• Maxillofacial Plastic and Reconstructive Surgery
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• v.20 no.3
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• pp.263-268
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• 1998

Many myocutaneous flaps have been used for the reconstruction of intraoral defects caused by the excision of oral cancer. Among these myocutaneous flaps, cervical island flap has been introduced by Farr et al. Although different in detail, this flap was designed as the platysma myocutaneous flap by Futrell et al in the supraclavicular site. Since many authors applied this flap to cover intraoral defect, they discussed deeply the blood supply of this flap. To improve further flap survival, it was modified by Tashiro et al. This flap makes its vascularity highly reliable. The amount of tissue needed for reconstruction can be accurately planned. The surgical and reconstruction procedure can be performed simply, rapidly, and effectively. Oral functions including deglutition, speech, and denture fitting are not compromised. With it's minimal deformity, new donor fields is not necessory. Of course, we keep in mind that this flap has limitations in patients where much bulk of tissue defects is needed and more than 3000 rad radiation due to the metastasis of neck lymph node is exposed. In three patients with intraoral squamous cell carcinoma($T_{1-3}N_0M_0$), we performed induction chemotherapy with FP regimen including pepleomycin. Thereafter, we ablated oral cancer and peformed reconstruction of intraoral defects with cervical island flap designed by Tashiro et al. Due to these significant benefits and minimal limitations, we have found that this flap is adequate for reconstruction of most intraoral defects following cancer ablation.

• Journal of Oral Medicine and Pain
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• v.30 no.4
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• pp.411-426
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• 2005

The purpose of this study was to investigate the effects of occlusal condition and clenching level on the mandibular torque rotational movement. For this study, healthy 14 men without any symptoms and signs of temporomandibular disorders were selected. Mandibular torque rotational movement was observed in each circumstance of combination of three occlusal conditions such as natural dentition, with wafer of 3.6 mm thickness, and wafer with resin stop of 14 mm thickness total during hard biting of bite stick at maximum voluntary contraction(MVC) and 50% of MVC level of surface EMG activity of masseter muscle. Electromyographic activity and mandibular torque rotational movement were observed using BioEMG and BioEGN in $BioPak^{(R)}$ system. Each biting movement in each circumstance was composed of clenching one time and hard biting of wooden stick two times. The observed items were opening distance, velocity and amount of torque rotational movement in mandibular movement, and the data were statistically processed with $SPSS^{(R)}$ windows (ver.10.0). The results of this study were as follows: 1. There were no differences in the mandibular movement distance between those value in both biting sides, and between those in both clenching forces, but the mandibular velocity showed a different results by clenching force. For the amount of torque rotational movement, there were no difference in the value of the frontal plane but some significant difference was in the value of the horizontal plane by biting side. 2. The mandibular movement distance and the mandibular velocity in both planes were higher by maximum voluntary contraction than those by half maximum voluntary contraction, and amount of torque rotational movement in the horizontal plane was also increased by maximum voluntary contraction. 3. The opening distance in both planes were decreased with the increase of vertical dimension of occlusion, namely, by the occlusal appliances, and this pattern was also showed in the mandibular velocity in case of hard biting by maximum voluntary contraction. However, the amount of torque rotational movement were not different by the increase of vertical dimension of occlusion. 4. The value of angle and distance of the torque rotational movement in the hard biting of wooden stick were generally higher than those in the clenching without wooden stick in both planes without regard to occlusal conditions and/or clenching forces.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.27 no.3
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• pp.226-237
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• 2005

Purpose : Extensive defect of oral and maxillofacial area is usually reconstructed with composite flap including skin paddle. However, if the defects are lined with only skin components, the mucosa's role in mastication and texture are not restored. Furthermore, stiffness and hair-growing prevent denture rehabilitation and good oral hygiene. This study was performed to overcome the disadvantages of composite soft tissue flaps including the skin and to make a model for myo-mucosal flaps. Materials and methods : Buccal mucosa sized $0.5\times1.0\;cm^2$ from New Zealand rabbit (around 1.5kg) was harvested and cultivated by the modification of Rheinwald and Green's keratinocyte culture method. Cultured mucosa was grafted on the fascia of latismus dorsi as form of mucosal sheet. After 7, 10, 14 days, the myomucosal flap was excised and evaluated under light microscope with H & E and immunohistochemical staining. As control group, harvested buccal mucosa from rabbit was transplanted to gracilis muscle(n=6). Results : From 7 days after prelamination, the basal layer of the grafted mucosa resembled that of normal mucosa. As control group, transplanted mucosa had original shape but there's slight inflammatory reaction. Prelaminated mucosa has 19.8$\pm$4.59 cell layers and some samples have more than 20 layers. The expression rate of PCNA was relatively strong (42.9%$\pm$14.1) at the basal layer of grafted mucosa and the laminin was found at the basal layer. On the contrary, prelaminated mucosa at 10 days showed moderate expression rate of PCNA(32.4%$\pm$4.62). We found the mucosal layer was somehow disappeared and there is strong inflammatory reaction. After 14 days prelamination, the grafted oral keratinocytes were almost disappeared and expression of PCNA was not observed. Conclusion : We can make 75 fold large mucosal($3850mm^2$) sheet from small samples of mucosa $(50mm^2)$. Epithelial sheet that grafted on the fascia of muscle underwent differentiation and proliferation. But after 10, 14 days, there was strong inflammatory reaction and the grafted mucosa was destroyed from surface layer. In rabbit model, transfer of fascio-mucosal flap should be done from 7 to 10 days after prelamination.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.36 no.5
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• pp.366-374
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• 2010

Introduction: This study evaluated the capability of silk fibroin (SF) and recombinant human bone morphogenetic protein-2 loaded SF (SF-BMP) as a bone defect replacement matrix when grafted in a calvarial bone defect of rats in vivo. Materials and Methods: A total 70 calvarial critical size defects (5.0 mm in diameter) made on 35 adult female Sprague-Dawley rats were used in this study. The defects were transplanted with (1) rhBMP-2 loaded silk fibroin graft (SF-BMP: 0.8+$10\;{\mu}g$), (2) Silk fibroin (SF: $10\;{\mu}g$), and (3) no graft material (Raw). The samples were evaluated with soft x-rays, alkaline phosphatase activity, calcium/phosphate quantification, histological and histomorphometric analysis at postoperative 4 and 8 weeks. Results: The SF-BMP group ($48.86{\pm}14.92%$) had a significantly higher mean percentage bone area than the SF group ($24.96{\pm}11.01%$) at postoperative 4 weeks.(P<0.05) In addition, the SF-BMP group ($40.01{\pm}12.43%$) had a higher % bone area at postoperative 8 weeks than the SF group ($33.26{\pm}5.15%$). The mean ratio of gray scale levels to the host bone showed that the SF-BMP group ($0.67{\pm}0.08$) had a higher mean ratio level than the SF group ($0.61{\pm}0.09$) at postoperative 8 weeks. These differences were not statistically significant.(P=0.168 and P=0.243, respectively) The ratio of the calcium and phosphate contents of the SF-BMP ($0.93{\pm}0.22$) group was lower than that of the SF ($1.90{\pm}1.42$) group at postoperative 4 weeks. However, the SF-BMP group ($0.75{\pm}0.31$) had a higher Ca/$PO_4$ ratio than the SF ($0.68{\pm}0.04$) at postoperative 8 weeks. These differences were not statistically significant.(P=0.126 and P=0.627, respectively) For the bone-specific alkaline phosphatase (ALP) activity, which is recognized as a reliable indicator of the osteoblast function, the SF-BMP ($23.71{\pm}8.60\;U/L$) groups had a significantly higher value than the SF group ($12.65{\pm}6.47\;U/L$) at postoperative 4 weeks.(P<0.05) At postoperative 8 weeks, the SF-BMP ($21.65{\pm}10.02\;U/L$) group had a lower bone-specific ALP activity than the SF group ($16.72{\pm}7.35\;U/L$). This difference was not statistically significant.(P=0.263) For the histological evaluation, the SF-BMP group revealed less inflammation, lower foreign body reactions and higher bone healing than the SF group at postoperative 4 and 8 weeks. The SF group revealed more foreign body reactions at postoperative 4 weeks. However, this immunogenic reaction decreased and the remnant of grafted material was observed at postoperative 8 weeks. For histomorphometric analysis, the SF-BMP group had a significantly longer bone length to total length ratio than those of the SF group at postoperative 4 and 8 weeks.(P<0.05) Conclusion: The rhBMP-2 loaded silk fibroin graft revealed fewer immunoreactions and inflammation as well as more new bone formation than the pure silk fibroin graft. Therefore, silk fibroin may be a candidate scaffold for tissue engineered bone regeneration.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.36 no.5
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• pp.346-352
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• 2010

Introduction: Heat shock protein70 (HSP70) is a highly conserved family of proteins produced after a variety of stresses. Many studies reported that the overexpression of HSP70 can improve the prognosis of the patients with sepsis through a reduction of the nitric oxide concentration. However, these results only revealed the effect of HSP70 and nitric oxide. No studies have examined the relationship between HSP70 and nitric oxide. The aim of this study was to evaluate the effect of the overexpression of HSP70 on the expression of inducible nitric oxide synthase and the nitric oxide concentration. In addition, the mechanism of the relationship of HSP70 and inducible nitric oxide synthase (iNOS) in sepsis was examined. Materials and Methods: The experiments were performed on male sprague-dawley rats. Sepsis was induced by a cecal ligation and puncture (CLP). Glutamine (GLN) or saline was administered 1 hour after the initiation of sepsis. Serum and lung tissues were acquired from the rats 12 hours or 24 hours after the initiation of sepsis. The nitric oxide concentration, the expression of HSP70 in lung, and the gene expression of iNOS in lung were analyzed. The three groups, sham operation, CLP and CLP+GLN, were compared. Results: Compared to the other groups, in CLP+GLN, GLN administered after the initiation of sepsis enhanced the expression of HSP70 in the lung at 12 hours ($47.19{\pm}10.04$ vs. $33.22{\pm}8.28$, P=0.025) and 24 hours ($47.06{\pm}10.60$ vs. $31.90{\pm}4.83$, P=0.004). In CLP+GLN, GLN attenuated the expression of iNOS messenger RNA (mRNA) in the lung at 12 hours ($5,513.73{\pm}1,051.60$ vs. $4,167.17{\pm}951.59$, P=0.025) and 24 hours ($18,740.27{\pm}8,241.20$ vs. $9,437.65{\pm}2,521.07$, P=0.016), and reduced the concentration of nitric oxide in the serum at 12 hours ($0.86{\pm}0.48$ vs. $3.82{\pm}2.53$, P=0.016) and 24 hours ($0.39{\pm}0.25$ vs. $1.85{\pm}1.70$, P=0.025). Conclusion: The overexpression of HSP70 induced by the administration of GLN in sepsis attenuates the expression of the iNOS gene but reduces the nitric oxide concentration.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.26 no.3
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• pp.254-261
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• 2000

The present study has attempted to look into the mechanism of ras-induced carcinogenesis in a human epithelial cell system. Human epithelial cells immortalized with Ad12-SV40 hybrid virus were used to assess carcinogenic potential of the ras-oncogene. Cells transfected with pSV2-ras showed characteristics of cellular transformation. The transformation parameters such as cell density, soft-agar colony formation, and cell aggregation were significantly increased in the cells expressing ras oncoprotein. In addition, the duration required for the appearance of foci was shortened in the ras-transfected cells. Consistent with other reports, our results demonstrated an evidence that the ras-oncogene induced the cellular transformation of human epithelial cell system. When a high concentration of glucocorticoid was added into the media, transformation process was accelerated. It is speculated that glucocorticoid may provide an advantageous environment for the proliferation of the transformed cells. The induction of the intracellular free calcium concentrations following agonist treatment was significantly lower in the transformed cells than in the control cells. These effects were more manifested in the presence of extracellular cacium, indicating that the transformation process may alter the influx pathway of extracellular calcium. The induction of $IP_3$ following agonist treatment was also lower in the transformed cells than in the control cells. Thus, it is suggested that phospholipase C-coupled pathway was down-regulated in the process of the ras-induced transformation. While the levels of $TGF-{\beta}_1$ and PAI-2 mRNAs were decreased, the level of fibronectin mRNA was increased. The results indicate that mechanism of the ras-induced transformation may be associated with the altered expressions of growth regulatory factors. The present study demonstrates an evidence that the ras-induced cellular transformation may be associated with alteration of signal transduction and growth regulatory factors. The study will contribute to improve the understanding of molecular mechanism of epithelium-derived cancers including oral cancer.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.22 no.2
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• pp.123-132
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• 2000

$TGF-{\beta}_1$ is a potent chemotactic factor for inflammatory cells and fibroblasts. It also stimulates the celluar source and components of extracellular matrix and the production of proteinase inhibitors. Collectively, these biologic activities lead to the accumulation and stabilization of the nascent matrix, which is vital to infection control. The objective of this study is to investigate production of $TGF-{\beta}$ in vitro fibroblast culture in the presence of Staphylococcus enterotoxin B(SEB) and/or lipopolysaccharide(LPS) and to elucidate the role of $TGF-{\beta}_1$ which may be responsible for infection control. The fibroblasts were originated from gingiva and facial dermis in 26 year-old male patient. In the presence of LPS($0.01{\mu}g$, $0.1{\mu}g$, $1.0{\mu}g$), SEB($0.01{\mu}g$, $0.l{\mu}g$, $1.0{\mu}g$) respectively, $cells(5{\times}10^3ml)$ were cultivated in vitro. At 1, 3, and 5 days after incubation, cells were counted. Also, $cells(2.5{\times}10^5ml)$ were cultivated in EMEM with LPS(0.01, 0.1 and $1.0{\mu}g$), SEB(0.01, 0.1 and $1.0{\mu}g$) respectively and $LPS(0.1{\mu}g)$ and $SEB(0.1{\mu}g)$ in combination for 24, 48, and 72 hours respectively. Culture supernatants were harvested at 1, 2, and 3 days after incubation period and triplicate culture supernatants were pooled and $TGF-{\beta}_1$ was assayed in duplicate. The results were as follows. 1. In gingival fibroblast induced with SEB and LPS respectively or in combination, the suppression of cell Proliferation occurred very significantly since 3 days after incubation, compared with the control and the production of $TGF-{\beta}_1$ occurred very significantly at 1 day after incubation, compared with the control. 2. In facial dermal fibroblast induced with SEB and LPS respectively or in combination, the suppression of cell proliferation occurred very significantly at 1 day after incubation, compared with the control. In SEB exposure, the production of $TGF-{\beta}_1$ was decreased very significantly at 1 day after incubation, compared with the control. However, in LPS, SEB and LPS exposure, the production of $TGF-{\beta}_1$ was increased very significantly at 1 day after incubation, compared with the control. In conclusion, the concentration of bacterial toxins and the incubation period correlated with cell proliferation and production of $TGF-{\beta}_1$ very significantly. The gingival and facial dermal fibroblasts have different phenotype each other The orchestrated understanding of fibroblast proliferation and $TGF-{\beta}_1$ production play an important part in host defense against the bacterial Infection and may prevent tissue necrosis such as necrotizing fasciitis and life-threatening syndrome such as multiple organ failure.

• Journal of Oral Medicine and Pain
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• v.33 no.1
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• pp.15-26
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• 2008

Purpose : To investigate the actual conditions of diagnosis and treatment of oral medicine inpatient with systemic disease. Methods : A total of 110 subjects, inpatient due to systemic disease for diagnosis and treatment of oral disease was requested to answer the medical history and dental treatment record. Results : Systemic disease is composed of Non-insulin-dependent diabetes mellitus 26%, Cerebral infarction 25.2%, Intracerebral hemorrhage, Polyarthrosis, Coxarthrosis 4.7%, Nerve root and plexus disorders, Hypertensive heart and renal diseases, Ankylosing spondylitis 2.4%. Chief complain of oral disease is composed of toothache 28.6%, routine check 23%, tooth mobility 8.7%, hypersensitivity 7.1%, periodontal bleeding 6.4%. Oral disease is composed of Gingivitis and periodontal diseases 28.9%, Dental caries 17.1%, Diseases of pulp and periapical tissues 15.1%, Diseases of salivary glands 10.5%, Other diseases of hard tissues of teeth 8.6%, Within Normal Limit 5.3%. Treatment of oral disease is composed of periodontal treatment 17.95%, rejection of treatment 16.67%, medication for halitosis & dry mouth 13.46%, extraction 12.18%, prosthetic treatment 8.97%. Chief complain in oral medicine is composed of oral soft tissue problem 6.4%, craniomandibular disorders 5.6%, halitosis 4%, total 16%. Conclusion : These findings indicate that inpatient due to the systemic disease is significantly correlated to the oral disease. The patients of oral disease interrelationship between inpatient and outpatient of systemic disease should be validated by future research.

• Journal of Periodontal and Implant Science
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• v.37 no.sup2
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• pp.385-396
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• 2007

This study proposed a new classification system for maxillary anterior alveolar ridge deformities based on CAT-scan implant simulation as a useful concept in order to more precisely predict treatment outcomes and the necessity for ridge augmentation prior to implant placement. The results indicate that a high number of cases in the maxillary anterior area would require augmentation procedures in order to achieve ideal implant placement and restoration.

• The Journal of the Korea Contents Association
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• v.10 no.6
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• pp.336-343
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• 2010

Coronary artery CT angiography has short scanning length, the exposure dose is high. Therefore, it is required to study on the organ dose when using MDCT. We compared the differences between the absorbed dose and effective dose in the major organs assessing the absorbed dose in the major organs by 16-MDCT and 64-MDCT in the subjects with coronary artery CT angiography, the same protocol by 16-MDCT and 64-MDCT. As a result, the great orders of absorbed dose when conducting coronary artery CT angiography had been shown as heart, stomach, liver, pancreas, kidney, spleen, large intestine, lung, small intestine, thyroid gland, ovary, bladder, and orbit with the absorbed dose distribution of $0.538{\pm}0.026(Mean{\pm}SD,\;p<0.05)mGy{\sim}71.316{\pm}4.316mGy$ in 16-MDCT, and heart, stomach, pancreas, spleen, liver, kidney, small intestine, large intestine, lung, thyroid gland, ovary, bladder, and orbit with the absorbed dose distribution of $0.87{\pm}0.01mGy{\sim}115.26{\pm}1.59mGy$ in 64-MDCT, demonstrating some different distributions. The exposed doses to the patient per one time scanning with coronary artery CT angiography were $71.316{\pm}4.316mGy$ in 16-MDCT as the absorbed dose based on the heart and $115.26{\pm}1.59mGy$ in 64-MDCT. The effective doses were 7.41 mSv and 12.11 mSv in 16 and 64-MDCT, respectively. Taking into account the results of brain CT with 2.8 mSv that has comparatively large scanning length and size, facial CT 0.8 mSv, chest CT 5.7 mSv, pelvic CT 7.2 mSv, and abdominal and pelvic CT 14.4 mSv, it is very high considering the scanning length of 13 cm limited to the heart for the scanning range.