안면골 골절과 동반된 경동맥해면동루의 증례보고

박노부,서연호,문선혜,이용오,Park, No-Bu,Seo, Yeon-Ho,Moon, Seon-Hye,Lee, Yong-Oh 대한악안면성형재건외과학회 1993 Maxillofacial Plastic Reconstructive Surgery Vol.15 No.2

저자들은 두개저 골절을 동반하지 않은 단순 안면골 골절환자에서 본과에서 안면골 정복 수술후 발현한 외상성 경동맥해변동루 환자를 신경외과에 의뢰하여 분리풍선술식으로 처치한 후 현저한 임상적 증상의 개선을 가져왔고 12개월간 관찰시 다른 합병증도 유발되지 않았다. 외상성 경동맥해면동루는 두경부 손상시 매우 드물게 발생되는 심각한 합병증으로 임상증상의 복잡성 때문에 혼동하기 쉬으므로 Neurosurgeon과 협조하여 조기에 정확한 진단과 적절한 치료가 이루어지는 것이 바람직하다. Carotid-cavernous sinus fistula(CCSF) is an abnormal arterio-venous communication between the cavernous sinus and the internal carotid artery. It is usually caused by craniofacial trauma and a very rarely encountered complication, but it may also occur spontaneously. The most common cause of traumatic CCSF is blunt trauma, which usually associated with a skull base, frontal or midfacial fracture. The common clinical feature of CCSF are orbital bruit, headache, exophthalmos, chemosis, diplopia, visual disturbance and others. This dramatic ocular-orbital symptoms are principally due to orbital venous hypertension. The symptoms occured within a few hours to a maximum of a year after injury, usually within several weeks. The patient, 33-year-old female, developed a carotid-cavernous sinus fistula after only minimal closed trauma We present a rare case of CCSF associated facial bone fracture that was successfully treated by detachable balloon embolization with a review of the literature.

하악 과두부에 발생한 종양의 외과적 치험 2례

이용오(Yong Oh Lee),문선혜(Seon-Hye Moon),장세경(Sae Gyoung Jang) 대한치과의사협회 1986 대한치과의사협회지 Vol.24 No.5

하악골에 발생한 호산성 육아종의 치험1례

이용오(Yong Oh Lee),문선혜(Seon Hye Moon) 대한구강악안면외과학회 1988 대한구강악안면외과학회지 Vol.14 No.2

Histiocytosis X may be defined as a nonneoplastic proliferative disorder of histiocytosis which is pathogenetically akin to an inflammatory reaction with multiple clinical manifestations. Among the clinical syndrome included under the term histiocytosis X are Hand - Schüller - Christian disease, Letter - Siwe disease and eosinophilic granuloma of bone. Although it etiology and pathogenesis remain an enigma, an inflammatory etiology is favored because of the microscopic features, the clinical course and response of the disease to conservative therapy in most instances. Eosinophilic granuloma is a benign disorder with favorable prognosis, which involve nearly any bone, but most frequent in the craniofacial bones. Our case of eosinophilic granuloma consisted of an 1 year-old boy with a chief complaint of swelling on the left cheek, and rather well localized radiolucency on the left mandibular body, angle and ramus in roentgenograms series. We performed surgical biopsy and curettage including involved D E 6 tooth germ. During the periodic follow up for 13 months there were improvement and healing of intraosseous lesions by the recalcification of bone matrix, as viewed radiographically.

치은 섬유종증의 치험 1례

이용오(Yong Oh Lee),문선혜(Seon Hye Moon),서헤경(Hye Kyung Suh),장희숙(Hee Suck Jang),사공억(Uck Sa Gong),박노부(No Bu Park) 대한구강악안면외과학회 1993 대한구강악안면외과학회지 Vol.19 No.1

Gingival fibromatosis which represents a fibrous hyperplasia of the gingival tissue is relatively uncommon benign oral condition. Characteristically, the firm enlarged gingival tissue often obscure the anatomic crowns of the teeth. They may deform palatal contours and subsequently crowd the tongue with a resultant interferance in speech and mastication as well as inability to maintain normal lip closure. Numerous examples not accompanied by ingestion of dilantin sodium, hypertrichosis, hereditary factors, cherubism, or ectodermal dysplasia have been generally labeled idiopathic . Although it has been stated that the treatment of choice is surgical removal of the enlarged tissues, there is a tendency for the condition to recur within a few years. The patient, 21-year-old female, was admitted to department of dentistry, Dong San Hospital, Keimyung University with the chief complaint of mastication difficulty and cosmetic problem-elephantiasis gingivae. She showed severe fibrous enlargement of maxillary and mandibular attached and nonattached gingivae. The gingival tissues generally were firm and dense, and the teeth were covered with dense, fibrous tissues, and this tissues may interfere with eruption. There was an operation history of excision of excessive gingival enlargement at five year old. She was diagnosed empty sella syndrom with partial hypopituitarism at endocrine tests. We got the good results in esthetics and functions by extraction of all teeth and surgical excision of the hyperplastic gingival tissue followed by complete dentures.

구강내에 발생한 신경초종의 치험 1례

이용오(Yong Oh Lee),문선혜(Seon Hye Moon),박욱(Wook Park) 대한구강악안면외과학회 1991 대한구강악안면외과학회지 Vol.17 No.1

A neurilemmoma is a benign, encapsulated, slowly growing nerve sheath tumor of Schwann cell origin. 1. The typical symptom is only the presence of an asymptomatic mass. 2. Clinically, the soft-tissus lesion is a single, varing-sized & circumscrived nodule with intact overlying epithelium. 3. Histologically, the tumor is encapsulated and consists of two types of tissue; Antoni type A tissue and Antoni type B tissue 4. The treatment of choice is surgical excision and local recurrences are unusual. 5. This is a case of large neurilemmoma(5.5×4.5×2.5㎝)in left maxillary buccal mucosa extending to infratemporal fossa of 37-year-old female patient. 6. We performed the surgical excision. On follow-up check during 9 months, it revealed good healing on the operated sites.

좌측 악하부와 경부에 발생한 거대한 기형종의 외과적 치험1례

이용오(Yong Oh Lee),문선혜(Seon Hye Moon),김태훈(Tae Hoon Kim) 대한구강악안면외과학회 1988 대한구강악안면외과학회지 Vol.14 No.1

This is a case presentation of surgical treatment of a huge teratoma. Teratoma is a lesion that has been ordinary described as a tumor containing disorderly arrangement of tissues and organs. In this case, there is an epithelial-lined cavity, as well as mesodermal and endodermal derivatives, as well as the typical dermal appendages of the dermoid cyst. Chief complaint of this 39-year-old male patient was pain, difficulty in respiration and swallowing, motion disturbance of head and neck. He had psychogenic tension due to this huge mass. Neck CT showed narrowing of the respiratory tract due to tumor growing medialward. The mass was removed totally as an encapsulated state via a submandibular approach. There was mild disturbance in free movement of the tongue immediately after operation but this improved very much. At present, after 5 months follow up, he is satisfied in function and cosmetic aspect.

우측 하악 과두부에 발생한 골연골종의 외과적 치험 1례

이용오(Yong Oh Lee),문선혜(Seon Hye Moon),김은관(Eun Goan Kim) 대한구강악안면외과학회 1991 대한구강악안면외과학회지 Vol.17 No.1

Osteochondroma is a benign tumor. Cartilage-capped exostoses, although frequently seen in the general skeleton, occur only rarely on the condyle of the mandible. Sign and symptoms of osteochondroma on mandibular condyle are related with facial asymmetry, malocclusion, and TMJ disorder. The patient, 30-yean-old female, was admitted to our hospital with a chief complaint of the facial asymmetry and masticatory difficulty. The patient had moticed a slowly deviation of the mandible to the left side for 20 years, and intermittent dull pain on the right TMJ area. The treatment of osteochondroma, especially occur in the condyle, is simple surgical excision of tumors and replace condyle with prosthesis after surgical excision. We treated with subcondylar osteotomy and casting prosthesis for condylar replacement. The prothesis was made of titanium. We obtained successful functional and esthetic results and no specific change has been seen in four months postoperative follow up.

협부에 전이된 지방육종의 치험례

김우철,홍락원,김태훈,문선혜,박노부,이용오,Kim, Woo-Cheol,Hong, Lak-Won,Kim, Tae-Hoon,Moon, Seon-Hye,Park, No-Boo,Lee, Yong-Oh 대한악안면성형재건외과학회 1994 Maxillofacial Plastic Reconstructive Surgery Vol.16 No.3

지방육종은 주로 근간 간엽조직으로부터 발생되어지며, 중년이상의 남성에서 호발하고 주된 발병부위는 하지 및 후복막강이고 구강 주위조직에 이환되는 경우는 극히 드문 악성종양이며, 본 증례에서는 4년 전 좌측 하지에서 발생되어 우측 하지 및 좌측 협부에 전이된 것으로 생각되어지는 점액양의 지방육종으로 종물의 외과적 절제술 및 화학요법을 시행하였고 장기적인 관찰이 요구된다. Liposarcoma is one of the most common malignant mesenchymal neoplasm, comprising approximately 15% of all soft tissue sarcoma. This is a tumor with an incidence peak between age 40 and 60 years, and is slightly more common in men than women. Although all body region may be involved, the most frequent sites are lower extremities and retroperitoneum but rare in the head and neck region. Liposarcoma can be classified to four subtypes ; myxoid, well-differentiated, round-cell, pleomorphic. The myxoid type is the most common and accounts for almost one half of all liposarcoma. Wide surgical excision with or without radiation therapy has been used to manage this lesion. We report a case of 50-year old man with soft tissue swelling on the left cheek, previously diagnosed as myxoid liposarcoma in the left lower extremity. After radiologic and ultrasonic study and surgical excision with biopsy, the lesion of cheek was diagnosed as myxoid liposarcoma with round cell differentiation.

下顎骨에 發生한 Paget s Disease의 外科的 治験 1例

Yong Oh Lee(李容五),Sang Kil Byun(卞相吉),Seon Hye Moon(文善惠) 대한구강악안면외과학회 1983 대한구강악안면외과학회지 Vol.9 No.1

Paget s disease of bone is an unusual idiopathic disease of the adult skeleton. This curious bone disorder is characterized by simultaneous destruction and repair of the involued tissues. This is a case of 21 year-old Korean female with a diagnosis of Paget s disease in the mandible. Chief complaint of the patient was facial asymmetry by slow growing mass with dull pain on the right mandibular body. Diagnosis was obtained by incisional biopsy of affected mandible after taking several radiograms, which was Paget s disease. Patient was treated by first subtotal mandiblectomy and resin splint implantation. We gained satisfactory result by secondary autogenous marrow bony graft from the iliac crest with titanium mesh for tray of bone chips. It is rarely that Paget s disease occurs in the second decade and mandible is the primary origin of paget s disease of bone.

DMBA 유도 햄스터협낭암 발생과정에서의 p53 유전자, 상피성장인자수용체 (EGF-r) 및 증식세포핵항원 (PCNA) 에 대한 면역조직화학적 연구

문선혜 慶北大學校 齒科大學 1994 慶北齒大論文集 Vol.11 No.2

저자는 DMBA 유도 햄스터협낭암의 다단계 발암과정에서 암억제유전자산물 p53, 상피성장인자수용체 (EGF-r) 및 증식세포핵항원 (PCNA)의 상호 관련성을 연구하기 위해 햄스터(Syrian golden hamster) 92 마리를 실험동물로 하여 대조군은 0, 4, 8, 16 주에, 실험군(DMBA 도포군)은 4, 8, 16 주에 각각 희생시켜 표본제작하여 면역조직화학적 검색을 행한 바 다음과 같은 결과를 얻었다. DMBA 유도 햄스터협낭암에서 정상점막부터 과형성, 이형성증과 유두종 및 편평상피암의 발생을 시기별로 관찰할 수 있었다. p53 변이는 햄스터의 전암병소인 과형성부터 나타나 병변이 이형성증을 거쳐 편평상피암으로 진행될수록 빈도가 증가되어 비교적초기에 p53 변이가 생겨 DMBA 유도 햄스터 편평상피암의 발생 및 진전에 p53 유전자의 변이가 관여함을 알 수 있었다. EGF-r 발현은 주로 전암병소에 증가되어 암발생에 부수된 소견으로 간주되었다. 세포의 증식능을 알 수 있는 PCNA 양성율은 정상조직보다 전암병소인 과형성과 이형성증에서 더 높았다. 전암병소중 이형성이 중정도이상인 경우 더욱 높은 양상을 보였다. 편평상피암에서 전암병소보다 더욱 높은 수치의 PCNA 양성율을 보여 병변이 진행될수록 종양의 증식능도 높아짐을 알 수 있었다. 이와 같이 햄스터의 협낭암 발생에 p53 변이가 세포증식능의 증가와 수반되어 암발생의 비교적 초기부터 나타나 p53 변이와 증가된 PCNA 증식능은 두경부암의 재발이나 제2원발암의 발생위험도를 측정할 수 있는 한 중요한 표식자가 될 수 있다고 생각되었다. This study was carried out to investigate the cellular and molecular mechanisms of hamster buccal pouch carcinogenesis treated with 0.5% DMBA (7.12-dimethylbenz[a]anthracene) in mineral oil. Ninety two Syrian golden hamsters, maintained on a stock diet, 4-6 weeks old, were divided into control and 3 experimental groups. Control group. (20 hamsters). Both buccal pouches of hamsters were left untreated. Animals were sacrificed at 0, 4, 8 and 16 weeks. Experimental groups (72 hamsters), were treated with 0.5% DMBA tri-weekly on the right buccal pouch. Animals were sacrificed at 4, 8, 16 weeks after treatment. Sacrificed animal buccal pouches were sectioned and examined for potential alterations in the expression of p53 tumor suppressor gene to determine whether p53 alterations are modulated in the different stages of hamster buccal pouch carcinogenesis. For these samples, we also investigated the expression patterns of EGF-r (epidermal growth factor receptor). PCNA (proliferating cell nuclear antigen) was used to investigate cell kinetics of hamster tumors. The results were as follows; 1. The DMBA-treated buccal pouches were generally white and irregularly thickened up to 8 weeks. There were multiple, various polypoid tumors throughout the mucosa at 16 weeks. Light microscopically the buccal pouch epithelium in BMBA- treated groups showed areas of hyperkeratosis and hyperplasisa at 4 weeks, dysplasia at 8 weeks, and early and invasive squamous cell carcinoma at 16 weeks. 2. The presence, pattern and distribution of p53 staining depended greatly on the morphology of the lesion. The non-neoplastic lesions were negative for mutant p53 protein, whereas preneoplastic (hyperplasia and dysplasia) and neoplastic lesions (squamous cell carcinoma) were positive for p53. 3. EGF-r expression was found in non-neoplastic and preneoplastic lesions, but no expression in the neoplastic lesion. 4. The PCNA labeling index correlated well with the stages of buccal pouch epithelium carcinogenesis. 5. The staining pattern and distribution for mutant p53 protein was directly correlated with PCNA distribution whereas neither directly correlated with EGF-r. These results suggest that p53 alterations occur in a multistep fashion with corresponding increase of cell kinetics revealed by PCNA during the hamster buccal pouch carcinogenesis. Mutation of the p53 gene is an important step in the pathogenesis of DMBA-induced hamster buccal pouch squamous cell carcinoma but EGF-r expression may be incidental.