• 한국의학물리학회지:의학물리
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• 제12권2호
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• pp.177-184
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• 2001

방사선 치료목표는 정해진 방사선량을 병변부위에 정확하게 조사시키고 주위 정상조직에는 방사선이 조사되지 알도록 하는 것이다. 이때에 조사야 배치, 차폐체 배치의 부정확성, 환자의 움직임 등으로 병변부위와 치료부위 사이에서 변위오차가 발생할 수 있다. 본 연구에서는 방사선 치료 위치의 확인을 위한 방법으로서 랜드마크를 이용하여 포탈영상과 x선 시뮬레이터 영상을 비교하는 알고리즘을 개발하여 방사선 치료 시 발생하는 부정확도를 이동, 스케일, 회전 정도로 나타내어 정량적으로 확인하였다. 등록 알고리즘은 랜드마크 정합 후 필드 경계 정합에 의해 두 영상의 변위오차를 분석하는 순서로 구현된다. 우선 각 영상의 두개의 랜드마크를 이은 대응선분들을 이용하여 변환변수 (이동, 스케일, 회전)를 구하여 랜드마크를 정합하였다. 다음으로 포탈영상의 필드경계를 추출한 후 $\rho$-$\theta$ technique을 적용하여 두 필드의 변위오차를 계산하였다. 팬톰 포탈영상에 적용하여 이동에서 2mm 이내, 회전에서 1$^{\circ}$ 이내, 스케일에서 1% 이내의 오차를 보였다. 본 연구의 결과를 통하여 방사선 치료 시 시뮬레이터 영상과 포탈영상을 정량적으로 분석함으로서, 환자 치료의 정확도 확인 연구에 기여할 수 있을 것으로 사료된다.

• Journal of Korean Neurosurgical Society
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• 제47권1호
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• pp.11-16
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• 2010

Objective: Abnormalities of the bone are frequently encountered in patients with meningioma, and hyperostosis and endostosis are common bone alterations in these tumors. Extensive bony destruction is very unusual in patients with meningioma. We report six cases of intracranial meningioma associated with an osteolytic lesion of the skull and discuss the underlying mechanisms that may be responsible for bone destruction in patients with meningioma. Methods: Six patients were classified into three groups, severe, moderate and mild, according to the degree of osteolytic bony destruction. The tumor was classified as intracranial or extracranial, depending on its location. We investigated the potential role of matrix metalloproteinase (MMP) in meningioma-associated osteolysis. The levels of MMP expression were determined by gelatin zymography, reverse transcription-quantitative PCR analysis (RT-PCR) and immunohistochemical analysis. Results: Complete surgical removal of the lesion was performed in each patient. Histological examination revealed benign meningioma in four cases, and two cases of atypical meningioma. Patients did not have a poor prognosis except one case of recurred atypical meningioma. Gelatin zymography and RT-PCR detected high levels of MMP-2 in almost all extracranial masses in comparison with the intracranial masses and MMP9 in two. There was no difference in the severity of bone destruction. Immunohistochemical analysis revealed MMP-2 expression in the vicinity of the bone destruction, and a few MMP-9-positive stainings were observed. Conclusion: Osteolysis of the skull in patients with meningiomas might not be indicative of malignant pathological features and poor prognosis. Invasion to the extracranial portion and osteolysis might be associated with MMP-2 expression in meningioma.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제34권6호
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• pp.398-403
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• 2012

Purpose: Mandible resection and discontinuity defect created lead to aesthetic and functional problems. The iliac crest bone graft exhibits relative ease for bone harvesting, possibility of two team approach, ability to close the wound primarily, large amount of corticocancellous bone and relatively few complications. Whereas the use of free vascularized flaps has donor site morbidity and worse-fitting bone contour, the use of nonvascularized iliac bone graft has advantages in the operation time and patients' recovery time. So, nonvascularized iliac bone graft could be an attractive option. Methods: Twenty-one patients (M:F=1:1.1) underwent iliac crest bone harvesting for reconstruction of mandibular discontinuity defect (mean length : $61.6{\pm}17.8$ mm), from May 2005 to October 2011 at the Department of Oral and Maxillofacial Surgery in Kyungpook National University. The average age was $44.1{\pm}16.4$ years and the mean follow up periods was $28.2{\pm}22.7$ months. Bone resorption rate, according to age, sex, primary lesion, location and distance of defect, type of fixation plate, time of graft and pre-operative radiation therapy, were measured in each patient. Results: The mean bone resorption rate was $16.1{\pm}9.0%$. Bone resorption rate was significantly increased in mandibular defect that is over 6 cm in size (P=0.015, P<0.05) and the cases treated pre-operative radiation therapy (P=0.017, P<0.05). All was successfully fixed and maintained for the long-term follow-up. There were a few donor site complications and almost all patients were shown favorable outcome without severe bone resorption in this study. Conclusion: The nonvascularized iliac bone graft seems to be a reasonably reliable treatment option for reconstruction of mandibular discontinuity defects.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제29권6호
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• pp.509-512
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• 2007

Purpose: The Le Fort I osteotomy is a commonly performed maxillary procedure for dentofacial deformity. One of the risks of this procedure is major hemorrhage resulting from injury to the descending palatine artery. So it is very important to know the exact position of the descending platine artery. An increased understanding of the position of this artery can minimize the intra-operative bleeding while allowing extension of the bone cuts to achieve exact positioning maxilla. The aim of this investigation was to study the position of the descending palatine artery as it relates to the Le Fort I osteotomy. Methods and patients: Total 40 patients who underwent Le Fort I osteotomy in SNUDH OMFS were studied in this study. We measured the distance from the pyriform aperture to the descending palatine artery (DPA distance) using a ruler. We investigated the relationship between DPA distance, the distance from A point to the McNamara line on lateral cephalography and the patient's body height. Results: The average distances from the pyriform rim to the descending palatine artery were 35.3 mm on the right (range: $30{\sim}40mm$) and 33.7mm (range: $30{\sim}41mm$) on the left in males. Those in females were 33.4 mm on the right (range: $28{\sim}40mm)$ and 32.8mm (range: $27{\sim}38mm$) on the left. The significances between the distance the DPA distance, the body height and the distance from A point to McNamara line were not found. Conclusion: Injury to the descending palatine artery during Le Fort I osteotomy can be minimized by not extending the osteotomy more than 30 mm posterior to the pyriform aperture in mal, and 27 mm in female.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제16권2호
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• pp.171-178
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• 1994

경부수활액낭종과 임파관종은 선천적으로 임파계가 발육이 정지되거나 방해 받으므로 나타나는 병소로 현재까지도 그 본태가 명확히 밝혀지지 않은 질환이다. 본 증례에서는 좌측 하악 우각부 및 상경부에 동통을 동반한 미만성 종창 및 연하장애로 1991년 7월 20일 본원을 내원한 5세 여아에서 임상 소견 및 방사선 소견을 통해 좌측 하악 우각부 및 상경부에 발생한 경부수활액낭종으로 진단하여 악하부 절개를 통해 $1{\time}6{\time}5cm$의 크기를 다방성 낭종구조를 가진 종물을 외과적으로 적출한 증례에 있어서 술후 현재까지 재발 등의 증상없이 양호한 결과를 얻었기에 문헌고찰과 함께 보고하는 바이다.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제33권5호
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• pp.535-542
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• 2007

Ameloblastoma, a benign tumor of odontogenic type, represents 10% of all tumors of the jaw. It is localized in the mandible(80%) and in the maxilla(20%). In every case, the selection of the surgical treatment must consider some fundamental elements, including the age and general state of health the clinicopathological variant, and the localization and extent of the tumor. This study was invested the clinicopathological findings of 23 patients with ameloblastoma which had been diagnosed by biopsy during the period of 1987 to 2005 at Chonnam National University Hospital. And it contained the statistical analysis according to the treatment methods and the clinicopathological findings such as sex, age, location, chief complaints, duration, radiographic findings, histologic findings, treatment methods. The results obtained are were follows. The age of patient ranged from 10 to 91 years(means, 35.9 years) at biopsy. Thirteen(57%) of the 23 subjects were males, and 10(43%) were females. Twenty(87%) of the 23 ameloblastomas were located in the mandible. Swelling was the most common symptom and was experienced by 20(87%) patients. Radiographically, 11(48%) of the 23 tumors were unilocular with a well-demarcated border and 12(52%) were multilocular. The most common histologic pattern was plexiform and acanthomatous rather then follicular. Conservative treatment was performed 7 cases(30%), radical treatment 11 cases(48%), and combined treatment 5 cases(22%). Follow-up period ranged from 2.1 years to 22 years(mean 5.1 years). Based on the above results, surgical excision after marsupialization was found to be useful as a preliminary treatment of the large cystic ameloblastoma in children and adolescents. On the contrary, the lesion with a soap bubble appearance, the one with ineffective marsupialization was subjected to extensive excision of the tumor with a wide margin of normal bone.

• Tuberculosis and Respiratory Diseases
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• 제52권1호
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• pp.86-91
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• 2002

기관지 동맥류는 매우 드문 질환으로 대부분 반복적인 대령 객혈로 나타난다. 수술 전 진단이 되지 못한 경우가 많아 원인을 찾을 수 없는 대량 객혈의 경우 원인 질환으로 의심할 수 있다. 기관지 내시경 중 조직 생검 후 박동성 대량 객혈이 발생시 즉각적인 이중관기관 삽관과 더불어 외과적 절제가 필요하다. 저자들은 대량객혈이 발생된 환자에게 기관지 동맥류로 밝혀진 1예를 경험하였기에 문헌 고찰과 함께 보고하는 바이다.

• Journal of Periodontal and Implant Science
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• 제35권3호
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• pp.563-575
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• 2005

The aim of present study is to evaluate the influence of adjacent tooth to the microbiology of clinically healthy implant. Control group included patients who had clinically healthy implant and tooth with healthy $periodontium(PD{\leq}3mm)$, test group was composed of patients who had clinically healthy implant and tooth with periodontal pocket(PD>3mm). The criteria of clinically health implant are no pain or discomfort, the restorative suprastructure provide satisfactory fit and function, and the tissue around the fixtures were firm and probing with standard periodontal probe with a rounded tip 0.5mm in diameter resulted in penetration of no more than 5mm when using a force of 0.5N at any location. 38 patients, partially edentulous subjects with endosseous root-form implants were selected. All subjects were medically healthy and had not taken systemic antibiotics and professional plaque control 3 months before sampling. Number of control group is 25(mean age $52{\pm}13$, 26 teeth, 34 implants) and test group is 13(mean age $60{\pm}13$, 13 teeth, 17 implants). All teeth and implants of each patient were examined probing depth(PD), bleeding on probing(BOP), and plaque index(PI), and samples of subgingival plaque were obtained at each site with sterile curet or fine paper points, then the plaque transferred to PBS. Obtained samples were examined for the presence of P. gingivalis, T. forsythensis, and T. denticola by the polymerase chain reaction(PCR). The relationship among clinical parameters and the colonizations by the 3 bacterial species from natural teeth and implants region were analyzed by student t-test. The results of this study were as follows: 1. PD was different in teeth between 2 groups(p<0.05), but the other parameters were not. 2. Statistically significant difference was not found in clinical parameters of implants between 2 groups. 3. All bacterial prevalences of teeth were higher in test group than in control group, and prevalence of T. forsythensis had statistically significant difference between 2 groups(p<0.05). 4. Prevalences of P. gingivalis and T. forsythensis are higher in test group than control group, and that of T. denticola is higher in control group than in test group. But there were no statistically significant differences between 2 groups. In conclusion, there is no statistically significant difference in prevalence of implant microbiology between 2 groups. But if the number of samples increased, it will be possible to find out statistical significance in prevalence of P. gingivalis. It seems that pocket of adjacent tooth influences prevalence of P. gingivalis. These results mean that improvement of the periodontal condition before implantation is very important.

• Journal of Periodontal and Implant Science
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• 제39권1호
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• pp.59-70
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• 2009

Purpose: The purpose of this study was to investigate the degree of compliance with supportive periodontal therapy(SPT), to determine if any significant differences existed in the characteristics of compliant, erratically compliant and non-compliant patients and to identify reasons for poor compliance. Materials and methods: Four hundred five patients who initially visited between July 2003 and December 2004 and were treated until June 2005 were retrospectively evaluated for their compliance with SPT in terms of attendance for a recommended schedule of visits. Patients' compliance was classified as complete compliance(attended more than 80% of the recommended appointments), erratic compliance(attended less than 80% of the recommended appointments or discontinued) and non-compliance(did not return for SPT). Analysis was made for each group to correlate the degree of compliance with gender, age, smoking, distance between their houses and the hospital, disease severity, type of therapy, implant, plaque control instruction and systemic diseases. Tele research of erratically compliant and non-compliant patients was carried out to identify reasons for their poor compliance. Results: Only 24.7% of the patients were in complete compliance. The highest drop-out rate(32.4%) occurred in the first year. A significantly greater percentage of non-smokers and patients who finished plaque control instruction were in complete compliance. A significantly greater percentage of patients without implant and patients who had been treated by only scaling and root planing were in non-compliance. More males were found to be compliant with SPT, although this was marginally significant. There were no significant differences between compliant, erratically compliant and non-compliant patients with regard to age, distance, disease severity and systemic disease. The survey revealed that the main reasons for poor compliance with SPT were inconvenient location and insufficient time. Conclusion: Patients' compliance with SPT was poor and the highest drop-out rate(32.4%) occurred in the first year. Significant relationships were found between the degree of compliance and smoking, type of therapy, implant, plaque control instruction and gender.

• 한국방사선학회논문지
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• 제4권2호
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• pp.13-20
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• 2010

견갑골의 골절 유 무와 외상에 의한 탈구를 진단하는데 있어 견갑골의 정측면상의 영상을 얻는 것이 매우 중요하다. 본 연구의 목적은 견갑골 측방향 촬영시 한국인 성인을 대상으로 견갑골의 정측면상을 얻는데 가장 적합한 회전 각도를 알아보는데 있다. 견갑골의 촬영을 위해 내원한 환자 20명(여 8명)을 대상으로 하였고 이들의 평균연령은 35.4세(15세부터 66세)였다. 수동각도기의 거상각도를 $30^{\circ}$, $40^{\circ}$, $45^{\circ}$로 하여 전 후방향 촬영하였다. 영상의 평가는 전문가 5명이 내측연과 외측연의 완전겹침이 있는 영상은 4점, 내측연과 외측연이 불완전 겹침이 있는 영상은 3점, 견갑골체 내측연과 외측연이 겹침이 없는 영상은 2점, 내측연과 외측연이 사방향으로 나타난 영상은 1점으로 4단계로 나누어 blind test를 하여 평가하였다. 평가한 각도별 평균점수는 $30^{\circ}$가 $1.53{\pm}0.39$점, $40^{\circ}$가 $3.83{\pm}0.15$점, $45^{\circ}$가 $2.17{\pm}0.43$ 점으로 나타났다. 도한 가슴둘레가 100cm이상인 군과 100cm이하인 군 간에는 유의한 차이가(p<0. 05) 없었고, 남자와 여자 간에도 역시 유의한 차이가 없는 것으로 나타났다. 지금까지 견갑골 정측면상을 얻는데 적합한 환자의 회전각도에 관한 연구가 없었으나, 본 연구를 통해 검사측을 $40^{\circ}$ 회전하며 검사측 상완골을 반대쪽으로 들며 촬영하는 것이 한국인 성인에서 견갑골의 정측면상을 얻는데 가장 적합하다는 결론을 얻었다. 본 연구 결과는 향후 견갑골의 측방향 촬영을 하는데 유용할 것으로 사료된다.