and colleagues demonstrated that transgenic mice with upregulated pleiotrophin expression developed a greater volume of cortical as well as cancellous bone. The proposed mechanism of action of pleiotrophin is demonstrated here. Through either environmental stresses and/or intracellular regulation, there is an increase in pleiotrophin production. The pleiotrophin is released extracellularly into areas requiring bone deposition. A receptor-mediated process recruits host osteoprogenitor cells into these areas. Therefore, the aim of our study was to investigate the osteoconductive properties of pleiotrophin. We wanted to determine if pleiotrophin coating facilitates cellular adhesion and furthermore if this has any effect on hMSCs derived bone formation in an animal model. The results showed a dose dependent response of cellular adhesion in fibronectin samples, and cellular adhesion was facilitated with increasing pleiotrophin concentrations. Histologic findings taken after 5 weeks implantation in SCID mouse showed no presence of bone formation with only a dense fibrous connective tissue. Possible explanations for the results of the osteogenesis assay include inappropriate cell loading.

PLEIOTROPHIN (PTN) EXPRESSION IN OSTEOBLASTIC CELLS

김병렬,임재석,권종진,장현석,이의석,전상호,김영진,Kim, Byeong-Yol,Rim, Jae-Suk,Kwon, Jong-Jin,Jang, Hyon-Seok,Lee, Eui-Seok,Jun, Sang-Ho,Kim, Young-Jin Korean Association of Maxillofacial Plastic and Re 2007 Maxillofacial Plastic Reconstructive Surgery Vol.29 No.6

Pleiotrophin or osteoblast-specific factor 1(HOSF-1) is a growth-associated protein present in bone matrix. This study was designed to study pleiotrophin expression in osteoblastic cells. Pleiotrophin was expressed by osteoblast-like cell line. Pleiotrophin expression increased following the proliferative phase and was minimal at the terminal phases of the induced differentiation of cultured MC3T3-E1 cells. Pleiotrophin expression represents another autocrine factor that may contribute to the physiologic control of induced bone formation. In this study, induced osteogenesis will be examined in the context of the osteoblast expression of and regulation by PTN. I hypothesized that PDGF-BB stimulation of PTN expression represents an important paracrine signal during the induced osteogenesis associated with periodontal and implant surgeries. The possible mediation by PTN of anabolic effects attributed to PDGF-BB stimulation was examined in cell culture models of osteoblast differentiation. These studies will contribute fundamental insights to osteoblast biology and insights regarding the potential use of factors such as PTN in the clinical environment.

악골의 낭종에 관한 임상적 연구

임재석(Jae Suk Rim),장현석(Hyon Seok Jang),손형민(Hyoung Min Son),남영원(Young won Nam) 대한구강악안면외과학회 2000 대한구강악안면외과학회지 Vol.26 No.3

The purpose of this study is to find the histopathological pattern of cysts. We reviewed the hospital chart, out-patient chart, roentgenogram, histopathologic report and operation report of 152 patients who had been diagnosed as cyst and treated at the department of Oral and Maxillofacial Surgery of Korea university hospital between Jan. 1, 1995 and Dec. 31, 1998. And then we studied clinically with regard to pathological classification, age and sex distribution, anatomical distribution and so on. The results were as follows: 1. In pathologic classification, radicular cyst (97cases, 64%), dentigerous cyst (35cases, 23%), odontogenic keratocyst (8cases, 5.3%) were dominant among cases of cyst. 2. The pattern of age distribution in cases of radicular cyst, dentigerous cyst and odontogenic keratocyst was similar to that found in previous studies. The peak incidence was in the second decade (27%) and third decade (29%) in overall cases. 3. The male-to-female ratio was 1.9:1. 4. Radicular cyst occured most frequently in the maxillary incisor teeth area, dentigerous cyst in mandibular wisdom teeth area, and odontogenic keratocyst in mandibular molar area.