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하악골 절제술후 재이식된 돌결자가골 재이식 : 치험 3례
김 식,김수관,김운규,김수민,류종희,이준길,조경안,김수흥,정태영,여환호 대한악안면성형재건외과학회 2001 Maxillofacial Plastic Reconstructive Surgery Vol.23 No.2
We described three cases of immediate reimplantation of a frozen-thawed autogenous mandible composed of a mixture of iliac bone, marrow, and particulate hydroxyapatite in tumors of the mandible. Acceptable outcomes were obtained in three patients who underwent immediate autogenous mandibular graft reconstruction. The conditions leading to successful outcome of the procedure are also discussed. Reimplantation of frozen autogenous lesioned mandible was performed in three patients with mandibular tumors. Two reimplanted grafts survived without complications following surgery. One case had postoperative infection that resolved with appropriate antibiotic treatment. There were no recurrences of the primary lesions. Satisfactory facial contour after surgery was achieved. These results are most promising, and we believe that, with further refinement, this technique will offer a new and acceptable modality for facial reconstruction in patients with cancer.
김상렬,김수관,여환호 대한악안면성형재건외과학회 2000 Maxillofacial Plastic Reconstructive Surgery Vol.22 No.4
The purpose of this retrospective study is to investigate the effects of conscious sedation in an outpatient setting. Data from 292 patients (154 males, 138 females), sedated for minor oral surgery, were studied using various parameters including age and sex distribution, as well as according to procedures and each drug group. Results show that this intravenous conscious sedation technique is a safe and effective method of controlling behaviour, but one has to be prepared to deal with any emergencies or complications. The specific results are as follows : 1.Most procedures (265/292) were used to Valium mixed with Demerol and Midazolam mixed with Demerol. 2.Valium revealed a high incidence of pain upon injection and symptoms limited to daily activity and thrombophlebitis. 3.Nausea and vomiting manifested in the procedure using Demerol. 4.The patient manifested comfort similar in response to the same drugs used in another treatment.
상악골에서 IMPLANT 매식을 위한 치조제 확대 골절단술
김수관,김영균,여환호,이기혁 大韓顎顔面成形再建外科學會 1997 Maxillofacial Plastic Reconstructive Surgery Vol.19 No.2
Ridge expansion osteotomy(REO) technique is a simple and more conservation method to widen a narrow alveolar ridge in the maxilla. This method is superior to drilling method in soft and narrow maxillary alveolar ridge and allows the surgeon to widen the ridge in routine office procedure. Therefore, it is the treatment of choice to implant the maxilla with narrow alveolar ridge. This article presents clinical cases and discusses the advantages, rationale and surgical protocol of REO technique.
구강점막섬유화에 의한 개구제한 : 증례보고 A CASE REPORT
김 훈,김수관,하정완 大韓顎顔面成形再建外科學會 2003 Maxillofacial Plastic Reconstructive Surgery Vol.25 No.2
Oral submucous Fibrosis(OSF) is an insidious chronic disease affecting the mucosa of the oral cavity and occasionally extending into the pharynx and esophagus. It is associated with a genetic predisposition and alterations, infectious and viral agents, carcinogens, nutritional and immunological factors. the etiology is obscure but it is correlated with a hypersensitivity to capsaicin, secondary to chronic iron and/ or vitamin B complex deficiencies or exposure to cashew kernel oil. We report a patient who had a month opening limitation caused by a fall when he was 8 years old despite several treatments at other hospitals. Excellent results were obstained by releasing the scar tissue using a standard split-thickness skin graft(STSG) which obtained from the thigh. It is important to recognize as a precancerous condition and to inspect the excision site and the remaining oral mucosa during long-term follow-up on a regular basis.
상악동에 발생한 낭종과 술후낭종에 대한 임상병리학적 연구
김수관,박정열,강태호,장현선 대한악안면성형재건외과학회 2000 Maxillofacial Plastic Reconstructive Surgery Vol.22 No.5
The purpose of this study is to evaluate the frequency of cysts and postoperative cyst in maxillary sinus and compare between cysts and postoperative cyst in maxillary sinus. Of 3,218 biopsy cases, 23 cases of cysts and 9 cases of postoperative cyst in maxillary sinus were found. Males were affected significantly more than females. The age distribution of the 23 patients was in a range of 13 to 76 years. Most of them were in the second and third decades. The postoperative maxillary cyst was occurred most frequently during ten years after Caldwell-Luc operation. Females were affected more than males. The age distribution of 9 patients was in a range of 29 to 64 years. Most of them were in the 6th decade. The most common symptoms were pain and swelling, and the sites were the molar area and vestibule of the maxilla. Radiographically, the lesions occurred most frequently unilateral radiopaque. The cysts were treated surgically in all cases. The literatures were reviewed regarding etiology, frequency, and radiologic and microscopic findings of those cysts.
김운규,김수관 대한악안면성형재건외과학회 2000 Maxillofacial Plastic Reconstructive Surgery Vol.22 No.6
Pilomatricoma or calcifying epithelialioma of Malherbe is an uncommon, benign growth with origination from the epithelial hair matrix or a skin appendage manifestating as a firm, solitary or multiple lesion of face and upper extremity. It generally measures several mm to cm in diameter and typically found in young people. We report a 14-year-old male who developed solitary mass on the left buccal cheek. The size of tumor was 4.5 by 3.5cm. Microscopically, the histologic appearance showed demarcated tumor lobules with thin fibrous capsule composed of eosinophilic shadow cells, basaloid cells and partial calcified area. We described unusual case of giant pilomatricoma and the typical features, variants, histopathogenesis, differential diagnosis, and therapy are reivewed
김미성,남옥현,김수관,조세인 대한악안면성형재건외과학회 2002 Maxillofacial Plastic Reconstructive Surgery Vol.24 No.4
This is a clinico-statistical study of 532 oral and maxillofacial infected patients who were treated at Chosun University Dental Hospital during the period 1996-2001. The following results were obtained. The ratio of male to female ratio was 0.85:1. The highest monthly incidence was shown in June (10.15%) and July (9.77%), and the age distribution peaked in the 60s (15.60%), followed by 50s (14.29%) and 40s (13.53%). The most frequent cause was dental caries (43.05%), periapical abscess (13.72%), periodontal lesion (8.83%), and pericoronitis (8.27%). In terms of the delay time between onset of symptoms and visit, the highest incidence (56.20%) occurred at 1-3 days. In terms of the length of treatment, the highest incidence (36.65%) occurred at 7-9 days. Underlying medical problems were found in 161 patients, the most common being hypertension (27.33%) and diabetes (26.71%). The most common facial space involved was the buccal space (34.85%), followed by the submandiblular space (29.30%), canine space (17.17%), submental space (6.23%), and sublingual space (3.87%). In respect of antibiotics therapy, penicillin, aminoglycoside and metronidazole complex were most prevalent.
Medpor 매식후 치유과정에 Methylprednisolone이 미치는 영향
김수관,정성수 전남대학교 치과대학 1999 전남치대논문집 Vol.11 No.1
The purpose of this study is to evaluate the effect of methylprednisolone on the healing process and the effect on the contact surface of Medpor?? and bone after administering the methylprednisolone, and also the effect on the elapse of time in healing and on thickness after implantation of Medpor??. In this study, the middle part of the rat skull was exposed and Medpor?? was placed under the periosteum; the diameter : 8 mm, thickness : 1.5 mm (thin) and 4.5 mm (thick). Then coverage of the periosteum was performed. After the administeration of methylprednisolone, the light microscopic and scanning electron microscopic examinations and hardness measurements were performed after 2-, 4-, 8-weeks implantation. The results of this study were obtained as follows : 1. The inflammatory responses of the control group and the experimental group were reduced over time, especially of the experimental group. They almost disappeared at 8 weeks after surgery. 2. In light microscopic examination, 1.5 mm implants responded better than 4.5 mm and osteoid formation showed a slightly at 4 weeks after surgery. It showed increased findings at 8 weeks after surgery and the experimental group showed slightly decreased findings compared to the control group. 3. In scanning electron microscopic examination, a large number of osteoblasts came up through the observation, inflammatory reactions disappeared faster in the experimental group than the control group. The arrangement and the amount of deposition of bone matrix over time in the experimental group was more irregular and reduced than in the control group. These findings were more remarkable in 4.5 mm than in 1.5 mm. The fibrous connective tissue was shown in the thicker implant rather than the bony tissue. 4. In hardness measurement, bone adjacent to Medpor?? showed a statistical difference in the hardness depending on the time, the thickness, and the use of methylprednisolone : Hardness was decreased over time and in the thicker implant, and the use of methylprednisolone (P<0.001). It is concluded that the methylprednisolone is considered to suppress the inflammatory reaction, however, it could delay the wound healing because of the inhibition of osteoblastic activity. So, the use of methylprednisolone should be restricted except serious inflammatory response after the operation.
치아회분-석고 혼합제와 생흡수성 차단막을 이용한 임플란트 주변 결손부 수복의 조직학적 평가
김영균,김수관 대한악안면성형재건외과학회 2002 Maxillofacial Plastic Reconstructive Surgery Vol.24 No.1
This study evaluated whether a particulate dentin-plaster of paris combination (PDPP) and bioresorbable membrane could be used to induce new bone to cover the partially exposed surface of titanium endosseous implants. Twelve AVANA (SooMin Synthesis Dental Materials Co., Korea) dental implants were placed in the ilium of mongrel dog. All implants were self-tapping screw implants, 10㎜ long and 4㎜ in diameter. A circumferential bony defect around the implant was made with surgical bur and the cervical 1/3 of the implant surface was exposed. Six implants were used as controls and the rest were covered with particulate dentin-plaster of Paris combination and Biomesh bioresorbable membrane (Samyang, Korea). The dogs were killed at 6 and 12 weeks. The defects treated with PDPP and Biomesh membrane were filled with newly formed bone and direct bone contact with the implant surface developed. Most of PDPP material was resorbed after 12 weeks. In histomorphometric study, there was a statistically significant difference in bone contact between two groups in 6 weeks (P < 0.05). This study showed that guided bony regeneration using PDPP and bioresorbable membrane induces new bone to form over the exposed portion of an implant.
김영균,이기혁,여환호,김수관,박노승 大韓顎顔面成形再建外科學會 1996 Maxillofacial Plastic Reconstructive Surgery Vol.18 No.4
The coronal approach is a versatile surgical technique. This methos becomes particulary useful for exposure and internal fixation of midfacial fractures and the harvest of calvarial bone graft to manage the complex facial bone fractures. The rectrospective clinical study on the use of this technique in 10 patients was performes. The result shows that this technique provides the excellent exposure of fractures site, the ability to reduce the fragment accurately and good cosmetic results in incision area. We discussed with literatures review that anatomy, technique, indications, and potential complications of the coronal approach.