과도한 출혈을 동반한 다발성 안면부 외상 환자의 치험례

오성섭,유대진,김일규,최진호,김형돈,오남식,황홍준,Oh, Seong-Seob,Yoo, Dae-Jin,Kim, Il-Kyu,Choi, Jin-Ho,Kim, Hyung-Don,Oh, Nam-Sig,Hwang, Hong-Jun 대한악안면성형재건외과학회 1999 Maxillofacial Plastic Reconstructive Surgery Vol.21 No.1

Multiple facial trauma patient should be carefully treated because of severe bleeding on extraoral and intraoral wound, possibilty of airway obstruction and hypovolemic shock. Hypovolemic shock may be divided to hemorrhagic shock and non-hemorrhagic shock. Also hemorrhagic shock is divided to mild, moderate and severe shock according to the degree of blood volume depletion. Mild shock occurs in blood loss of less than 20% of blood volume and moderate shock does in blood loss of 20-40% of blood volume. And Severe shock occurs in blood loss of more than 40% of blood volume. The goal of emergency care of trauma patient is that respiration and perfusion should be recovered to satisfactory level and that normal vital sign is maintained. We reported the case of multiple facial trauma patient with severe bleeding and hopovolemic shock and metabolic acidosis who was treated with adequate supply of fluid transfusion, intubation, tracheostomy and emergency operation.

신체 타부위 손상을 동반한 악안면골 골절환자의 손상중증도 평점(Injury Severity Score)에 관한 임상적 연구

오성섭(Seong Seob Oh),이의웅(Eui Wung Lee) 대한구강악안면외과학회 1987 대한구강악안면외과학회지 Vol.13 No.2

This is a retrospective study about ISS (Injury Severity Score) of facial bone fractures with multiple injuries on other sites. The study was based on a series of 416 patients with facial bone fractures treated as patients at Severance Hospital and Won Joo Christian Hospital during the period of Jan., 1981 through Dec., 1986. The results were obtained as follows: 1. The most common location was head and neck (57%) among multiple injuries with facial bone fracture. The extremities (27%), chest (9%), abdomen (7%) were then next in order of frequency. 2. Mandible fracture was predominent as 39% and there were also zygoma fracture (25%), Le Fort Ⅱ fracture (24%), Le Fort Ⅲ fracture (12%). 3. In Dept. of first admission, Neurosurgery was predominant as 73% and Orthopedic Surgery (10%), Oral Surgery (6%), others in order. 4. The mean Injury Severity Score was 24 in survival patients and 38 in died patients, but there were variable changes on minimum and maximum score. 5. The most common causes of death were intracranial injury (60%) hypovolemic shock (12.5%), sepsis (12.5%), pneumothorax (6%) respectively. 6. Emergency operation was carried in 60 patients (14%) for facial bone fractures. 7. The ratio of male to female was 4.1: 1, and 3rd decade (37%) was the highest age group in incidence.

악안면 근막극감염의 임상적 고찰

오성섭(Seong-Seob Oh),박은진(Eun-Jin Park),김일규(In-Kyu Kim),김형돈(Hyung-Don Kim),최진호(Jin-Ho Choi),오남식(Nam-Sik Oh) 대한치과의사협회 2000 대한치과의사협회지 Vol.38 No.1

한국인 구강 편평세포암종에서의 Ha-ras gene의 점돌연변이(point mutation)에 관한 연구

오성섭(Seong Seob Oh),이의웅(Eui Wung Lee) 대한구강악안면외과학회 1994 대한구강악안면외과학회지 Vol.20 No.3

The possible causes of oral squamous cell carcinoma include smoking, alcohol, viruses and chemicals. About 24 oncogenes involving the Ha-ras gene are known to be related to human and animal cancer. The ras gene point mutation varies among different tumors; for examples, Ha-ras gene is more frequent in human bladder carcinomas, Ki-ras gene is more frequent in lung and colon carcinomas, and N-ras gene in hematological tumors. The Ha-ras gene point mutation of oral SCC(squamous cell carcinoma) is variant from the race and geography, it appears to be frequent(about 35%) in Indian, but appears to be rare(about 3%) in Western. This study was undertaken to investigate the rate of Ha-ras gene point mutation of the oral SCC in Korean. DNA extraction, PCR and SSCP, DNA sequencing of Ha-ras gene were done, and the point mutation was searched in the formaline fixed, paraffin-embeded tissues of the oral SCC from the 39 Korean patients (M:29, F:10). Results were as follows: 1. The exon 1 of Ha-ras gene of 39 oral SCC was found in the 3 types(A, B, Ctypes) of band shift in the SSCP. 2. Each SSCP type A & B (37cases) of exon 1 has a normal DNA sequence, and no point mutation was detected. 3. Confirmation of SSCP type C of exon 1 was not possible presumably because of the artifact associated with DNA template purities. 4. The exon 2 of the Ha-ras gene in 39 ora SCC was found as a regular type of band shift in SSCP universally. From these results, the point mutation of the Ha-ras gene of oral SCC in Korean proved to be rare, and other oncogenes than the Ha-ras gene may be related to carcinogenesis of oral SCC. Verifying the other oncogenes thought to be quite helpful in the treatment, prediagnosis, carcinogenesis of oral cancer.

치아 기준의 악교정 수술용 석고모형 수술, 과연 가능하고 정확한가

이승훈,오성섭,이충국,박경란,이상휘,Lee, Seung-Hoon,Oh, Seong-Seob,Yi, Choong-Kook,Park, Kyung-Ran,Lee, Sang-Hwy 대한악안면성형재건외과학회 2011 Maxillofacial Plastic Reconstructive Surgery Vol.33 No.2

Purpose: Errors in orthognathic model surgery occur during the planning, measuring and/or moving of the models. However, there has been little effort to find ways to reduce these errors. In this study, we introduce a new orthognathic model surgery technique (Yonsei method) which adopts the tooth point as the reference and the occlusal index as a moving vehicle for the model. Methods: The technique consists mainly of: 1) measuring the three-dimensional lengths of model points, 2) fabricating and moving the occlusal index and 3) verifying the movement. Then we compared the accuracy of the Yonsei method to conventional methods, with special reference made to influencing factors. Results: Errors for the Yonsei method with the occlusal index were reduced to the range of 0.61~1.04 mm in three-dimension, providing a more accurate model surgery technique than conventional methods which have errors ranging from 0.77~3.11 mm. Conclusion: It provided us a more accurate model surgery technique based on the reference points onto the teeth and the use of occlusal index.

A Clinical Study of the Severe Degenerative Diseases of Temporomandibular Joint

김일규,오성섭,최진호,김형돈,오남식,Kim, Il-Kyu,Oh, Seong-Seob,Choi, Jin-Ho,Kim, Hyung-Don,Oh, Nam-Sig Korean Association of Maxillofacial Plastic and Re 1999 Maxillofacial Plastic Reconstructive Surgery Vol.21 No.3

저자등은 1996년 5월 부터 1999년 4월까지 인하대병원 치과에 악관절 질환을 주소로 내원한 958명의 환자 중 병력, 임상소견, 방사선학적 검사 결과 퇴행성 악관절 질환으로 진단된 68명에서 병록지 상에 기록된 환자의 성별, 나이, 주소, 병력, 현증상, 방사선학적 소견 및 치료방법 등에 관해 검사 후 다음과 같은 결론을 얻었다. 1. 남녀 발병 비율은 1:2로 여성에서 높았다. 2. 발병나이는 20대, 30대. 40대, 10대 순이었다. 3. 병력기간은 2년이상, 6개월이하, 1 - 2년 순이었다. 4. 전 환자에서 악관절 동통을, 44명의 환자에서 관절잡음을, 26명의 환자에서 개구제한을 호소하였다. 5. 그밖에 26명의 환자에서 관절부위에 민감성을, 5명의 환자에서 안면 비대칭을, 또한 개교합, 섬유성 악관절강직의 소견이 각각 2명의 환자에서, 양측성질환의 소견이 4명의 환자에서 관찰되었다. 6. 방사선학적 소견상, 15명 환자의 과두부에서 증식성 재성형소견(progressive remodeling)이, 51명의 환자에서 침식성 재성형소견(regressive or erosive remodeling)이 관찰되었으며, 침식성 재성형 환자 중 11명에서 과두주변부 증식성 재성형소견(peripheral remodeling or marginal lipping)이 관찰되었다. 7. 골증식체(osteophyte) 및 소성체(loose body)의 소견이 각각 2명의 환자에서 관찰되었다. 8. 약물에 의한 보존적 치료방법이 1차로 모든 환자에서 시행되었으며, 이중 12명의 환자는 교합안정장치를 병행하여 치료하였다. 9. 관절강내 스테로이드 주사요법에 의한 치료환자가 2명, 관절원판절제술 및 이개연골 이식술을 동반한 악관절성형술 환자가 각각 1명 및 2명이었다.

함치성 낭종과 연관된 다방성의 낭종성 법랑아세포종

이재휘,오성섭,Lee, Jae-Hwy,Oh, Seong-Seob 대한악안면성형재건외과학회 1992 Maxillofacial Plastic Reconstructive Surgery Vol.14 No.1

저자는 31세 여자환자의 좌측하악부에서 매복된 제3대구치 주위의 함치성 낭종에서 기원한 Group 3a type의 다방성의 낭종성 법랑아세포종을 경험하여 병소에 포함된 치아 발거슬 및 enucleation/curettage로 현재까지 재발없이 치유되었기에 병리조직학적 소견을 중심으로 문헌고찰과 함께 보고하는 바이다. Ameloblastoma is an aggressive but benign epithelial neoplasm of odontogenic origin, and the occurrence of odontogenic epithelium in the wall of a dentigerous cyst is well-known entity. The presence of ameloblastic proliferation in the walls of odontogenic cysts has been reported for many years. Cahn in 1933 described a case in which he considered an ameloblastoma to have originated in a dentigerous cyst, and numerous other cases of ameloblastomatous proliferation have since been reported. In 1977, Robinson and Martinez described a distinct variant of ameloblastoma in which the response to curettage was found to be favorable with a recurrence rate of 25%. The gross and microscopic features indicated that this variant vas associated with a large cystic cavity with either luminal or mural proliferation of ameloblastic tumor cells, and they referred to this variant as unicystic ameloblastoma. Unicystic ameloblastoma occurs most commonly in the second and third decades of life, which is considerably younger than the average age of discovery for the classical ameloblastoma. For the accurate histopathological diagnosis of the unicystic ameloblastoma, the specimen obtained the excisional biopsy, complete enucleation or incisional biopsy from the multiple site of the lesion. This article provides histopathologic evidence of multilocular unicystic ameloblastoma in which ameloblastic tissue was associated with a dentigerous cyst that was found in a 31-year-old female, and complete radiographic, photographic, and microscopic documentation is presented.

악하선 절제 환자에 대한 임상적 연구

노상엽,김일규,오성섭,최진호,전혜경,김준미,Noh, Sang-Yup,Kim, Il-Kyu,Oh, Seong-Seob,Choi, Jin-Ho,Chun, Hye-Kyung,Kim, Joon-Mee 대한악안면성형재건외과학회 1997 Maxillofacial Plastic Reconstructive Surgery Vol.19 No.1

The submandibular gland is one of the major salivary glands, salivary diseases frequently occuring site due to its anatomical weakness. This retrospective study evaluated data pertaining to history, sex, operation method, age distribution, diagnosis through the chart, operation record, radiographs, histologic finding of 51 patients operated on for the submandibular gland excision from 1986 to 1995 in our hospital so that we improve on the understand of the salivary gland diseases. The results were as follows ; 1. The chief complaints was mass, swelling mainly. 2. The ratio of affected site was 47.1 : 51 in left : right respectly, both sites was 1 case especially. 3. The ratio of men to women was 56.9 : 43.1 4. The operation performed all through the extraoral approach. 5. The sialolith presented at 24 cases. 6. The most patients had a two weeks duration period. 7. The age distribution was the third decade(29.4%), the second decade(27.5%) in order. 8. The symptoms accompanied the chief complaints was pain(37.3%), mass(17.6%), swelling(13.7%), trismus(13.7%) in order. 9. The diagnosis was sialadenitis with stone(S.W.S.) (45.1%), sialadenitis without stone(S.W.O.S.) (17.6%), pleomorphic adenoma(P.A.) (15.7%), abscess(Abs) (5.9%), tuberculosis(Tbc) (5.9%) in drder.

악골 낭종에 대한 임상적 연구

차상권,김일규,오성섭,최진호,오남식,임영일,김광식,허지영,Cha, Sang-Kweon,Kim, Il-Kyu,Oh, Seong-Seob,Choi, Jin-Ho,Oh, Nam-Sik,Lim, Young-Il,Kim, Wang-Sik,Heo, Ji-Young 대한구강악안면외과학회 2001 대한구강악안면외과학회지 Vol.27 No.2

Cystic lesion of the jaw are frequently encountered clinically. Although they rarely lead to development of tumors, they can result in resorption of the jaw bone or asymmetry of the face may occur. The purpose of this study is to find the clinical and histopathological pattern of cysts and to help better understanding for the diagnosis and treatment of jaw cysts. The hospital chart, out-patient chart, panorama X-ray, histopathological report and operation report of 246 patients were reviewed who had been diagnosed as cyst. Sex distribution, age distribution, classification, anatomic distribution, clinical sign & symptoms, treatment, post-operation complications, recurrence rate were studied. Then significant difference between the diameter of cyst with bone graft and none-bone graft was calculated with SAS program. The results were as follows. 1. Among the total patient of 246 cases, male were 163 case(67.0%), and female were 83 case(37.0%), male predominated by the ratio of 1.98. 2. By age group, the 20's accounted for the largest proportion of the cases(27.2%) and the 30' accounted for the 2nd largest proportion of the case(19.5%). 3. Radicular cyst and dentigerous cyst were most common cysts, irrespective of 166 case(67.5%) and 62 case(25.2%). 4. Clinical sign & symptoms were swelling(167case), pain(85case), pus discharge(53case), teeth discoloration(28case), indicating that most complaints were related to inflammation and facial asymmetry. 4.9% of the total cases were discovered accidentally. 5. The primary site of cysts were maxillary anterior area(43.9%), the others were, in descending order, mandibular posterior area(25.6%), maxillary posterior area(14.6%). 6. Enucleation with endodontic treatment was a main treatment method(133 case, 54.1%) and 38 cases(15.4%) were enucleation with extraction, and 37 cases(15.0%) were only enucleation, and 21 cases(8.5%) were enucleation with bone graft. 7. The average diameter of cysts with bone graft was significally greater than with non-bone graft(p<0.05). 8. Post-operation complications occurred in 10 case(4.1%), all of this were due to secondary infection.

설하선에 발생한 다발성 타석증 : 증례보고

최진호,김일규,오성섭,오남식,윤승환,Choi, Jin-Ho,Kim, Il-Kyu,Oh, Seong-Seob,Oh, Nam-Sik,Yoon, Seung-Hwan 대한악안면성형재건외과학회 1999 Maxillofacial Plastic Reconstructive Surgery Vol.21 No.2

Sialolithiasis is relatively common disease of the salivary gland in the field of Oral & Maxillofacial surgery. Obstruction of salivary secretion by a sialolith can result in swelling and pain, as well as infection of the gland. The swelling is usually correlated to meals, when salivary secretion is enhanced. Sialolithiasis occurs mainly in the submandibular gland(92%) and to a lesser degree in the parotid gland(6%). The sublingual gland and the minor salivary gland are rarely affected(2%). This is a report of rare case, the authors have experienced, within the left sublingual gland and the minor salivary glands. It is multiple sialolithiasis(about 22 silaoliths) in the sublingual and the minor salivary glands which has very low incidence of sialolithiasis. The pathosis were removed using transoral sialolithotomy with sublingual sialadenectomy.