골격성 3 급 부정교합 환자에서 양악 수술후 연조직 변화에 대한 연구

박홍주(Hong Ju Park),최홍란(Hong Ran Choi),유선열(Sun Youl Ryu) 대한악안면성형재건외과학회 1998 Maxillofacial Plastic Reconstructive Surgery Vol.20 No.4

The purpose of this study was to assess the soft tissue changes using twenty skeletal class III malocclusion patients who treated with bimaxillary surgery for the correction of dentofacial deformities. Patients were divided into two groups. One was impaction and advancement of maxilla with mandibular set-back (Group 1), the other was downward and advancement of maxilla with mandibular set-back (Group 2). Preoperative and postoperative one year cephalometric data were analyzed and compared. Results obtained were as follows: 1. The ratio of horizontal changes of soft tissue to hard tissue at Nt to ANS, Ls to UI, Li to LI, sPog to Pog were 1:0.60, 1:0.79, 1:0.47, 1:0.63 in group 1 respectively, and 1:0.59, 1:0.48, 1:0.83, 1:1.09 in group 2 respectively. Soft tissue changes were highly predictable at the upper lip, lower lip, and chin area. 2. The ratio of vertical changes of soft tissue to hard tissue at Nt to ANS, Li to LI were 1:0.72, 1:0.06 in group 1, and others showed no statistically significant difference. 3. The ratio of horizontal changes of Ls to hard tissue movements at LI(h) was 1:-0.82 in group 1 and at UI(h), LI(h) were 1:0.48, 1:0.01 in group 2. These ratios of group 1 were greater than those of group 2. 4. The direction of horizontal change of Li was the same as that of hard tissue change. The ratio of horizontal changes of Li to LI was 1:0.47 in group 1 and others showed no statistically significant difference. 5. The changes of upper lip thickness and length were -1.6mm, -1.4mm in group 1, and -1mm, -2.7mm in group 2. 6. The ratios of thickness of upper lip to ANS, UI, LI were 1:-0.83, 1:-0.37, 1:0.11 in group 1. There was similar trend in group 2, and there were no statistically significant difference. These results suggest that prediction of changes in soft tissue of upper lip, lower lip, and chin were 79%, 47%, and 63% in group 1, and 48%, 83%, and 109% in group 2. There was a tendency to decrease in thickness and increase in length of the upper lip.

골격성 III급 부정교합 환자에서 양악 수술후 연조직 변화에 대한 연구

박홍주,최홍란,유선열,Park, Hong-Ju,Choi, Hong-Ran,Ryu, Sun-Youl 대한악안면성형재건외과학회 1998 Maxillofacial Plastic Reconstructive Surgery Vol.20 No.4

The purpose of this study was to assess the soft tissue changes using twenty skeletal class III malocclusion patients who treated with bimaxillary surgery for the correction of dentofacial deformities. Patients were divided into two groups. One was impaction and advancement of maxilla with mandibular set-back (Group 1), the other was downward and advancement of maxilla with mandibular set-back (Group 2). Preoperative and postoperative one year cephalometric data were analyzed and compared. Results obtained were as follows: 1. The ratio of horizontal changes of soft tissue to hard tissue at Nt to ANS, Ls to UI, Li to LI, sPog to Pog were 1:0.60, 1:0.79, 1:0.47, 1:0.63 in group 1 respectively, and 1:0.59, 1:0.48, 1:0.83, 1:1.09 in group 2 respectively. Soft tissue changes were highly predictable at the upper lip, lower lip, and chin area. 2. The ratio of vertical changes of soft tissue to hard tissue at Nt to ANS, Li to LI were 1:0.72, 1:0.06 in group 1, and others showed no statistically significant difference. 3. The ratio of horizontal changes of Ls to hard tissue movements at LI(h) was 1:-0.82 in group 1 and at UI(h), LI(h) were 1:0.48, 1:0.01 in group 2. These ratios of group 1 were greater than those of group 2. 4. The direction of horizontal change of Li was the same as that of hard tissue change. The ratio of horizontal changes of Li to LI was 1:0.47 in group 1 and others showed no statistically significant difference. 5. The changes of upper lip thickness and length were -1.6mm, -1.4mm in group 1, and -1mm, -2.7mm in group 2. 6. The ratios of thickness of upper lip to ANS, UI, LI were 1:-0.83, 1:-0.37, 1:0.11 in group 1. There was similar trend in group 2, and there were no statistically significant difference. These results suggest that prediction of changes in soft tissue of upper lip, lower lip, and chin were 79%, 47%, and 63% in group 1, and 48%, 83%, and 109% in group 2. There was a tendency to decrease in thickness and increase in length of the upper lip.

백서 구개 전층 창상의 치유에 미치는 피브린 접착제의 영향

소광섭,최홍란,유선열,So, Kwang-Sub,Choi, Hong-Ran,Ryu, Sun-Youl 대한악안면성형재건외과학회 1998 Maxillofacial Plastic Reconstructive Surgery Vol.20 No.4

The purpose of this study was to examine the effects of the fibrin adhesive (Beriplast$^{(R)}$) on healing of full-thickness wounds in the rat's hard palate. Twenty Spraque-Dawley strain white male rats, each weighing 250~300 gm were used. Creation of full-thickness wounds of $4{\times}4mm$ in size were performed on the hard palate. Beriplast$^{(R)}$, a wound dressing material, was applied immediately in the experimental group, but not applied in the control group. All wounds were protected with palatal resin splints. The animals were sacrificed on the 2nd, 4th, 7th, 14th, and 28th day after the operation for macroscopic and microscopic examinations. Results obtained were as follows ; 1. On the 7th day after the operation, epithelial proliferation was greater in the experimental group than that in the control group. 2. The inflammatory reaction of the experimental group was less than the control group on the 2nd and 4th day after the operation. Beriplast was resorbed on the 7th day after the operation. 3. In the control group, the epithelial proliferation occurred from the 7th to the 14th day after the operation, and in the experimental group, epithelial proliferation occurred from the 4th day after the operation. 4. On the 14th and 28th day after the operation, there was no prominent difference between the two groups in histological findings. These results suggest that the use of fibrin adhesive (Beriplast$^{(R)}$) as a palatal wound dressing results in greater epithelial proliferation and less inflammation in the early stage of wound healing.

구강내 연조직 질환과 구강점막 각화도와의 관계

송주종,김병국,최홍란,Song, Ju-Jong,Kim, Byung-Goo,Choi, Hong-Ran 대한안면통증구강내과학회 2001 Journal of Oral Medicine and Pain Vol.26 No.1

To investigate the relationship between several intraoral soft tissue lesions(hairy tongue, lichen planus, recurrent aphthous stomatitis, oral candidiasis, glossitis and oral herpetic lesion) and oral mucosal keratinization, exfoliative cytological smear on intraoral mucosal surfaces were performed on each number of patients and 25 controls keratinization cell (yellow-stained cell) ratio was then measured. In hairy tongue, there was no significant difference between patient group and control group in all kind of cells. Only blue cell ratio of women was more than of men in patient group. In lichen planus, there was no difference between patient and control group in yellow cell ratio. Red cell ratio in the control group was more than in the patient group. Blue cell ratio in the patient group was more than that in control group. But there was no sex predilection between both groups in the ratio of all kind of cells. In recurrent aphthous stomatitis, Yellow cell ratio in the control group was more than that in the patient group. Red cell ratio in the control group was more than that in control group. Blue cell ratio in the patient group was more than that in control group. But there was no sex predilection between both groups in the ratio of all kind of cells. In oral candidiasis, Yellow cell ratio in the control group was more than that in the patient group. Red cell ratio in the control group was more than that in control group. Blue cell ratio in the patient group was more than that in control group. There was no sex predilection between both groups in yellow cell ratio. Red cell ratio of women was more than of men in patient group. Blue cell ratio of men was more than of women in patient group. In herpetic lesions, there was no difference between patient and control group in yellow cell ratio. Red cell ratio in the control group was more than in the patient group. Blue cell ratio in the patient group was more than that in control group. Yellow cell ratio of women was more than of men in control group. Red cell ratio of men was more than of women in control group. Blue cell ratio of men was more than of women in patient group. In glossitis, Yellow cell ratio in the control group was more than in the patient group. There was no difference between patient and control group in red cell ratio. Blue cell ratio in the patient group was more than that in control group. Yellow cell ratio of women was more than of men in control group. Red cell ratio and blue cell ratio of men were more than of women in control group. According to above results, the ratio of keratinized cell in atrophic, ulcerated, or pseudomembranous lesions was lowered than in control, but the ratio of keratinized cell in keratotic, vesicular or lesions on keratinized surface lesions had no difference to control group. Thus, keratotic, vesicular or lesions on keratinized surface lesions have not closely relation to mucosal keratinization. And, there was a little sex predilection between men and wemen in mucosal keratinization.

앵글씨 분류에 의한 성인 골격구조 및 하악운동량 평가

김재형,김병국,최홍란,Kim, Jae-Hyung,Kim, Byung-Gook,Choi, Hong-Ran 대한안면통증구강내과학회 2001 Journal of Oral Medicine and Pain Vol.26 No.2

The purpose of this study was to identify the difference of vertical movement of mandible according to Angle's molar relationship and by skeletal factors affect to vertical movement of mandible. 172(age ranged from 20 to 30) subjects who go to college within territory of Kwangju city without any experience of temporomandibular disorder, extraction and orthodontic treatment. were selected for this study. The subjects were classified into class I(male:30, female:49), class II(male:18, female:24) and class III(male:18, female:33) according to Angle's molar relationship. The distance was measured between incisal edge of maxillary and mandibular central incisor and between bottom of central fossa of maxillary and mandibular 1st molar with ruler. The arch length and width were measured on the diagnostic cast. Cephalometrics were taken and then traced. Landmarks were identified and analyzed. 1. Maximal interincisal opening of male is larger than that of female in class I, class II and class III. Among each group maximal interincisal distance is the largest in class III. Maximal intermolar distance of male is superior to that of female in class I, class II, and class III, but there is no siginficant difference among them. 2. On maximal opening movement of Angle's classification class I and class II, total mandibular length, mandibular ramal length, madibular inferior border length and upper arch width were important variables and facial length, upper arch length and lower arch length had negative relationship to that. On maximal opening movement of Angle's class III, the upper arch length, the lower arch length and anterior facial length were important variables especially when compared with class I and II, and upper arch width had negative relationship. These results suggest that maximal opening movement is affected by facial morphology in all classes, but each group is affected by different facial skeletal variables. Accordingly, facioskeletal variables might be considered as diagnosis and treatment to improve the amount of mouth opening.

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.

상악골에 발생한 악성섬유성조직구종

류선열,박석인,이진환,정무강,정종철,최홍란,Ryu, Sun-Youl,Park, Suk-In,Lee, Jin-Hwan,Chung, Mu-Gang,Chung, Jong-Chull,Choi, Hong-Ran 대한악안면성형재건외과학회 1992 Maxillofacial Plastic Reconstructive Surgery Vol.14 No.1

우측 협부의 종창과 압통을 주소로 내원한 59세의 여자 환자에서 방사선 소견상 우측 상악골의 광범위한 골파괴상이 나타났고 조직생검에서 MFH로 진단되었다. 치료는 술전과 술후에 SWOG외 CY-VA-DIC요법을 변형시킨 화학요법과 총 40Gy의 $^{60}Co$ 방사선요법 그리고 우측 상악골전적출술의 삼자병용요법을 시행하였다. 술후 2년이 경과된 현재까지 재발이나 전이 등의 소경은 관찰되지 않고 있으며 환자의 예후에 대하여 주의 깊은 관찰을 계속하고 있다. Malignant fibrous histiocytoma rarely occurs in the jaws. A case of malignant fibrous histiocytoma originated from the maxillary sinus is reported with review of literature. A 59-year-old woman visited the Chonnam University Hospital in March, 1990, with chief complaint of swelling and tenderness in the right cheek. Radiographic findings revealed wide destruction of the maxilla. The biopsy taken from the maxilla showed histopatholgic findings of malignant fibrous histiocytoma. Accordingly the patient received preoperative and postoperative anticancer chemotherapy by the modified CY-VA-DIC protocol of the Southwest Oncology Group (SWOG). Preoperative and postoperative radiotherapy were also given to her in total 40Gy of $^{60}Co$ And she underwent radical resection of the maxilla. No evidence of recurrence or metastasis was shown for 2-year period of postoperative follow up.

Johanson 방법을 응용한 연령추정

이원준,김병국,김재형,임회순,이금숙,최홍란,Lee, Won-Joon,Kim, Byung-Gook,Kim, Jae-Hyung,Lim, Hoi-Soon,Lee, Guem-Sug,Choi, Hong-Ran 대한안면통증구강내과학회 2005 Journal of Oral Medicine and Pain Vol.30 No.2

Age estimation is fundamental and important in personal identification with forensic medicine and dentistry. Recently, a lot of studies using various part of the body have been done for age estimation. Age estimation with teeth is the most significant method comparing ones with other part of the body. Gustafson method and Johanson method using postmortem teeth have been authorized in accuracy and systemization and used domestically and internationally. The verification of the accuracy in above methods had been tried many times but it is still rare in Korea. Fifty-nine teeth(incisors, canine, premolars and molars) which were extracted due to periodontal diseases or orthodontic problem were collected. Present study is to 1) compare the accuracy of estimated age in applying Gustafson method and Johanson method to the teeth in Korea, 2) compare and analyze the correlation with results using Gustafson method and Johanson method by age, gender, maxilla - mandible and anterior - premolar - molar. Teeth were embedded in resin and sliced and then examined each one using Gustafson method and Johanson method. The results are as follows: 1. Actual age was a significant difference in estimated age by Johanson method. Actual age was a significant correlation in estimated age by Gustafson method and modified Johanson method. Modified Johanson method was more significant than Gustafson method. 2. In estimated age by Gustafson method, Johanson method and modified Johanson method, there was no significance with actual age by location and gender. 3. In estimated age by Gustafson method, Johanson method and modified Johanson method, there was significance with actual age by age group. Finally, Gustafson method and Johanson method can be used in Korea. To make more accurate verification, however, it needs more specimen and postmortem teeth. Johanson equation proposed by himself has to be developed by further studies.

두경부 편평세포암종에서 전이와 예후 인자에 대한 연구

서구종(Gu-Jong Seo),유선열(Sun-Youl Ryu),김옥준(Ok-Joon Kim),최홍란(Hong-Ran Choi) 대한구강악안면외과학회 2002 대한구강악안면외과학회지 Vol.28 No.1

The present study was carried out to evaluate the correlation of metastasis and prognostic factors in squamous cell carcinoma of head and neck. Examination was performed on a series of thirty-seven patients who were confirmed to squamous cell carcinoma and its lymphatic metastasis by pathologist. Correlations of metastasis and other factors such as angiogenesis, histologic grading, and p53 expression and ras oncogene were studied. The depth of tumors was around 1 to 27mm. Twenty cases were more than 10mm deep, of which seventeen cases were shown lymphatic metastasis. Total score of histologic grading including keratinization, nuclear atypia, growth pattern and intensity of inflammation was ranged from 5 to 10 points. Of these factors, nuclear atypia with intensity of inflammation, and nuclear atypia with growth pattern was correlated with nuclear atypia each. For angiogenesis, number of new-formed vessels were counted 13 to 58 each. Twenty-eight cases were shown to lymphatic metastasis. No correlation with histologic grading and lymphatic metastasis was found. The results of immunohistochemical staining for p53 and ras oncogene revealed that positive cases were 16 and 22, negative for 21 and 15 each. However, both were not correlated with histologic grading and lymphatic metastasis. These results were revealed that angiogenesis was not correlated with lymphatic metastasis of squamous cell carcinoma arising in head and neck. Nuclear atypia with intensity of inflammation and dysplasia with growth pattern were correlated with histologic grading, which suggested that more careful and adequate advice is needed for effective treatment.

이하선 다형성 선종의 괴사

유선열(Sun-Youl Ryu),백승(Sung Baek),박홍주(Hong-Ju Park),최홍란(Hong-Ran Choi) 대한구강악안면외과학회 2004 대한구강악안면외과학회지 Vol.30 No.2

Pleomorphic adenoma is the most common neoplasm of the parotid gland, generally presenting as a slowly growing, firm, well-circumscribed, painless nodule. It is often difficult to separate into benign and malignant categories because its bland histomorphologic and cytologic features. This tumor can be rarely associated with cystic change, hemorrhagic necrosis, or spontaneous infarction. Necrosis of lesional tissue may be associated with malignant transformation, particularly in a pleomorphic adenoma. We report a case of 50-year-old woman presented with a enlarging right parotid mass. Computed tomographic scan demonstrated a right superficial lobe mass with ill-defined border. The preoperative fine needle aspiration yielded necrotic debris and atypical squamous elements that were thought to be compatible with high degree of mucoepidermoid carcinoma. A total parotidectomy with intraoperative frozen section revealed extensive necrosis and diagnosed as malignant tumor. This tumor was finally diagnosed as a pleomorphic adenoma with necrosis on permanent sections. Caution should be exercised in evaluation of the parotid neoplasms with central necrosis to avoid misdiagnosis of such lesions as malignancy.