• Title/Summary/Keyword: 구강외과

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CORRELATION BETWEEN P53, PCNA AND KI-67 EXPRESSION IN HEAD NECK SQUAMOUS CELL CARCINOMA (두경부 편평상피세포암의 p53단백과 PCNA 및 Ki-67의 발현양상)

  • Lee, Eun-Jin;Lee, Sang-Han;Sohn, Yoon-Kyung
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.27 no.2
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    • pp.142-149
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    • 2001
  • To investigate the correlation between the clinical features and the expression of p53, PCNA, and Ki-67 of the head neck squamous cell carcinoma, immunohistochemicalstaining of p53, PCNA, and Ki-67 on the paraffin embedded tissue blocks of 116 surgically removed specimens were done. The staining intensity was divided as grade 1 to grade 3 and the results were statistically analysed. 1. The positive reation rates of cell proliferation markers (PCNA and Ki-67) were higher than that of p53. There was significant correlations of the PCNA and Ki-67 expression but there was no significant correlations between p53 and PCNA or p53 and Ki-67. 2. There were no significant correlation between the expression of p53, PCNA and Ki-67 and tumor site or tumor size. 3. There was no significant differences in the positive response according to the nodal status. The node metastasis groups revealed that higher proportion of grade 3 staining of PCNA and Ki-67 than node negative group. From the above results it is concluded that p53 and cell proliferation markers PCNA and Ki-67 might have their unique mechanism involving in the growing and progression of tumor. Overexpression of p53 does not appear to represent an independent prognostic marker in head neck squamous cell carcinoma.

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ACCURACY TESTS OF 3D RAPID PROTOTYPING (RP) MEDICAL MODELS: ITS POTENTIAL AND CLINICAL APPLICATIONS (Rapid Prototyping으로 제작한 3D Medical Model의 오차 측정에 관한 연구 (임상 적용 가능성 및 사례))

  • Choi, Jin-Young;Choi, Jung-Ho;Kim, Nam-Kuk;Lee, Jong-Ki;Kim, Myeng-Ki;Kim, Myung-Jin;Kim, Yeong-Ho
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.25 no.4
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    • pp.295-303
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    • 1999
  • Presented in this paper are the experimental results that measure rapid prototyping (RP) errors in 3D medical models. We identified various factors that can cause dimensional errors when producing RP models, specifically in maxillofacial areas. For the experiment, we used a human dry skull. A number of linear measurements based on landmarks were first obtained on the skull. This was followed by CT scanning, 3D model reconstruction, and RP model fabrication. The landmarks were measured again on both the reconstructed models and the physical RP models, and these were compared with those on dry skull. We focused on major sources of errors, such as CT scanning, conversion from CT data to STL models, and RP model fabrication. The results show that the overall error from skull to RP is $0.64{\times}0.36mm(0.71{\times}0.66%)$ in absolute value. This indicates that the RP technology can be acceptable in the real clinical applications. A clinical case that has applied RP models successfully for treatment planning and surgical rehearsal is presented. Although the use of RP models is rare in the medical area yet, we believe RP is promising in that it has a great potential in developing new tools which can aid diagnosis, treatment planning, surgical rehearsal, education, and so on.

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ANALYSIS OF MINOCYCLINE IN TISSUE AND SERUM AFTER LOCAL APPLICATION OF MINOCYCLINE OINTMENT (by High-Performance Liquid Chromatography) (미노싸이클린 연고의 근육 내 투여 후 조직 및 혈중 약물농도의 분석 (High-Performance Liquid Chromatography를 이용하여))

  • Hwang, Hye-Wook;Lee, Sang-Chull;Kim, Sung-Jin
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.25 no.4
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    • pp.304-310
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    • 1999
  • This study was designed to find the effect of Minocycline loaded microcapsule applied locally to tissue by measuring drug concentration in tissue and serum by HPLC and to achieve optimal drug delivery system and duration to a specific target site. Control group were administrated minocycline intramuscularly twice a day with $0.2{\mu}g/100g$ for 1 to 10 days. In experimental group, surgical wound was created on Rt. cheek and then minocycline loaded microcapsule was applied into the space between superficial and deep layer of masseter muscle. Animals were sacrificed at 1, 3, 5, 7, 10 days after initial administration, blood was obtained from heart and right masseter muscle was excised. Blood sample was centrifuged at 3000rpm for 15min. Tissue sample was homogenized, left at room temperature for 48hr and centrifuged at 4000g for 5min. Supernatant was completely dried and dissolved in distilled water. Analysis was conducted using a ${\mu}Bondapack$ C18 column. The mobile phase was 0.2M Ammonium Oxalate/0.1M EDTA/DMF=11/4/5 solution, which was injected into the column and detected with photodiode detector at 344nm wavelength. The results were as follows : 1. This method was reliable, could be replicated and suitable for minocycline analysis in tissue as well as serum. 2. In tissue, concentration of minocycline of experimental group was higher than that of control group for 5days. 3. Except 1 day, concentration of minocycline in serum of experimental group was lower than that of control group. 4. Concentration of minocycline in tissue was much higher than that in serum. From these results, minocycline loaded microcapsule might be effective tool for local drug delivery system might be useful for treatment of infections of oral and maxillofacial region and management of infected surgical wound, minimizing systemic effects.

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A CLINICAL STUDY ON PULMONARY FUNCTION AFTER INTERMAXILLARY FIXATION (악간고정이 호흡기능에 미치는 영향에 대한 임상적 연구)

  • Kim, Chul-Hwan;Kim, Mi-Suk
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.25 no.4
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    • pp.361-366
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    • 1999
  • Intermaxillary fixation is routine procedure to oral and maxillofacial area in jaw bone fracture, surgical correction of jaw deformity, osseus reconstruction of jaw. After transoral surgery, accompanied by intermaxillary fixation, dysphagia or airway obstruction may be followed due to blood clot, vomitus, or laryngeal spasm resulting from irritation by blood or secretions. Lingual or pharyngeal edema is other contributing factors of airway obstruction. In addition, intermaxillary fixation itself may cause obstruction of airway. In this study, pulmonary function test and arterial blood gas analysis were evaluated before and after intermaxillary fixation in 30 patients suffered from mandibular fractures. Comparative analysis was performed by estimated values. The results were as followed. 1. The spirometric values of FEV1, FEV1/FVC and FEF25-75% without intermaxillary fixation were reduced from 97.57%, 85.1%, 98.3,% to 71.7%, 66.5%, 61.2% with intermaxillary fixation, indicating the presence of obstructive pulmonary impairment. 2. Spirometric value of MVV, as the most influencing value of sensitive to extrapulmonary factors, was changed from 84.5% to 46.48%. 3. After intermaxillary fixation, the spirometric value of FVC, as indicator of restrictive pattern of pulmonary function, was not reduced significantly as measured from 94.47% to 89.97%. 4. $O_2$ saturation of arterial blood gas analysis without intermaxillary fixation was 97.86%. While intermaxillary fixation, $O_2$ saturation was 97.47%. The results indicate that careful airway management is mandatory undergoing intermaxillary fixation of various oral and maxillofacial surgery.

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EXPRESSION OF OSTEONECTIN IN DEVELOPING TOOTH GERM AND ODONTOGENIC TUMORS (발생 치배와 치성 종양에서 Osteonectin발현에 관한 연구)

  • Jeen, Goog-Beum;Kim, Soo-Nam;Kim, Eun-Cheol
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.25 no.4
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    • pp.311-323
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    • 1999
  • The osteonectin is a sort of glycoprotein which is secreted in human tissues. The osteonectin is generally detected in number of normal or neoplastic human tissues in vivo, but hasn't been studied the role of osteonectin in developing human teeth and odontogenic tumors. We evaluated degree of the expression of osteonectin immunohistochemically in 20 cases of developing tooth germ which growth from fetus 5 to 38 weeks, and total 51 odontogenic tumors whitch has taken from routine biopsy, such as 10 ameloblastomas, 5 cases of adenomatoid odontogenic tumors and odontomas and odontogenic fibromas, 4 cases of cementomas and calcifying epithelial odontogenic cyst and odontogenic keratocyst and dentigerous cysts and periapical cysts, and 3 cases of ameloblastic fibromas and myxomas. The results were as follows: 1. The osteonectin on the bud stage of tooth germ was strongly expressed in the epithelial dental lamina and in the outer dental epithelium on the early bell stage, and also strongly expressed in the inner dental epithelium on the late bell stage of tooth germs. 2. In ameloblastoma, the osteonectin was strongly expressed in the epithelial tumor component and especially in the acanthomatous types. 3. In both of calcifying epithelial odontogenic tumor and adenomatoid odontogenic tumors, the osteonectin was moderately expressed on the duct like spindle cells and epithelial tumor cells around calcification areas. 4. In odontogenic tumors originated from epithelial-mesenchymal tissues, the osteonectin was moderately expressed on the epithelial tumor components and in odontogenic cysts, it was expressed in ghost cells and calcification areas only. These were summaried the osteonectin may be strongly related to the developing tooth germ and odontogenic tumors and could be regulated hard tissue of human tooth in morphogenesis and involved with calcification mechanism in development odontogenic tumors.

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SEPSIS FROM ODONTOGENIC INFECTION : A CASE REPORT (패혈증으로 진행된 치성 감염 : 증례보고)

  • Oh, Seng-Seob;Park, Eun-Jin;Kim, Il-Kyu;Choi, Jin-Ho;Kim, Hyung-Don;Oh, Nam-Sik
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.25 no.4
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    • pp.375-378
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    • 1999
  • Incidence and mortality rate of maxillofacial infection is relatively low in the era of antibiotics. Despite the use of antibiotics, delayed treatment, underlying systemic diseases, drug-resistant microorganisms may result in life-threatening situations. The deep neck infection developed from odontogenic infection may result in sepsis, mediastinitis, aspiration pneumonia, asphyxia. Sepsis is the most dangerous complication which can quickly result in a number of lethal situations. The treatment of sepsis includes awareness of such complication, use of sensitive antibiotics, removal of infection source, and hemodynamic, respiratory and metabolic support. We experienced a patient who died of sepsis, which developed from odontogenic infection. The initial diagnosis was a buccal space cellulitis. However, in spite of medical and surgical treatment, this progressed to Ludwig's angina and then deep neck infection and finally sepsis. On the 10th hospital day, the patient died of multiorgan failure caused by sepsis.

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MORPHOLOGICAL ANALYSIS OF DEVELOPMENTAL CHANGES IN SOMA AREA OF DIGASTRIC MOTONEURONS IN THE RAT TRIGEMINAL MOTOR NUCLEI (흰쥐의 두힘살근 운동신경세포의 발달과정에 관한 형태학적 분석)

  • Kim, Jae-Hyun;Park, Mi-Hwa;Paik, Sang-Kyoo;Ma, Su-Kyung;Baek, Sang-Heum;Cha, Du-Won
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.31 no.2
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    • pp.137-142
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    • 2005
  • To analyze the developmental changes in soma diameters of digastric motoneurons, wheat-germ agglutinin conjugated horseradish peroxidase (WGA-HRP) was injected into the digastric muscle and visualized the retrogradely HRP-labeled motoneurons through tungstate/tetramethylbenzidine (TMB) and following diaminobenzidine (DAB) reactions. The results obtained from Sprague-Dawley rats at postnatal days 1 (P1), 10 (P10) and 30 (P30) indicated as follows: firstly, soma diameters of digastric motoneurons showed unimodal distribution in all postnatal days examined; secondly, the period of P1 to P10 (period 1) showed about 2 times faster growth rate than that of P10 to P30 (period 2); thirdly, the smallest soma examined in each postnatal day exhibited slower growth rate with that of the largest one (increase ratio in soma diameters from P1 to P30, smallest vs. largest = 1.62 : 1.93); Finally, relative growth rates a day showed again that period 1 had faster growth rate than that of period 2. Consequently, developmental changes in soma diameters of digastric motoneurons resulted in very different growth rates between both periods. This implies that the growth of the soma is almost completing within P10 and thereafter growing slowly. The period 1 and 2 are corresponding to sucking and sucking/masticatory period, respectively. Therefore present study providing morphological changes in soma diameters of digastric motoneurons suggests that both periods and their different growth rates of the motoneurons in each period may closely be related with each other.

THE CLINICAL STUDY FOR AVAILABLE VOLUME OF ANTERIOR PART OF ASCENDING RAMUS AS A DONOR SITE IN ORAL AND MAXILLOFACIAL REGION (공여부로서의 하악 상행지 전방부의 가용 용적에 관한 임상적 연구)

  • Jung, Sung-Uk;Lee, Eui-Seok;Yun, Jung-Ju;Lee, Sung-Jae;Jang, Hyun-Seok;Kwon, Jong-Jin;Rim, Jae-Suk
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.31 no.2
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    • pp.130-136
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    • 2005
  • Bone grafts are widely used in the reconstruction of osseous defects in the oral and maxillofacial region. Autogenous bone grafts are considered the gold standard in grafting of the oral and maxillofacial region, because of its osteoconductive and osteoinductive properties. Mandibular symphysis & ascending ramus bone graft have been used more frequently because of easy surgical access, reduced operative time, and following minimal morbidity. However, even though the frequent use of the anterior part of ascending ramus and the different regions of mandible, rare of the reports provide information about the quantity of bone available in this donor site. So this study was taken to evaluate & quantify the amount of bone graft material in the anterior ascending ramus regions. This study was made on 36 samples of CT image. In 3D volume image, imaginary osteotomy & segmentation were done and the dimensions and volume of the bone grafts were measured and evaluated. the average volume of the graft materials obtained from the ascending ramus was $3656.83{\pm}108.19mm^3$, and the average dimensions of graft materials were $(33.68{\pm}0.48){\times}(34.92{\pm}0.51){\times}(15.96{\pm}0.27){\times}(9.05{\pm}0.27)mm$.

SOLITARY NEUROFIBROMA OF THE INCISIVE NERVE: A CASE REPORT AND IMMUNOHISTOCHEMICAL STUDY (절치신경 기원의 신경 섬유종: 증례보고와 면역조직화학적 연구)

  • Jeon, Hyo-Sang;Son, Dai-Il;Kim, Seong-Gon;Kim, Mi-Ja;Park, Hye-Rim;Lee, Dong-Geun;Cho, Byoung-Ouck;Cho, Nam-Sung;Park, Young-Joo
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.30 no.1
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    • pp.56-59
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    • 2004
  • The neurofibroma in oral cavity is typically associated with neurofibromatosis. The solitary neurofibroma is commonly observed in skin. It is relatively rare in oral cavity and usually observed in the tongue, buccal mucosa, and vestibule. The rare types of solitary neurofibromas have been reported as a case report and they were in the inferior alveolar nerve, infratemporal fossa, maxilla, and palatal ginviva. In our hospital, the presented case was the first case as reported as solitary neurofibroma in the oral cavity. The prognosis after excision and the review of literatures were presented.

The conservative treatment of mandibular fracture in a child with circummandibular wiring: case report (환악 결찰술을 이용한 소아 하악 골절의 보존적 치료: 증례보고)

  • Kim, Hyung-Mo;Kim, Tae-Wan;Song, Seung-Il;Lee, Jeong-Keun
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.36 no.2
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    • pp.145-148
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    • 2010
  • Maxillofacial injuries are less common in children than in adolescents and adults. This lower incidence is a result of the relatively small size of mandible, the resilient nature of the bones, and a relatively protected environment, which distinguish the treatment principles of pediatric mandibular fractures from those of the adult. The bone of child is malleable, so pediatric fractures tend to be less displaced and rarely comminuted. Moreover, high regeneration potential of the wound allows more conservative treatment modalities for the pediatric mandibular fracture. High risk of damaging unerupted tooth bud renders many clinicians to resort to more conservative treatment modality for the reduction of displaced segments. This case report describes two successful treatment cases using the circummandibular wiring which was applicated to the fracture on parasymphysis of mandible. Circummandibular wiring can protect the tooth buds, and there is no need for intermaxillary fixation so that it prevents the possible complications of intermaxillary fixation such as the temporomandibular joint ankylosis and the facial growth disturbances. The acrylic splint was removed after 3 weeks, which showed clinically good union across the fracture line without complications. They showed complete clinical and radiological bone healing with an optimum occlusion.