放射線照射가 白鼠顎骨 및 拔齒創 治癒에 미치는 影響에 關한 實驗的 硏究

李義雄 연세대학교 대학원 1980 延世論叢 Vol.16 No.2

This study was undertaken to observe in jaws and extraction-wound healing of rats when exposed to a single dose and fractionated dose of Cobalt-60 irradiation. One hundred-sixty albino rats of a sprague dawley strain, weighing approximately 180 grams each at the begining of the experiment were divided into control group and 3 experimental groups. In experimental groups, group I recieved 1200 rads every week until the 4800 rads reached, group II recieved 2000 rads with a single dose and group III recieved 2500 rads with a single dose. Irradiation was carried out using a RAC-120 Cobalt-60 Teletherapy Unit with a dose rate 62.1 r/min measured at 100cm from source. All animals of III group were died from 8th to 12th day after radiation. Group I and II were divided into 4 subgroups after radiation respectively. Extraction on lower third molar was performed in each group at 1st, 2nd, 3rd and 4th week after exposure. Serial sacrifice of two or three experimental and two control animals was begun one week after extraction and was performed on a weekly basis thereatfter until all experimental arimal were used. When all animals were sacrificed, the following specimens available for hislologic study; Control group; 3,7,10,14,21,28,35 and 42 days postextraction, Group I & II were shown as Figure. After examination and comparision of all specimens, the results of this study were obtained as follow. 표삽입 원문참조 1. The mortality during this experimental period were shown, group I : 50%, group II : 43.75% and group III : 100%. 2. The time when all experimental animals began to recover as normal, appearance group I : from 3 weeks after radiation. group II : from 5 weeks after radiation. 3. Osteoradionecrosis of jaw bone appeared to result primarily from the direct effect of irradiation on the osteocyte, revealed pyknosis and loss of ostescyte, and appeared congestion of blood vessels and thickening the Vessel walls. 4. Subgroup A, and C of group I and A of group II showed pyknosis and loss of osteocyte in bone lacunae, especially 1 week after extraction. 5. Extraction-wound healing in subgroup B. and C of group II took as normal healing process, but subtroup A of group I only continued necrotic process upto 4 weeks post extraction. 6. Extraction-wound healing was in direct relationship to total dosage of radiation and the time interval for extraction after radiation. 7. Epithelization of extraction-wound was influenced by size of wound, mucosal laceration and remained foreign body. 8. General condition after radiation leas improved by tube feeding with milk. -supportive therapy. 9. when teeth are extract following radiation, the time interval for extraction after radiation must be taken two weeks at least.

악관절 수술후 안면신경 손상에 대한 임상적 연구

주재동,이의웅,김준배,박광호,김형곤 大韓顎顔面成形再建外科學會 1994 Maxillofacial Plastic Reconstructive Surgery Vol.16 No.4

Authors have studied retrospectively the facial nerve injury after TMJ surgery through the preauricular approach routine. The study material used was 4 patients of all 113 patients who were diagnosed as internal derangement and have been operated from March 1989 to February 1991 in Youngdong severance hospital, and were induced postoperatived facial nerve injury. The patient group who had the postoperative injured facial nerve was recognized degree of injury using the diagnostic method, Electromyography(EMG) and Nerve conduction test(NCT) which are used widely at present and was treated as conservative care and we identified the recovery time as the same method. The results as follows : 1. The meticulous care and precious surgical technique are needed in both operation and postoperation. During the TMJ surgery, the excessive retraction of the flap and frequent use of nerve stimulator and electric surgical knife should be avoided as possible and postoperative hematoma and swelling should be minimized. 2. The 4 patients were experienced with the postoperative facial nerve injury of all 133 patients who had been operated the TMJ surgery through the routine preauricular approach on our hospital. And the incidence of postoperative facial nerve injury happened was about 0.3% and its incidence was relatively low comparing with any other previous reports. 3. EMG and NCT were considered as useful methods which can diagnose the nerve injury objectively and identified the effect of treatment and recovery time. 4. The faical nerve-injured patients who were induced postoperatively after TMJ surgery, were diagnosed as second-degree nere injury through the EMG and NCT. And the patient group was treated well as conservative physical therapy for about 2 to 4 months.

최근 6년간 연세의료원에서 경험한 한국인 안면골 골절에 대한 임상적 연구

권준호,이충국,이의웅,민우석,윤중호,박형식 大韓顎顔面成形外科學會 1989 Maxillofacial Plastic Reconstructive Surgery Vol.11 No.1

This is a series of continuing research on facial bone fractures of Koreans worked by Dept. of Oral and Maxillofacial surgery, Dental College of Yonsei University, Seoul, Korea, since 1972. The study was based on a series of 630 patients with facial bone fractures treated as in patient at Yonsei Medical Center, Yonsei University, during the period of Jan. 1982 through Dec, 1987. The results obtained are as follows: 1. The ratio of Men to Women was 4.3 : 1, and admissions for facial bone fractures have been increased year after 1984. 2. The age frequency was highest in the third decade(38.3%). and fourth, second, fifth decade in orders. 3. The traffic accident was the most frequent cause of facial bone fractures(51.3%). 4. The most common location of facial bone fractures was the Mandible(35.3%), and Zygoma complex(29.8%), Nasal bone(15.0%), Maxilla(11.0%) were next in order of frequency. 5. In 291 patients of Mandible fractures, 226(77.7%) had fractures only in Mandible and 65(22.3%) had another facial bone fractures. The most frequent fracture site of mandible was the Symphysis(43.0%) and Angle(22.4%), and Simple fracture was the most frequent in type of fracture(66.9%). Intermaxillarty fixatin & Open reduction was major method of treatment(36.9%). 6. In 394 patients of Midface fractures 323(82.0%) had fractures only in Midface and 71(18.0%) had another facial bone fractures. The most frequent site of Midface fractures was zygoma complex & zygomatic arch(42.7%), and Simple fracture was the most common type of fractures. Observation(Maxilla :44.2%, Zygoma :51.0%) and Open Reduction(Maxilla :20.0%. Zygoma :23.5%) were the major method of treatment. 7. The frequency of Nasal bone fracture was about 1/5 of Midface fractures, and Closed Reduction(42.2%) was the major method of treatment. 8. The complication was reported in only 16 patients, and Malunion was the major complication. 9. Head(44.4%), Lower extrimities(14.5%) and Eye(12.3%) were injured commonly with facial bone fractures. 10. The elapsed time from injury to hospital was within 24 hours in 73.8% of patients, however 15.5% of patients arrived the hospital 72 hours after injury.

囊腫 摘出術과 齒根端 切除術로 治驗한 上顎 前齒部 過剩埋伏齒의 含齒性 囊腫 3例

Eui Wung Lee(李義雄),Houng Gon Kim(金亨坤),Jung Ho Yoon(尹仲鎬) 대한구강악안면외과학회 1980 대한구강악안면외과학회지 Vol.6 No.1

This is a report of three cases of dentigerous cyst treated by enucleation with apicoectomy. With X-Ray findings these cases of dentigerous were located upper anterior portionp originated from the supernumerary teeth. The result were as follows. 1. Early finding & treatment of dentigerous cyst which is associated with impacted supernumerary teeth is very important. 2. Enucleation with apicoectomy was performed and obtained good func tional & ethetic results. 3. Until now, post follow up examination of all patients revealed good result without complication & recurrence.

抗癌化學療法劑가 白鼠唾液腺組織에 미치는 影響에 關한 實驗的 硏究

Eui Wung Lee(李義雄) 대한구강악안면외과학회 1982 대한구강악안면외과학회지 Vol.8 No.1

This study was undertaken to observe the salivary gland of white rat when administrated to single dose of antineoplastic agents: 5-Fluorouracil, Cyclophosphamide, and Methotrexate. Eighty eight Sprague Dawley strain white rats, weighing about 180 grams were used and devided into control and three experimental groups. Sixteen rats were injected 0.5cc of normal saline solution intravenously as placebo in control group. In experimental groups, each twenty four rats in group I, II and Ill were injected intravenously 200mg. 5-Fluorouracil, 32mg. Cyclophosphamide, and 2.5mg. Methotrexate per kilogram body weight with single dose respectively. Rats were serially sacrificed on 1st, 3rd, 5th, 7th, 10th, 14th, 21st, 28th day after injection of placebo and antineoplastic agents. At sacrifice, the parotid, submandibular, and sublingual gland were dissected out in toto, and stained with 1) Hematoxylin and Eosin: 2) Periodic Acid Shiff. After examination and comparision of all specimen, the results of this study were obtained as follow. 1. The severity of tissue damage after injection of antineoplastic agents showed duct and acinar, whereas serous and mucous gland in order. 2. Parotid gland showed rather high cytotoxic effect while submandibular and sublingual gland showed varied cytotoxic deffect which is thought due to a mixed gland. 3. The cytotoxic effects showed Cyclophosphamide, 5-Fluorouracil, and methotrexate in order. 4. The most destructive salivary gland was on 3rd day after injection of antineoplastic agent and began to repair after 7th day. 5. In PAS reaction, severe change was observed especially in serous gland while irregularity of reaction revealed.

顎下腺 導管에 發生한 唾石症의 治驗例

Eui Wung Lee(李義雄),Il Kyu Kim(金一圭),Jung Ho Yoon(尹仲鎬) 대한구강악안면외과학회 1980 대한구강악안면외과학회지 Vol.6 No.1

This is a case report of the sialolithiasis on the left wharton s duct of the submandibular gland corrected by sialithotomy. The results are as follows. 1. The obstruction of the duct by salivary calculi is the major cause of the acute or chronic sialadenitis. 2. The surgical intervention is the choice of the treatment in the patient with sialolithiasis. 3. When sialithotomy, it is desirable to maintain the pholy ethylene tube passing through the salivary duct more than 2 weeks to avoid the fistula formation on the mucosa! incised wound. 4. When the blunt dissection through the loose connective tissue of the mouth floor, it might elicit the anesthesia or paresthesia owing to the cutting of the lingual nerve or other injuries.

下顎骨體部 骨折除術에 依한 下顎前突症의 治驗例

Eui Wung Lee(李義雄),Myung Rae Kim(金命來),Jung Ho Yoon(尹仲鎬),Nyoun Jong Lee(李年鍾),Jong Ho Shin(申宗浩) 대한구강악안면외과학회 1975 대한구강악안면외과학회지 Vol.1 No.1

This is to report a case of extreme mandibular prognathism corrected by bilateral ostectomy in the body of the mandible. After the precise clinical, cephalometric and model analysis, the 27-year-old female patient was treated by removal of a section of bone from both mandibular second molar region. The results are as follows; 1. The postoperative cephalometric analysis reveals remarkable reduction of mandibular body length, ratio of mandibular body to anterior cranial base, SNB, ANB, SNPo, anterior face height. The surgical correction resulted in satisfactory cosmetic and functional improvement without any noticeable complications. 2. To control the axial inclination of upper and lower anterior teeth, minor teeth irregularities and to eliminate the premature contact, fixed type orthodontic appliances with occlusal equilibration have been performed for about one year. The prosthodontic restoration was also required for the edentulous lower posterior region to obtain better oral rehabilitation.

下顎骨 矮小症을 수반한 兩側性 顎關節骨強直의 治驗例

Eui Wung Lee(李義雄),Houng Gon Kim(金亨坤),Jung Ho Yoon(尹仲鎬),Hyoung Sik Park(朴亨植),Jung Kyun Kim(金正均),Gi Ho Kim(金知浩) 대한구강악안면외과학회 1981 대한구강악안면외과학회지 Vol.7 No.1

This is a case report of the bilateral bony ankylosis of temporomandibular joint associated with micrognathia, which was corrected by arthroplasty with silicone rubber implant in left side, condylectomy and coronoidotomy in right side. We suspected this deformity to be arised from unknown high fever in childhood. Ankylosis occured before mixed dentition period was main etiological factor of facial deformity. So, the earlier correction is the better result. It is to prevent recurrence of ankylosis and improve the prognosis that adequate bone resection, proper selection of interposing material and post-operative continuous forceful mandibular movement.

下顎 右側 骨體部 및 隅角部에 發生한 琺瑯芽 細胞齒牙腫의 骨 切除術에 依한 治驗例

Eui Wung Lee(李義雄),Dong Kyun Park(朴東均),Jung Ho Yoon(尹仲鎬),Hyung Sik Park(朴亨植) 대한구강악안면외과학회 1977 대한구강악안면외과학회지 Vol.3 No.1

This is a case report of an ameloblastic odontoma occured in the right mandibular body and angle region of 46-year-old male In reviewing this case, the following points should have been understood 1. In this case, this tumor occured at 46-yea-old male, and it was rarely seen in this age 2. It is important early detection of ameloblastic odontoma is of value in preventing the bone destruction, malocclusion and facial disfigurment. 3. mandibular ostectomy on the right mandibular body and angle region, and reconstruction with the acrylic resin plate resulted in satisfactory cosmetic and functional improvement and removal of potential recurrence.

CO₂Laser가 백서의 4-nitroquinoline 1-oxide(4NQO) 유도 구개암에 미치는 영향에 관한 실험적 연구

이의웅(Eui Wung Lee),양성익(Sung Ik Yang) 대한구강악안면외과학회 1985 대한구강악안면외과학회지 Vol.11 No.2

The carbon dioxide laser has become more available widely in recent years and is now employed in many branches of surgery. It is important to understand the biological effects of CO₂ laser on normal oral mucosa and tumor tissues so that the likely response in patients can be predicted. However, little information is available on the biological effects of CO₂ laser in removing the tumor tissues. The present study was undertaken to investigate the effects of carbon dioxide laser on 4-nitroquinoline 1-oxide (4NQO) induced palatal carcinoma of the albino rats. 113 albino rats, Sprague Dawley strain, 6 week old, were used in this experimental study, divided into control group (15) and experimental group (30) in the first experiment (experimental carcinogenesis), then, normal group (33) and cancer group (35) in the second experiment (Laser irradiation). The first experiment was carried out to produce induced palatal carcinoma by the application of 0.5% 4NQO in propane 1,2-diol on palatal mucosa of the albino rats three times weekly for 30 weeks. The animals of experimental group were sacrificed every other week serially after the application of carcinogen. In the second experiment, CO₂ laser and blade wounds were created on normal palatal mucosa while laser wound on the tumor tissues. All animals were sacrificed serially immediately, 2, 4, 7, 14, 21, 28th day after each wound creation. The palatal mucosa was excised involving the laser or blade wounds. Tissue was examined grossly, light-microscopically and electron-microscopically. The obtained results were as follows. 1. In the experimental carcinogenesis for 4NQO induced palatal carcinoma, mild acanthosis only in 2 to 8th week, marked acanthosis with early acantholysis and epithelial dysplasia in 10 to 22th week and well differentiated squamous cell carcinoma in 24 to 30th week were observed lieht-microscopically. 2. In electron microscopic observation, we observed decrease of desmosomes and widening of intercelluar space in 6 to 10th week of carcinogenesis. Vacuolar degeneration and decrease of tonofilaments in cytoplasm were also seen in 10 to 20th week progressively. Lately, destruction of desmosome, widening of intercellular space, vacuolar degeneration and swelling of mitochondria in cytoplasm, cytoplasmic process extension with absence of basal lamina, irregular patterns of nucleus and cell features, prominent nucleoli were observed in 24 to 30th week of squamous cell carcinoma. 3. In light microscopic observation of the blade wounds in normal palatal mucosa, necrosis, inflammation and granulation tissue formation were seen until 7th day after wound creation but fibrosis and normal connective tissue formation were observed after 1st week, while in the laser wound, more severe necrosis, inflammation and granulation tissue formation were seen continuously until 3rd week, but fibrosis was seen on 3rd week and similar healing findings compared to blade wound were noted on 4th week. Fibrin thrombi formation was also observed variably within blood vessels. 4. In the laser wound of palatal carcinoma, its healing process was similar to that in normal palatal mucosa with extensive necrosis and fibrin thrombi within blood vessels, but the ultrastructural changes of tumor cell were not observed. Specific morphologic changes of the laser wound were extensive tissue necrosis and fibrin thrombi formation within blood vessels of connective tissue mainly, thus delayed healing was prominent in the early stage, but there were no significant differences between laser and blade wound in the later healing process. It was considered that direct dissemination of the tumor cell was probably inhibited due to vascular occlusion by intravascular thromboses during CO₂ laser surgery for malignant tumor