• 구강회복응용과학지
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• 제28권1호
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• pp.1-13
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• 2012

짧은 임플란트는 상악동이나 하치조신경 등의 해부학적 구조물이 있거나 심한 치조골 흡수로 인해 제한적인 치조제 높이를 가지는 부위에서 사용되고 있다. 본 연구는 길이 10 mm 이하의 임플란트에서 임플란트의 길이, 직경, 식립 부위, 골이식술 유무, 보철물의 연결고정 유무가 임플란트의 생존율과 변연골 흡수에 미치는 영향을 알아보고자 하였다. 원광대학교 치과병원 임플란트센터에서 길이 10 mm 이하의 임플란트를 식립한 137명의 환자, 227개 임플란트를 대상으로 진료 기록부를 통해 임플란트의 길이, 직경, 식립 위치, 골이식 유무, 보철물의 연결고정 유무를 조사하였다. 변연골 흡수량은 Emago advanced v5.6(Oral diagnostic systems, Amsterdam, The Netherlands) 프로그램을 이용하여 측정하였다. 총 227개의 임플란트 중 8개가 실패하여, 전체 짧은 임플란트의 생존율은 96.5 %로 나타났다. 골이식 부위와 상악에 식립된 경우 더 높은 실패율을 보이는 경향이 있었으며, 임플란트의 길이와 직경은 변연골 흡수량에 영향을 미치지 않았다. 실패 요인을 조사하였을 때, 상악의 불량한 골질과 골이식 유무가 임플란트의 더 높은 실패율에 영향을 미쳤다. 10 mm 이하 임플란트에서 길이, 직경, 식립 부위, 골이식술과 보철물의 연결 고정은 임플란트 생존율과 변연골 흡수량에 영향을 끼치지 않았다.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제22권2호
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• pp.164-173
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• 2000

The p16 protein is a cyclin dependent kinase inhibitor that inhibits cell cycle progression from $G_1$ phase to S phase in cell cycle. Many p16 gene mutations have been noted in many cancer-cell lines and in some primary cancers, and alterations of p16 gene function by DNA methylation have been noticed in various kinds of cancer tissues and cell-lines. There have been a large body of literature has accumulated indicating that abnormal patterns of DNA methylation (both hypomethylation and hypermethylation) occur in a wide variety of human neoplasma and that these aberrations of DNA methylation may play an important epigenetic role in the development and progression of neoplasia. DNA methylation is a part of the inheritable epigenetic system that influences expression or silencing of genes necessary for normal differentiation and proliferation. Gene activity may be silenced by methylation of up steream regulatory regions. Reactivation is associated with demethylation. Although evidence or a high incidence of p16 alterations in a variety of cell lines and primary tumors has been reported, that has been contested by other investigators. The precise mechanisms by which abnormal methylation might contribute to carcinogenesis are still not fully elucidated, but conceivably could involve the modulation of oncogene and other important regulatory gene expression, in addition to creating areas of genetic instability, thus predisposing to mutational events causing neoplasia. There have been many variable results of studies of head and neck squamous cell carcinoma(HNSCC). This investigation was studied on 13 primary HNSCC for p16 gene status by protein expression in immunohistochemistry, and DNA genetic/epigenetic analyzed to determine the incidence, the mechanisms, and the potential biological significance of its Inactivation. As methylation detection method of p16 gene, the methylation specific PCR(MSP) is sensitive and specific for methylation of any block of CpG sites in a CpG islands using bisulfite-modified DNA. The genomic DNA is modified by treatment with sodium bisulfate, which converts all unmethylated cytosines to uracil(thymidine). The primers designed for MSP were chosen for regions containing frequent cytosines (to distinguish unmodified from modified DNA), and CpG pairs near the 5' end of the primers (to provide maximal discrimination in the PCR between methylated and unmethylated DNA). The two strands of DNA are no longer complementary after bisulfite treatment, primers can be designed for either modified strand. In this study, 13 paraffin embedded block tissues were used, so the fragment of DNA to be amplified was intentionally small, to allow the assessment of methylation pattern in a limited region and to facilitate the application of this technique to samlples. In this 13 primary HNSCC tissues, there was no methylation of p16 promoter gene (detected by MSP and automatic sequencing). The p16 protein-specific immunohistochemical staining was performed on 13 paraffin embedded primary HNSCC tissue samples. Twelve cases among the 13 showed altered expression of p16 proteins (negative expression). In this study, The author suggested that low expression of p16 protein may play an important role in human HNSCC, and this study suggested that many kinds of genetic mechanisms including DNA methylation may play the role in carcinogenesis.

• 구강회복응용과학지
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• 제34권2호
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• pp.104-115
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• 2018

목적: 본 연구는 현재 시판되고 있는 구강스캐너를 사용하여 구강스캐너 정확도 평가를 위해 국제표준이 제안하고 있는 모형의 스캔이미지 획득이 가능한 지 분석하고, 이를 통해 표준모델이 가지고 있는 문제점을 파악하는 데 있다. 연구 재료 및 방법: ISO12836과 ANSI/ADA no.132에서 규정하는 국제표준을 참고하여 3D 프린터기를 이용하여 모델을 제작하였으며, 모델스캐너와 두 가지 구강스캐너를 이용하여 스캔을 하였다. 스캔이미지 획득 정도를 3등급으로 분류하여 스캐너의 성능을 비교하였으며, 모델 표면의 상태에 따른 이미지 획득 능력도 비교하였다. 결과: 모델 스캐너가 모든 모델에서 가장 우수한 이미지를 얻을 수 있었으며 TRIOS3는 둥근 형태의 구조물, CS3500은 각진 형태의 구조물에 대한 이미지 재현이 좋은 결과를 보였다. 표준 모델의 표면상태에 따른 스캔이미지 재현에서는 초경석고 모델이 스캐너 종류와 관계없이 가장 우수하였다. 3D 프린팅 모델의 경우, 표면에 파우더 처리를 한 모델에서 가장 우수한 스캔이미지를 얻을 수 있었다. 결론: ISO12836과 ANSI/ADA 132의 표준모델의 경우, 구강스캐너의 field of view (FOV)를 벗어나는 구조물을 스캔할 때 서로 다른 면인 것을 구분하는 기준점이 존재하지 않게 되면 연속적인 스캔 및 정합과정에서 정확한 이미지를 나타내지 못한다는 것을 알 수 있었다. 그러므로 단순한 패턴의 반복과 대칭구조를 가지지 않는 새로운 표준모델이 필요하다고 여겨진다.

• 대한두경부종양학회지
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• 제7권2호
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• pp.120-128
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• 1991

Reconstruction of the pharynx and cervical esophagus presents a tremendous surgical challenge to the Head and Neck Surgeon. Because life expectancy of patients with advanced carcinoma of the hypopharynx, and cervical esophagus is limited, treatment must be aimed at palliation. A variety of techiques have been proposed over the years with none proving entirely satisfactory. These techiques include prosthesis; skin graft; cervical flaps; tubed cutaneous and myocutaneous chest flaps; visceral reconstruction with stomach, colon. and jejunum; and jejunal free autografts. Many factors dictate the best method of reconstruction in any given clinical situation. The goal of the surgery is a one-stage reconstruction of swallowing function with minimal morbidity to allow as short a hospital stay as posible. Nine patients underwent the free jejunal autograft reconstruction of the pharyngoesophagus after the ablative surgery for the advanced hypopharyngeal cancer. Postoperative complications included one perioperative death, two abdominal wound dehiscences, two neck hematomas, one carotid rupture, one funtional dysphagia, one late strictures. There were no graft failure, no immediate stenosis and no fistula. An oral diet was started between days 8 and 16, with an average of 9 days and median of 8 days. Patients left the hospital between days 9 and days 38, with an average of 23.4 days and median of 23 days. This method of reconstruction is advocated as reliable palliative procedure with short-term follow-up. In conclusion, we at Korea Cancer Center Hospital are of the opinion that the free jejunal autograft offers an excellent, safe and relative easy method of the pharyngeal and cervical esophageal reconstruction with significant advantages over other techiques.

• 대한치과의사협회지
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• 제55권8호
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• pp.528-536
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• 2017

Treatment with removable partial denture is effective for partially edentulous patients who are unable to obtain sufficient retention and stability for functional and esthetic restoration. There are several cases reporting the improvement of retention and stability of the partial denture using a small number of implants. However, there are limited studies on the implant-assisted removable partial denture using a small number of remaining teeth and the bar locator system. The bar locator system has an advantage in that it could compensate the angle of insertion of removable prosthesis on implant with inconsistent placement angle due to anatomical constraints compared to when using the locator only. This case report describes the patient with $Parkinson^{\circ}$Øs disease who was treated with the Locator bar system using two previously placed implants and two remaining teeth on maxilla. No additional implants could be placed because of the medical and economic condition of the patients, and the angle of one of two implants could not be matched with the direction of the removable partial denture insertion. Considering the angle of the implants, the patient was treated with implant-assisted RPD using the Locator bar system and had satisfactory results in the aspect of esthetics, masticatory function, and oral hygiene maintenance.

• Journal of Periodontal and Implant Science
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• 제30권2호
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• pp.359-374
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• 2000

Cyclosporine A(CsA) is a widely used immunosuppressant for transplant patients and is also used for the treatment of a wide variety of systemic diseases with immunologic disorders. However, its use is frequently limited because of complications such as nephrotoxicity or gingival hyperplasia. Although several hypotheses have been postulated for CsA-induced gingival hyperplasia, i.e. various cytokine effects of inflammatory cells, existence of plaque or CsA itself, but its pathogenesis is still unclear. For experimental chronic CsA toxicity, salt depletion has been shown to increased susceptibility of rodents to the effects of CsA, and this maneuver facilitates production of arteriolopathy and interstitial fibrosis in kidney that mimic the changes found in human. The purpose of this study was to evaluate pathogenesis of CsA-induced gingival hyperplasia by comparing changes between CsA administration groups of normal standard diet and those of low salt diet group. Specific pathogen-free, 20 to 25 days old(120 to 150 g), male Fisher-344 rats(KIST, Korea), 120 to 150g of body weight, were assigned to four groups of six animals each after one week of adaptation period for powder food. Group 1 received olive oil($300{\mu}l/g\;of\;diet$) with normal standard diet(0.4% of sodium)(NSD). Group 2 received CsA(Cypol-N, Jonggundang, Korea; $300{\mu}g/g\;of\;diet$) with normal standard diet(NSD+CsA). Group 3 received same amount of olive oil with low salt diet(0.05 % of sodium, Teklad Premier, U.S.A.)(LSD). Group 4 received same dose of CsA with low salt diet(LSD+CsA). Rats were pair fed and were sacrificed after six weeks. Renal histologic lesions associated with CsA, consisted of cortical interstitial fibrosis, tubular atrophy and hyalinization of arterioles and the impairment of renal function including increase of serum creatinine and decrease of glomerular filtration rate was more severe in low salt diet group. These were proved as the results of activated of renin-angiotensin system in the kidney by low salt condition. Meanwhile the degree of gingival hyperplasia at incisor and molar tooth was less severe in low salt diet group compared with normal sodium diet group. Hyperplastic gingiva showed mild epithelial hyperplasia and expanded underlyng stroma which consisted of matrix increasement, capillary proliferation and dilatation. While the number and the activation of fibroblasts were increased, inflammatory cells were rare in the stroma. The immunohistochemistry for TGF-${\beta}_1$ in the kidney and gingiva revealed stronger positive in LSD+CsA in kidney but in gingiva of NSD+CsA. These results suggested followings; Gingival hyperplasia can be developed without inflammatory cells infiltration and seemed not induced by CsA by itself. The major role for gingival hyperplasia by CsA would be the secondary effect of TGF-${\beta}$, which maybe upregulated by CsA administration. Low salt diet can attenuate this hyperplasia perhaps by decreasing the activation of $TGF-{\beta}$.

• 대한후두음성언어의학회지
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• 제21권1호
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• pp.42-47
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• 2010

Backgrounds and Objects: Carcinoma of the tongue is the most common cancer of the oral cavity. A primary treatment strategy includes surgery and/or radiotherapy. Resection of the tongue often results in speech dysfunction, which depends on the site and extent of resection, type of reconstruction, and the mobility of remaining tongue. This study aimed to evaluate the characteristics of articulation errors that were resulted from the partial glossectomy without free flap reconstruction. Materials & Method : Articulation evaluations including speech intelligibility and percent of correct consonants (PCC) were performed for 24 patients who underwent partial glossectomy for their T1 or T2 tongue cancer. Mobility of the tongue, size of the resected tongue, and the history of adjuvant radiotherapy were analyzed for their relationship with the results of articulation evaluation. Results: Speech intelligibility score was $6.4{\pm}0.9$ (on 7-point scale) and overall PCC was 96.9%. There were close relationships between the size of resection and limitations in the tongue mobility, especially in "protrusion and elevation (r=-0.687)" and "retroflexion (r=-0.775)". Errors in "alveolar fricatives" and "palatal affricates" were also closely related with the size of resection (r=-0.537 and -0.538, respectively). PCC for "liquid sound" /r/ was 83.2%, which was closely related with the history of radiation therapy. Conclusion : Overall articulatory function was satisfactory in cases of early tongue cancer after partial glossectomy of a limited volume without flap reconstruction. However, the size of resection and the history of radiation therapy were closely related to the limitations in some types of tongue mobility and the resultant articulation errors.

• Tuberculosis and Respiratory Diseases
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• 제43권5호
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• pp.693-700
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• 1996

연구배경: 1980년대 들어서 폐결핵의 치료는 INH, RFP, EMB(또는 SM)의 6개월 표준 단기 요법이 정착되었고 치료 성적 또한 괄목한 만한 향상을 보여왔으나 초치료 실패 및 재치료 실패 환자에서는 약제 내성 및 약제 부작용으로 인한 치료 중단이 큰 문제가 되었다. 1980년대 개발된 Quinolone 계통의 항생제인 OFX은 감영성 호흡기 질환 치료제로서의 역할을 할 뿐만 아니라, 최근에는 결핵 치료제로 사용되고 있다. 이에 따라 저자들은 PTA, CS, PAS, OFX을 사용하여 폐결핵 환자들의 재치료 또는 재재치료의 임상효과를 알아보았다. 방법: 1993년 3월부터 1995년 8월까지 국립 공주 결핵병원에 입원하였던 객담내 결핵균 양성 환자중 초치료및 재치료에 실패한 환자로 추척이 가능한 66명을 대상으로하여 후향적 조사를 하였다. 결과: 1) 객담내 균음전 객담 도말 양성 환자 66명 중 42 명(64%)이 15개월내에 객담내 균음전되었다. 2) 흉부 X-선상의 호전은 경증에서는 3명(75%), 중등중에서는 23명(64%), 중증은 12명(46%)이었고, 전체적으로는 38명(58%)에서 호전되었다. 4) 질병 기간에 따른 균 음전율은 각100%(병력이 1년미만), 88%(1-3년), 80%(3-5년) 그리고 52%(5년이상)이었다. 5) 부작용 PTA의 부작용은 위장판 장애(소화불량, 구역, 구토, 복통등)와 경한 간기능 장애를 보여주었고, CS은 정신상태 이상(주로 불면과 감정장애)이 8명(12%)에서 있었으며, 경련은 없었다. PAS에 의한 위장 장애는 오심, 구토, 복부 불쾌감과 같은 위장장애가 대부분으로 41명(62%)에서 관찰되었다(Table 5). 결론: 폐결핵 치료 역시 다른 모든 질환과 마찬가지로 환자의 병력이 젊을수록, 흉부 X-선상의 병변이 적을수록 좋은 성적을 보였으며, 38명(58%)의 경우에는 X-선상의 호전을 보였으나 일부에서는 매우 제한적이고 더 이상의 호전을 기대하기가 어려울 것으로 생각되는 예도 있었다. 부작용으로는 위장장애(소화장애, 오심, 구토, 변비, 설사)가 주가 되었으며, 위장장애는 대부분의 경우에서는 규칙적인 증상 치료로 많은 호전을 가져 왔다. 또한 무엇보다도 전문가에 의한 적절한 치료약제의 결정과 지속적인 항결핵제 복용을 위한 정기적인 의사와의 면담 및 추후검사가 필요할 것으로 생각된다.