구강악안면외과 영역에서의 MIDFACIAL DEGLOVING APPROACH의 유용성

차인호,윤현중,이의웅,Cha, In-Ho,Yoon, Hyun-Joong,Lee, Eui-Wung 대한악안면성형재건외과학회 1998 Maxillofacial Plastic Reconstructive Surgery Vol.20 No.3

Midfacial degloving approach의 장점으로는 비강, 비중격, 상악동, 사골동, 접형골동, 비인두 부위 병소의 접근에 좋은 시야를 제공하며, 수술방법이 기존의 방법에 비해 수월하고, 두피관상 절개법, 측두부 절개법, 구개부 절개법과 함께 사용하여 수술시야를 넓힐 수 있으며, 안면부에 나타나는 흉터가 없어 심미적으로 만족스러우며 특히, Keloid 체질에서 유용하다는 것을 들 수 있다. 이에 저자 들은 구강악안면외과 영역에서도 중안면부 외상, 두개안면부 기형 처치, 상악골 절제술을 요하는 경우, 상악골과 비골의 동시 수술을 요하는 경우 등에 midfacial degloving approach가 유용한 수술 접근 방법으로 사료되었다. In the treatment of maxillary lesion including a maxillary sinuses, most of oral and maxillofacial surgeons have used the vestibular incision or the Weber-Fergusson incision. However, the vestibular incision has disadvantage which it provides a rather limited exposure and the Weber-Fergusson incision leaves visible scar in the midface. Furthermore, because the scar is confined on unilateral side only, the technique is hesitated to apply especially in children, younger patients and women. Since Casson first introduced midfacial degloving technique, this approach has been used frequently to treat the lesion on nasal cavity, nasopharynx, skull base and paranasal sinuses by ENT surgeons. But, we think this technique can be used usefully in oral and maxillofacial regions. So, we experienced favorable results which it provided a proper exposure, no visible facial scar and it could be used on bilateral midfacial lesions.

동물분변에서 Escherichia coli O157:H7의 분리 및 이들 균이 생산하는 Verotoxin-2의 생물화학적 특성 I. 소와 돼지의 분변에서 E coli O157:H7의 분리 및 Verotoxin-2 생산에 관여하여 파아지의 분리에 관하여

차인호,김용환,Cha, In-ho,Kim, Yong-hwan 대한수의학회 1996 大韓獸醫學會誌 Vol.36 No.2

Three and 2 strains of E coli O157 were isolated from fecal materials of cattle (390) and pigs (420) in Korea, respectively. One strain of O157:H7 isolated from cattle and 2 strains of O157:H7 isolated from pigs were identified as verotoxin-1 (VT-1) produing strains and 2 strains (O157:H7 and O157:H-) isolated from cattle were identified as verotoxin-2 (VT-2) producing strains by neutralization test on HeLa and Vero cells. Culture supernatants of the isolates were cytotoxic to HeLa and Vero cells. The levels of cytotoxin produced by isolates were $10^2{\sim}10^4$ cytotoxic dose($CD_{50}$)/ml. Also, VT-2-converting bacteriophage was isolated from KSC109 strain which had been isolated from cattle. Molecular weight of the phage DNA was determined as approximately 45 Kb in 0.8% agarose gel electrophoresis, and morphology of the phage stained with phosphotungstic acid was observed by transmissible electron microscopy.

동물분변에서 Escherichia coli O157:H7의 분리 및 이들 균이 생산하는 Verotoxin-2의 생물화학적 특성 II. 동물분변에서 분리한 Escherichia coli O157:H7으로부터 Verotoxin-2의 정제 및 특성

차인호,김용환,Cha, In-ho,Kim, Yong-hwan 대한수의학회 1996 大韓獸醫學會誌 Vol.36 No.2

The objects of the present study were to establish the method of purification, subunit dissociation of verotoxin-2 (VT2) produced by Escherichia coli O157:H7, and to investigate the characteristics of purified verotoxin-2 such as molecular weight and composition of amino acid. The results were summerized as follows; Verotoxin-2 was extracted by addition of polymyxin B sulfate into bacterial cell lysate prepared from Escherichia coli O157:H7(KSC109). As an initial step, the bacterial cell lysate was precipitated with 30% saturated ammonium sulfate. The precipitated crude toxin was then subjected to anion-exchange, chromatofocusing and cation-exchange chromatography. Using this scheme, we obtained highly purified toxin with a specific activity of $1.1{\times}10^9$ $CD_{50}/mg$. Sodium dodecyl sulfate-polyacrylamide gel electrophoresis(SDS-PAGE) for purified VT2 showed two protein bands. The upper band, approximately 32 Kd, was supposed as A subunit and the lower band, approximately 7.7 Kd, was supposed as B subunit. When the toxin was separated in the subunit-dissociating solution, two peaks emerged with retention times of 15 and 28 min by HPLC. These peaks represented A subunit and B subunit, respectively. The amino acid composition of purified VT2 were made up in order of glutamic acid, histamine, asparaginic acid, histidine, lysine, alanine and leucine etc. The largest amount among the amino acid composing VT2 was methionine.

구강암 세포주의 이소위 누드마우스 종양 모델

김종현(Jong-Hyun Kim),황영선(Young-Sun Hwang),김현실(Hyun-Sil Kim),남웅(Woong Nam),차인호(In-Ho Cha) 대한구강악안면외과학회 2009 대한구강악안면외과학회지 Vol.35 No.2

In order to make successful oral cancer treatment, we need to understand about tumor biology and effective chemotherapeutic agents. To achieve these studies, it is necessary to develope a proper in-vivo model. Therefore the author will make try to develop more improved animal model of more applicable in various method of cancer study. In this study, the author induced in-vivo tumorigenesis in nude mice by YD-10Bmod cell line used by YD-10B cell line originated from oral tongue squamous cell carcinoma and observed tumor formations and invasiveness of surrounding tissue, and found some results as follows : 1. The experimental group (YD-10Bmod, subcutaneous injection) produced tumors 13 out of 15 mice, while the control group produced none of 5 mice. 2. The inoculation of 1×106cells/mouse produced tumors 3 out of 5 mice and inoculation of 1×107cells/mouse, 2×107cells/mouse produced tumors in every 5 mice. 3. In the histopathologic studies, the inoculation of 1×106cells/mouse group showed the characteristic features of well-differentiated squamous cell carcinoma and demarcated expansile growth, while the inoculation of 1×107cells/mouse, 2×107cells/mouse group showed the expansile growth with partial central necrosis and invasive growth to surrounding fat & connective tissue. These findings suggest that atopic xenograft of YD-10Bmod cell line in nude mice has a improved productivity of tumors, produced tumors showed the characteristics feature of human tumor and invasive growth to surrounding tissue in histopathologic appearance. These atopic nude mouse model of tongue carcinoma might assist in studying oral cancer biology and effective choice of chemotherapeutic agents.

한국인 성인에서 두정골의 부위별 두께에 대한 연구

차인호,김희진,정영수,이충국,정인혁,Cha, In-Ho,Kim, Hee-Jin,Jeong, Young-Soo,Yi, Choong-Kook,Chung, In-Hyuk 대한악안면성형재건외과학회 1998 Maxillofacial Plastic Reconstructive Surgery Vol.20 No.3

To clarify the clinical utility of the calvarial bone graft in the maxillofacial reconstruction, we performed on anatomical study by measuring the regional thickness of the parietal bone on 17 Korean adult dry skulls. Before the sectioning the calvarium, the anatomical landmarks were marked on each specimens. And then we measured the total thickness of the parietal bone, the thickness of the outer and inner cortical plates on various points in each sections of parietal bones using a digital caliper under the stereomicroscope. The total thickness of the parietal bone was ranged from 5.17mm to 7.50mm, and there were no statistical difference in the total thickness of the parietal bone on the same points bilaterally. But there was a tendency that the thickness of the parietal bone was thicker toward to the lambda point than the coronal suture area. At the other hand, the thickness of the outer and inner plate of the parietal bone was the thickest at the first point of the right aspect on the line 1, the first point of the left aspect on the line 5, respectively. In conclusion, this study showed that the donor site of the parietal bone for the maxillofacial reconstruction should be located at more posterior and medial area of the parietal bone than the prevalent known donor site.

절제된 정상위벽의 자기공명영상기법에 관한 연구:조직소견과의 비교

서보경,설혜영,이남준,차인호,정규병,김정혁,박철민,이지영,Seo, Bo-Gyeong,Seol, Hye-Yeong,Lee, Nam-Jun,Cha, In-Ho,Jeong, Gyu-Byeong,Kim, Jeong-Hyeok,Park, Cheol-Min,Lee, Ji-Yeong 대한영상의학회 2001 대한영상의학회지 Vol.45 No.5

목적:급속자기공명영상기법을 이용하여 절제된 정상위벽을 관찰하고,이를 조직소견과 비교 연구하여,위벽의 관찰을 위한 최적기법을 찾고자 하였다. 대상과 방법:25명 환자의 모두 41개 절제된 정상위조직을 수술후 수지(polyethylene)통에 넣고,생리식염수로 채워 자기공명영상을 시행하였다.T1강조FLASH,지방억제T1강조FLASH, T2강조TSE와 True-FISP 등 4가지 기법으로 위조직의 영상을 얻었다.자기공명영상에서는 위벽의 층수와 각층의 신호강도를 관찰하였고,이를 조직소견과 비교하였다.자기공명영상소견을 조직소견과 비교한 후 위벽 각층의 명확성과 각층간의 구분,및 전체 영상의 질에 대하여 비교하였다.4가지 기법 중 가장 좋은 방법은 3,가장 나쁜 방법은 0으로 하여 등급을 판정하였다. 결과:자기공명영상에서 위벽의 층수는 T1강조FLASH에서 2층이 41예 중 6예(14.6%),3층 31예(75.6%),및 4층 4예(9.8%)였고,지방억제T1강조FLASH에서 2층 6예(14.6%)와 3층 35예(85.4%),T2강조TSE에서 3층 24예(58.5%),4층 11예(26.8%),및 5층 6예(14.6%)였으며,True-FISP에서 1층 2예(4.9%),2층 8예(19.5%),3층 23예(56.0%),4층은 4예(9.8%), 및 5층 4예(9.8%)이었다.위벽의 신호강도는 T1강조FLASH와 지방억제T1강조FLASH에서 2층으로 보인 예는 위내강으로부터 고-중등도,3층인 경우는 고-저-고/중등도,4층인 예는 고-저-고-중등도신호강도였다.T2강조TSE에서는 3층으로 보인 예는 등도/고-저-중등도,4 층인 경우는 중등도-저-고-중등도/저,5층인 예는 저-고-저-고-저신호강도였다.자기공명 영상소견을 조직소견과 비교하였을 때 위벽이 3층으로 보인 경우 이것은 “점막층-점막하층-근층 ”에 해당하였다.관찰한 3가지 면 모두에서 T1강조FLASH,지방억제T1강조FLASH,T2강조TSE 기법이 True-FISP보다 통계적으로 유의하게 우수하였다(p=0.001).점막층의 명확성에 있어서 가장 우수한 기법은 T1강조FLASH와 지방억제T1강조FLASH이었고(p<0.05),점막하층의 명확성과 점막하층과 근층간의 구분은 T2강조TSE가 가장 우수하였다(p<0.05).전체적인 영상의 질은 T1강조FLASH와 T2강조TSE에서 가장 우수하였다(p<0.05). 결론:자기공명영상은 위벽의 각 층을 구별할 수 있는 우수한 검사로 조직소견과 높은 연관성을 보이며,전체 영상의 질,점막하층의 명확성 및 점막하층과 근층간의 구분이 T2강조TSE에서 가장 우수한다. Purpose: To evaluate normal human gastric wall layers in vitro using magnetic resonance*(MR) imaging, to correlate the results with the histologic findings, and to determine the optimal technique for evaluation of the gastric wall. Materials and Methods: Forty-one normal resected gastric specimens obtained from 25 patients were dissected and placed in a polyethylene tube filled with normal saline. MR imaging with four MR sequences, T1-weighted FLASH*(T1FLASH), fat-saturated T1-weighted FLASH, T2-weighted TSE*(T2TSE), and True-FISP, was performed. The number of gastric wall layers and signal intensity of each layer were determined, and after correlating MR images with the histologic findings, the conspicuity of each layer*(mucosa, submucosa, and muscle), the distinction between each layer, and overall image quality were assessed. results: The gastric wall was shown by TIFLASH to have two (n=6, 14-6%), three (n=31, 75.6%) and four layers (n=4, 9.8%); by fat-saturated TIFLASH to have two (n=6, 14.6%) and three (n=35, 85.4%) ; by T2TSE to have three (n=24, 58.5%), four (n=11, 26.8%), and five (n=6, 14.6%); and by True-FISP to have one (n=2, 4.9%), two (n=8, 19.5%), three (n=23, 56%), four (n=4, 9.8%), and five (n=4, 9.8%) . The signal intensity of each layer at T1FLASH and fat-saturated T1FLASH was high-intermediate from the lumen in two-layer cases, high-low-high/intermediate in three-layer cases, and high-low-high-intermediate in four-layer cases. The signal intensity of each layer at T2TSE was intermediate/high-low-intermediate in three-layer cases, intermediatelow-high-intermediate/low in four-layer cases, and low-high-low-high-low in five-layer cases. Three-layered gastric wall corresponded mostly to mucosa, submucosa, and muscle from the inner to outer layers, respectively. T1FLASH, fat-saturated T1FLASH, and T2TSE were superior to True-FISP in evaluating the gastric wall. T1FLASH and fat-saturated T1FLASH were the best sequences for demonstrating mucosa (p<0.05), and T2TSE was the best for submucosa and the distinction between this and muscle (p<0.05). Both T1FLASH and T2TSE provided the best overall image quality (p<0.05). Conclusion: In-vitro MR imaging is an excellent technique for the evaluation of layers of normal gastric wall. T2TSE is the sequence which best demonstrates the conspicuity of submucosa, the distinction between submucosa and muscle, and overall image quality.

한국인 정상성인의 하악골 형태에 관한 연구

차인호(In Ho Cha),이충국(Choong Kook Yi),배정수(Jung Soo Bae) 대한구강악안면외과학회 1991 대한구강악안면외과학회지 Vol.17 No.3

Over the 200 years ago, Hunter(1771) recognized that mandibular bone actually grows in a predominantly upward and backward direction toward the base of the skull. Charles(1925) has described the importance of the condyle in the mandibular growth. Most authors agree that the mandibular growth occur predominantly at the condyle(Brodie, 1941, Björk, 1955, Sarnart & Robinson, 1956). But recent theoretical and experimental studies have fundamentally altered our understanding the growth process of the mandible. In opposition to the condyle as a primary site of mandibular growth, Moss (1960, 1968) postulated the functional matrix hypothesis that the mandible is composed of various funtional components, including an alveolar portion, the coronoid process, the gonial region, the condyle area, and corpus portion. Growth of the mandible is the sum of growth of all of its functioal component which has independent growth. He proposed that the relation of funtional components has an invariable ratio. A similar conclusion reached by Precious & Delaire(1987). The aim of this study is to observe the ratio and correlation between the functional components of the mandible in Korean normal adults on the basis of the Moss and Delaire s hypothesis. The author selected 57 females and 60 males who have normal faces in Korean adults. Using the Panoramic X-ray, the author measured the length the condyle, coronoid process, angle portion, corpus portion from lingular and ramal height. The result as follows ; 1. There were significant invariable ratio and correlation between the ratio of length of condyle, coronoid and corpus portion. 2. In both sexes, the absolute length of ramus, condyle, coronoid, angular and corpus were significantly difference. 3. There were correlation in the length of each counterpart between right and left side. 4. The ratio between the length of condyle and coronoid was 1.2302±0.110 in the female group and 1.2277±0.120 in the male group. The ratio between the length of condyle and corpus was 0.5233±0.047 in the female group and 0.5266±0.043 in the male group. The ratio betwen the length of coronoid and corpus was 0.4282±0.044 in the female group and 0.4313±0.039 in the male group.

조명디자인에서 빛의 수직적 요소의 공간접근성

차인호(Cha, In-Ho) 한국실내디자인학회 2015 한국실내디자인학회논문집 Vol.24 No.4

In lighting design and lighting in the light of how the physical space rather than the amount of light metering is implemented in the same space as horizontal illuminance and luminance study of the spatial analysis as a basis for improving the quality of scientific and cognitive aspects analyzed the vertical component of the light. Vertical component of the light and the ability to interpret the information space can be secured more easily sense the brightness of a small area compared to the horizontal components of electrical energy, due to the contrast between the dark and the surrounding induce customers to public facilities or commercial space The pedestrian aids to facilitate the determination of the copper. In addition, to secure the brightness of the overall sense of space allows to have a sense of comfort to lower the tension of the space. The vertical component of light also has a deep relationship to improving the quality of light in electrical energy savings increase the accessibility of space, space, nightscape in the humanities also contribute to environmental and looking for one trillion people in the city in terms of cultural development and identity There.

소타액선에 발생한 다형성선종의 임상 및 병리학적 고찰

백석기(Seok-kee Baik),차인호(In-Ho Cha),김진(Jin Kim),이의웅(Eui-Wung Lee) 대한구강악안면외과학회 2003 대한구강악안면외과학회지 Vol.29 No.2

Pleomorphic adenoma is the most common salivary neoplasm mainly occurring in the major salivary glands - especially in parotid gland, which is characterized by variable histopathologic appearances and high recurrence rate with malignant transformation according to surgical situations. And this benign mixed tumor occurring in minor salivary glands is believed to shows same clinicopathologic appearances and relatively low recurrent rate compared with the case in major salivary glands. But there are few comparative studies of large series of pleomorphic adenoma occurring in minor salivary glands which includes different histopathologic appearance, clinical characteristics, treatment methods, recurrence rate, and malignant transformation. We retrospectively studied the 54 patients who were pathologically confirmed with pleomorphic adenoma occurring in minor salivary glands, and analyzed the clinico-histopathological appearance, surgical methods, recurrent cases. The results obtained are as follows. 1. The incidence of the tumor was most frequent in 4th & 5th decade, and in female. 2. Palate(90%) including hard & soft palate was the most frequent site for pleomorphic adenoma in minor salivary glands. 3. The exact duration could not be known due to asymptomatic slow growth patterns of the tumor. 4. The mean tumor size was 2.3cm. 5. 28 (52%) pleomorphic adenomas were classified as Cellular type (cell-rich), 17 (31%) specimen as Intermediate type(equal cell to stroma ratio), and 9 (17%) as Myxoid type(stroma-rich). 6. Surgically 51 cases (94%) were showed well-encapsulated tumors, but histopathologically only 34 specimen (63%) were wellencapsulated. Therefore pleomorphic adenomas in minor salivary glands also have to be excised more widely, not enucleated. And in case of suspicious malignancy or large tumor, preoperative incisional biopsy can be applied in the center of the tumor for prevention of rupture of tumor cell, and total excision with use of frozen biopsy for detection of malignancy and confirming the excision margin, and closed follow-up according to final histopathologic results is recommended.

구강암 경부임파절 전이에 대한 술전 평가의 정확성

이재준(Jae-Jun Lee),남웅(Woong Nam),차인호(In-Ho Cha) 대한구강악안면외과학회 2006 대한구강악안면외과학회지 Vol.32 No.2

Purpose : The aim of this study was to determine the accuracy of clinical and radiologic assessments in detecting positive cervical lymph nodes in oral cancer. Materials and Methods : We had reviewed the preoperative clinical, radiologic and postoperative histopathologic reports of 46 patients who had been diagnosed as oral cancer and underwent surgical excision combined with neck dissection (52 sides of neck) in the Department of Oral and Maxillofacial Surgery, College of Dentistry, Yonsei University from the July 1, 1992 to the April 30, 1999. Results : The results were as follows 1. The male to female ratio was 4.38 : 1 and the mean age was 57. 2. Sensitivity values for the preoperative assessment of cervical lymph node metastasis in oral cancer were 62.5 % in clinical examination and 50.0% in radiologic assessments. Specificity values were 77.8 % in clinical examination and 94.4 % in radiologic assessments. 3. False positive values were 44.4 % in clinical examination and 20.0 % in radiologic assessments. False negative values were 17.6 % in clinical and 19.0% in radiologic assessments. 4. Overall efficiency values were 73.1 % in clinical examination and 80.8 % in radiologic assessments. Summary : There were some limits on the accuracy of clinical and radiologic assessments in the preoperative detection of the cervical lymph nodes in oral cancer. To improve the accuracy, it is important to communicate between clinician and radiologist, and adjunctive diagnostic measures, ultrasound and fine needle aspiration cytology, were helpful increasing the overall efficiency. In the high risk sites (oral tongue and floor of the mouth) the false negative value is higher and the overall efficiency in radiologic evaluation is lower than those of the low risk sites (gingiva and alveolar ridge, retromolar trigone and buccal mucosa ). The elective neck dissection should be considered in the high risk sites.