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칼슘포스페이트 나노-크리스탈이 코팅된 골이식재와 자가골을 병행 이용한 상악동 거상술
방강미,이보한,알라쉬단,유상배,성미애,김성민,장정원,김명진,고재승,이종호,Pang, Kang-Mi,Li, Bo-Han,Alrashidan, Mohamed,Yoo, Sang-Bae,Sung, Mi-Ae,Kim, Soung-Min,Jahng, Jeong-Won,Kim, Myung-Jin,Ko, Jea-Seung,Lee, Jong-Ho 대한악안면성형재건외과학회 2009 Maxillofacial Plastic Reconstructive Surgery Vol.31 No.3
Purpose: Rehabilitation of the edentulous posterior maxilla with dental implants often poses difficulty because of insufficient bone volume caused by pneumatization of the maxillary sinus and by crestal bone resorption. Sinus grafting technique was developed to increase the vertical height to overcome this problem. The present study was designed to evaluate the sinus floor augmentation with anorganic bovine bone (Bio-$cera^{TM}$) using histomorphometric and clinical measures. Patients and methods: Thirteen patients were involved in this study and underwent total 14 sinus lift procedures. Residual bone height was ${\geq}2mm$ and ${\leq}6mm$. Lateral window approach was used, with grafting using Bio-$cera^{TM}$ only(n=1) or mixed with autogenous bone from ramus and/or maxillary tuberosity(n=13). After 6 months of healing, implant sites were created with 3mm diameter trephine and biopsies taken for histomorphometric analysis. The parameters assessed were area fraction of new bone, graft material and connective tissue. Immediate and 6 months after grafting surgery, and 6 months after implantation, computed tomography (CT) was taken and the sinus graft was evaluated morphometric analysis. After implant installation at the grafted area, the clinical outcome was checked. Results: Histomorphometry was done in ten patients.Bio-$cera^{TM}$ particles were surrounded by newly formed bone. The graft particles and newly formed bone were surrounded by connective tissue including small capillaries in some fields. Imaging processing revealed $24.86{\pm}7.59%$ of new bone, $38.20{\pm}13.19%$ connective tissue, and $36.92{\pm}14.51%$ of remaining Bio-$cera^{TM}$ particles. All grafted sites received an implant, and in all cases sufficient bone height was achieved to install implants. The increase in ridge height was about $15.9{\pm}1.8mm$ immediately after operation (from 13mm to 19mm). After 6 months operation, ridge height was reduced about $11.5{\pm}13.5%$. After implant installation, average marginal bone loss after 6 months was $0.3{\pm}0.15mm$. Conclusion: Bio-$cera^{TM}$ showed new bone formation similar with Bio-$Oss^{(R)}$ histomorphometrically and appeared to be an effective bone substitute in maxillary sinus augmentation procedure with the residual bone height from 2 to 6mm.
방강미,지영민,김성민,명훈,최진영,이종호,정필훈,김명진,황순정 대한구순구개열학회 2007 대한구순구개열학회지 Vol.10 No.2
Otitis media with effusion is known to be very common among children with cleft palate and is the common cause of acquired hearing loss in childhood. The purpose of the present study was to examine the anatomic variances, incidence and treatment of middle ear disease in children with cleft palate. In Korea, before 4-year-old age, the prevalence of otitis media was as high as 91.7%. Common treatments for otitis media were conservative or surgical treatment. The medical treatment options include the use of decongestants, antihistamines, antibiotics and mucolytics. Surgical treatment options include grommet insertion, myringotomy. Unlike the case for children without clefts, cleft patient has a higher incidence of recurrence, so surgical treatment between the age of 3 month and 6 month was recommended. The effect of palatoplasty on middle ear disease has remained controversial. Early and periodic evaluation on the symptomatic infection or significant of hearing loss was recommended.
Dehydrothermal Treatment로 제작한 흡수성 콜라겐 골유도재생술 차단막
방강미,정한울,김성포,양은경,김기호,김성민,김명진,장정원,이종호,Pang, Kang-Mi,Choung, Han-Wool,Kim, Sung-Po,Yang, Eun-Kyung,Kim, Ki-Ho,Kim, Soung-Min,Kim, Myung-Jin,Jahng, Jeong-Won,Lee, Jong-Ho 대한악안면성형재건외과학회 2011 Maxillofacial Plastic Reconstructive Surgery Vol.33 No.2
Purpose: Collagen membranes are used extensively as bioabsorbable barriers in guided bone regeneration. However, collagen has different effects on tissue restoration depending on the type, structure, degree of cross-linking and chemical treatment. The purpose of this study was to evaluate the inflammatory reaction, bone formation, and degradation of dehydrothermal treated porcine type I atelocollagen (CollaGuide$^{(R)}$) compared to of the non-crosslinked porcine type I, III collagen (BioGide$^{(R)}$) and the glutaldehyde cross-linked bovine type I collagen (BioMend$^{(R)}$) in surgically created bone defects in rat mandible. Methods: Bone defect model was based upon 3 mm sized full-thickness transcortical bone defects in the mandibular ramus of Sprague-Dawley rats. The defects were covered bucolingually with CollaGuide$^{(R)}$, BioMend$^{(R)}$, or BioGide$^{(R)}$ (n=12). For control, the defects were not covered by any membrane. Lymphocyte, multinucleated giant cell infiltration, bone formation over the defect area and membrane absorption were evaluated at 4 weeks postimplantation. For comparison of the membrane effect over the bone augmentation, rats received a bone graft plus different covering of membrane. A $3{\times}4$ mm sized block graft was harvested from the mandibular angle and was laid and stabilized with a microscrew on the naturally existing curvature of mandibular inferior border. After 10 weeks postimplantation, same histologic analysis were done. Results: In the defect model at 4 weeks post-implantation, the amount of new bone formed in defects was similar for all types of membrane. Bio-Gide$^{(R)}$ membranes induced significantly greater inflammatory response and membrane resorption than other two membranes; characterized by lymphocytes and multinucleated giant cells. At 10 weeks postoperatively, all membranes were completely resorbed. Conclusion: Dehydrotheramal treated cross-linked collagen was safe and effective in guiding bone regeneration in alveolar ridge defects and bone augmentation in rats, similar to BioGide$^{(R)}$ and BioMend$^{(R)}$, thus, could be clinically useful.
방강미(Kang-Mi Bang),김성민(Soung-Min Kim),명훈(Hoon Myoung),김명진(Myung-Jin Kim),이종호(Jong-Ho Lee) 대한치과의사협회 2011 대한치과의사협회지 Vol.49 No.3
Historically, the screening of patients for signs of oral cancer and precancerous lesions has relied upon the conventional oral examination. A variety of commercial diagnostic aids and adjunctive techniques are developed to potentially assist in the screening of healthy patients for evidence of occult cancerous change. This paper is reviewing the literature associated with current oral cancer screening aids such as spectroscopy, chemoiluminescence, exfoliative cytopathology, vital staining and saliva as a diagnostic tool. Despite the increased public awareness of oral cancer, no technique or technology to date has provided definitive evidence to suggest that it improves the sensitivity or specificity of oral cancer screening beyond clinical oral examination alone.
비스포스포네이트 관련 악골괴사(BRONJ)의 병기 2기에서의 외과적, 보존적 치료에 대한 비교 연구
이호경,서미현,방강미,송승일,이정근,Lee, Ho Kyung,Seo, Mi Hyun,Pang, Kang Mi,Song, Seung Il,Lee, Jeong Keun 대한악안면성형재건외과학회 2013 Maxillofacial Plastic Reconstructive Surgery Vol.35 No.5
Purpose: This study evaluated the prognosis of conservative and surgical treatment according to the staging of bisphosphonate-related osteonecrosis of jaw (BRONJ) by American Association of Oral and Maxillofacial Surgeons and American Society for Bone and Mineral Research. Methods: We evaluated 53 patients of BRONJ who visited Department of Dentistry, Ajou University School of Medicine from May 2007 to February 2013. Twenty eight patients in stage 2, were divided into surgical and conservative groups with cessation of bisphosphonate therapy. Fifteen patients belonged to the conservative treatment group, in which mouth rinsing and antibiotics medication were done. Thirteen patients were treated with debridement or sequestrectomy, in the surgical treatment group. Each study list was analyzed by SPSS ver. 14.0 (SPSS Inc., USA) software and the favorable rate was verified by the Fisher exact test. P-values less than 0.05% were deemed significant. Results: Clinical outcome was evaluated on the basis of both clinical and radiographic findings. Of all the 28 patients of stage 2, 15 patients underwent conservative treatment and 13 patients received surgical treatment. In the surgical group, 9 of 13 (69.2%) showed good prognosis, 4 of 13 (30.7%) showed recurrence. In the conservative group, 13 of 15 (86.6%) showed no change duting the follow-up period. Two of 15 patients even showed a bad prognosis, such as pain and pus discharge, which are criteria for stage 3. P-value was 0.067 (>0.05). Conclusion: The results of the present study suggests that surgical intervention is good choice against the conservative treatment, after proper drug holidays period, while further investigation is needed for a definite solution to BRONJ.
하악골에 발생한 Gorham-Stout 증후군: 증례 보고
지영민,송진아,신정현,방강미,김성민,명훈,서병무,최진영,이종호,정필훈,김명진,황순정,Ji, Young-Min,Song, Gin-Ah,Shin, Jung-Hyun,Pang, Kang-Mi,Kim, Soung-Min,Myoung, Hoon,Seo, Byoung-Moo,Choi, Jin-Young,Lee, Jong-Ho,Choung, Pill-Hoon,Kim, 대한악안면성형재건외과학회 2008 Maxillofacial Plastic Reconstructive Surgery Vol.30 No.6
Gorham-Stout 증후군은 조직학적으로 양성의 혈관 증식을 보이면서 광범위한 골 용해 현상을 나타내는 희귀한 병으로 알려져 있다. 병인론은 아직 명확히 밝혀져 있지 않으며 주로 남성과 젊은 성인에게서 호발하는 것으로 알려져 있다. 진단에는 컴퓨터 단층촬영, 자기공명영상, 핵의학검사, 혈관조영검사 등의 영상검사가 도움이 되며, 조직학적검사 역시 몇몇 특이 소견을 통해 진단에 도움을 줄 수 있다. 발생하는 부위에 따라서 그 예후는 매우 다르며, 특히 척추나 흉곽에 발생할 경우는 생명을 위협할 수 있다. 저자등은 우측 하악골의 병적 골절을 주소로 내원한 환자에서 임상검사, 방사선학적 검사, 조직병리학적 검사를 통해 Gorham-Stout 증후군으로 진단한 환자를 비골유리피판을 이용한 하악골 재건술을 통해 치료하였고 4년 동안 관찰 기간 중 재발 없이 양호한 치유 경과를 보였기에 문헌고찰과 함께 보고하는 바이다. Gorham-Stout disease is a rare skeletal disease which is progressive and spontaneous and idiopathic resorption of whole body bone. In the initial stage, the osteolytic site is replaced by histologically benign vascular proliferation without new bone formation and finally by dense fibrous tissues. We encountered with a patient involving the mandible with attention by the clinical, radiographic, scintigraphic, angiographic, and computed tomography. We resected the mandibular lesion which was reconstructed with a fibular free flap. We report literature review with a mandibular lesion involved with Gorham-Stout disease.
신정현,박주용,지영민,송인석,방강미,최성원,Shin, Jung-Hyun,Park, Joo-Young,Ji, Young-Min,Song, In-Seok,Pang, Kang-Mi,Choi, Sung-Weon 대한악안면성형재건외과학회 2008 Maxillofacial Plastic Reconstructive Surgery Vol.30 No.6
Running title: A plunging ranula extended into parapharyngeal space Ranulas are lesion of sublingual gland origin, which occur in the floor of the mouth. Most ranulas, whether simple or plunging, are pseudocysts without and epithelial lining and ranulas have higher levels of salivary amylase and protein content. They can be classified into two types based on their extent: simple ranulas, confined to the sublingual space and plunging ranula which extend into adjacent spaces. Plunging ranula requires differential diagnosis with other lesions (neuroma, monomorphic adenoma, hemangioma, lipoma, dermoid cyst, lateral cervical cyst). The patient was diagnosed as plunging ranula. We experienced 17 years old male, visited to our department, who complain Rt. cervical swelling and in MRI view, this lesion involved sublingual, submadibular, parapharyngeal, skull base. We experienced a rare case of plunging ranula, extended into parapharyngeal space. We report the case.