• Maxillofacial Plastic and Reconstructive Surgery
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• 제20권4호
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• pp.341-354
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• 1998

GMI (Fibrel${(R)}$) is one of the dermal filling substances which have been successfully used for the treatment of depressed cutaneous scar and wrinkles. It's major components are; Gelatin powder, which provides a framework for the clot to form and remains stable under the scar, and ${\varepsilon}$-aminocaproic acid, which inhibits the production of fibrinolysin, and Plasma, which provides the necessary ingredients for collagen synthesis. GMI has advantages of low immunogenicity and increased longevity. It has been known to induce fibroblast activity and promote new collagen synthesis. We used 34 Sprague-Dawley rats which were bred under the same condition and duration. 18 of experimental animals were undergone cardiac puncture, and their blood were collected, centrifugated, and stored in freezer. Out of 16 animals, control group were injected with 2ml plasma into the subcutaneous tissue of Lt. scapular, while experimental group were implanted of 2 ml GMI into the Rt. same area. Experimental animals were sacrificed at the 3rd day, 5th day, 1st week and 2nd week respectively after implantation of GMI. To observe the histopathologic change of GMI and surrounding tissue reaction of GMI, we had examined with H&E staining, immunohistochemical staining with vimentin, ${\alpha}$-SMA, S-100 under LM and SEM. The obtained results were as follows ; 1. In LM study, the inflammatory cell infiltrations and granulation tissue formation were observed, and muscle tissues were well attached with adipose tissues in the control group. In the experimental group, inflammatory cell infiltrations had been observed by the 2nd week and irregular adipiose tissues and well differentiated mesenchymal tissues were examined. 2. In immunohistochemical study, the experimental group of ${\alpha}$-SMA study, there were a prominent positive response on endothelial development of granulation tissues and mesenchymal tissues compare with the control group. In vimentin study, positive response on mescenchymal fibroblast continued to 2nd week, but negative in the control group. In S-100 study, both groups were positively responded on irregular adipose tissues. 3. In SEM study, collagen fibers were embedded by the plasma by the 5th day in the control group, and in the 3rd day experiment GMI were resorved but communited with collagen fiber till the 1st week. Collagen fibers were infilt-rated into GMI at the 2nd week and the infilltrated GMI were conglomerated with the mature adipose cells and the collagen fibers. From the above results, GMI implantation in the subcutaneous tissue of Sprague-Dawley rat, the mild infiltration of inflammatory cells were showed till 2nd week and the granulation tissues were observed. GMI were nearly resorbed till 2nd week, but well attached with adipose tissue and collagen fibers. The endothelium and fibroblasts were actively proliferated. Adipose tissues and mesenchymal tissue cells were observed. As already expressed, GMI showed resorptive change in course of time without any early immune reaction, and seemed to induce fibroblast activity and promote new collagen synthesis.

• 대한영상의학회지
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• 제85권1호
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• pp.36-53
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• 2024

척추 수술의 빈도 증가와 더불어 radiography, CT, MRI 등의 의료 영상 촬영 건수도 증가하고 있으며, 이와 관련된 영상 판독의 중요성이 점점 더 커지고 있다. 본 논문에서는 척추 수술 후 발생 가능한 다양한 합병증을 이해하고, 이를 정확하고 효과적으로 진단하는 영상 검사의 중요 소견에 대해 다루고자 한다. 특히, 수술 후 초기 및 중장기 합병증을 구분하여, 각 시기별 특징적인 영상 소견을 자세히 설명한다. 척추 수술 후 초기 합병증으로는 부적절한 수술 기구 배치(instrument malposition), 장액종(seroma), 혈종(hematoma), 거짓수막류(pseudomeningocele), 수술 주변 감염(infection) 등이 있으며, 중장기 합병증으로는 수술 기구 주변의 골용해(osteolysis), 융합 실패(failure of fusion), 인접 분절 질환(adjacent segment disease), 경막외 섬유화 또는 흉터 조직(epidural fibrosis or scar) 형성 등이 포함된다. 이러한 척수 수술 후 발생하는 합병증 관련 영상 평가에 대한 정확한 이해는 척추 수술 후 합병증을 적시에 정확하게 진단하여 효과적인 환자 치료에 기여할 것이다.

• Childhood Kidney Diseases
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• 제3권2호
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• pp.187-195
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• 1999

목적 : 방광요관역류는 방광에서 요관과 신장으로 소변이 역류하는 현상으로 요로감염증의 약 1/3에서 발견되며 정도는 1도에서 5도까지 나눌수 있다. 소아의 방광요관역류의 진단에 있어 사용되는 RI VCUG(Radioisotope voiding cystourethrography(이하 VCUG)) 와 X-ray VCUG의 결과를 비교하여 방광요관역류의 진단에 어느 방법이 더 유용한지 평가하고자 본 연구를 시행하였다. 방법 : 1991년 1월부터 1998년 7월까지 7년 6개월동안 순천향병원 소아과 외래를 방문한 환아중 잦은 요로감염증이나 초음파 검사상 이상소견을 보인 9개월에서 17세까지 평균 5년 6개월의 남아 19명, 여아 21명을 대상으로 대상환아들에게 X-ray VCUG나 RI VCUG 또는 두가지 방법을 동시에 시행하였으며 요검사와 소변 배양검사를 1개월마다, 신장 초음파 검사를 3개월마다, RI VCUG를 6개월마다 추적검사를 시행하여 방광요관역류의 소실여부를 관찰하며 예후를 평가하였다. 결과 : 대상환아중 24명이 RI VCUG를 시행하여 17명이 방광요관역류소견을 보여 70.1%의 양성률을 보였고 22명이 X-ray VCUG를 시행하여 9명이 방광요관역류소견을 보여 40.1%의 양성률을 보였으며 19명이 두가지 검사를 모두 시행하여 15명이 RI VCUG상 양성소견을 보였고 이중 7명이 X-ray VCUG상 양성소견을 보였고 RI VCUG상 음성소견을 보인 4명은 X-ray VCUG 상에서도 음성소견을 보였다. 방광요관역류환아의 예후는 중복신장을 동반한 1례에서는 수술로 교정되었으며 다낭포신을 동반한 1례에서는 역류가 지속되었고 그외 단순한 역류에서는 자연소실과 반혼의 형성이 각각 8명이었으며 역류가 지속된 경우가 5명, 수술로 교정된 경우는 2명, 신기능이 감소된 경우가1명, 추적관찰이 되지않은 경우가 1명이었다. DMSA(2,3-dimercaptosuccinic acid 이하 DMSA) sacn상 방광요관역류환아 9명중 8명이 반흔을 형성하였고 역류가 없던 8명에서는 반흔을 형성하지 않았다. 요배양검사상 방광요관역류환아가 19명중 17명으로 역류가 없던 환아 21명중 15명이 양성소견을 보인것보다 양성률이 높았으며 원인균으로는 대장균이 가장많았고 방광요관역류환아에서 요로감염이 없던 기간은 14개월로 방광요관역류가 없는 환아에서의 26개월보다 짧았다. 결론 : 소아의 방광요관 역류의 진단에 있어 RI VCUG가 X-ray VCUG보다 양성률이 높음을 확인할수 있었다. 그러므로 초기진단시 방광요관 역류가 의심되나 X-ray VCUG로 발견되지 않은 경우에는 RI VCUG를 꼭 시행하는 것이 방광요관역류의 정확한 진단을 하는데 도움이 된다.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제34권6호
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• pp.644-648
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• 2008

Purpose: The aim of this study was to investigate the clinical cases of subcondylar fracture with intraoral approach. Material and Method: Fifteen patients with unilateral subcondylar fracture were treated in the department of oral and maxillofacial surgery, Kangdong Sacred Heart Hospital, College of Medicine, Hallym University between 2006 and 2007. Each patients was examined by computed tomography(CT) and panorama. 3D-CT taken when fractured segment was displaced and comminuted. Patients was done intermaxillary fixation to occlusal stability and prevent displacement of fractured segment before general operation. Open reduction and internal fixation(ORIF) accomplished under general anesthesia and used to intraoral approach. We examinated the state of occlusion, maximum opening. Evaluation of the state of occlusion was divided in patient`s subjective evaluation that compare pre-traumatic occlusion with postoperative occlusion, and estimator`s objective evaluation that use articulating paper. Examination was done at 2 weeks, 1, 3, 6 month postoperative by follow up. Result: The ORIF through intraoral approach was good in all patients. In the state of occlusion, all patients recovered pre-traumatic occlusion in 6 month postoperation. Maximum opening was gradually increased. In 3 month postoperative, maximum opening was excessed 40mm. Conclusion: Our study indicate that the intraoral approach is a good technique for subcondylar fracture. Intraoral approach prevent complication that facial nerve damage, scar formation caused by extraoral approach. So, we recommend intraoral approach when subcondylar fracture.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제21권3호
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• pp.277-283
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• 1999

This study was aimed at furnishing the data of Naso-orbito-ethmoidal fractures and aiding treatmenting Naso-orbito-ethmoidal fractures A 5-year review of Naso-orbito-ethmoidal fractures and concomitant injuries is presented. The patients were treated in the Dept. of Oral and Maxillofacial Surgery of Wankwang University Hospital from Jan. 1, 1993 to Dec. 31, 1997. The results were as followes: Male predominated over female by a ratio of 4.6 : 1. The most common reasons is traffic accident(88.2%). The elapsed time from injury to operation is average 9.2 days, and the mean admission days were 79 days and removal of plates were average 217.3 days. The most associated facial bone fractures is Zygomatico-Maxillary complex fracture(20%). Associated injuries were neurologic injury(29.4%), orthopedic injury(23.5%), opthalmologic injury(17.6%), body injury(5.8%), neuropsychologic injury(5.8%) and otolaryngologic injury(5.8%) in this order. The most injured teeth were upper and lower incisors. The intubation methods for surgery were orotracheal(29.57%), submental(29.5%), and nasotracheal technique(41%). Most patients had complications, that were post-traumatic telecanthus, nasal depression, scar formation. This results suggest that early diagnosis and treatment is prerequisits to satisfactory result. Aggressive management of NOE fracture with direct or bicoronal exposure with aid of CT is now an accepted norm.

• 한국생물공학회:학술대회논문집
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• 한국생물공학회 2003년도 생물공학의 동향(XIII)
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• pp.164-166
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• 2003

본 연구에서는 손상된 심근의 재생을 위하여 골수단핵세포를 피브린 고분자와 함께 SD 래트에 이식하였고 8주 후에 신생혈관의 형성과 더불어 심장의 기능이 향상되었음을 확인할 수 있었다. 이 연구는 세포이식을 통한 조직 재생시 세포 이식용 매트릭스의 중요성을 보여준다. 환자 자신의 골수세포를 사용한다면 면역 문제가 없어서, 이 방법이 심부전 환자의 치료에 쉽게 이용될 수 있을 것이다.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제18권3호
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• pp.366-370
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• 1996

Bilateral cleft lip reconstruction can be performed in one-or two-stages. The choice depends on the surgeon's proficiency and experience. However the type and severity of the cleft must be considered. Complete or incomplete symmetric, bilateral clefts in which the premaxilla is within the alveolar arch or slightly protruded can be successfully treated with simultaneous lip reconstruction on both sides. There are some advantages that one-stage lip reconstruction facilitates creation of a symmetric and balanced lip, retraction of protruding premaxilla and the parent's psychologic satisfaction. However, there are some disadvantages such as micrognathia of the upper jaw by severe scar formation and poor adaptation of flap margins by severe tension. The surgeon must be able to judge and exploit the advantages offered by one-stage approach. We present the case report of one-stage reconstruction of primary bilateral cleft lip with literature reviews.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제36권6호
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• pp.548-552
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• 2010

The submandibular gland is the second largest major salivary gland, which secretes 40% of the total daily saliva. Owing to its anatomic characteristics as well as the high viscosity and basicity of the saliva, sialolithiasis is found most commonly in the submandibular gland. Sialolithiasis that cannot be treated by conservative treatment is conventionally removed by an excision of the submandibular gland. Generally, an excision of the submandibular gland is performed via an extra-oral approach but the disadvantages of this treatment include a risk of injuring the facial nerve and scar formation. Case reports have revealed an even less invasive intraoral surgical technique for the removal of sialolith that does not affect the submandibular gland function. The functional recovery of the gland, complications and recurrence rates after surgery with this conservative intraoral procedure were all successful. We report 5 patients from the department of Oral and Maxillofacial Surgery at Dental Hospital, Yonsei University, who had undergone a resection of the sialolith though the intraoral approach with successful results.

• 한국생물공학회:학술대회논문집
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• 한국생물공학회 2003년도 생물공학의 동향(XII)
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• pp.302-305
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• 2003

It is difficult to obtain sufficient healthy skin for coverage of a wide area of skin wound. In the skin, an additional population of living epithelial cells is located in the outer root sheath (ORS) of hair $follicles.^{1),2)}$ ORS cells should be a good source of epithelium because they are easily obtainable and patients do not have to suffer from scar formation at donor sites. We modified ordinary primary culture technique for the purpose of solving such problem that epithelial cells have a low propagation and easy aging during culture periods. First of all, we improved primary cultivation methods. In the ordinary primary culture, average yield of human ORS cells was $2\;{\times}\;10^3$ cells/follicle by direct incubation with trypsin (0.1%)/EDTA (0.02%) solution for 15 min at $37^{\circ}C$ but we could obtain about $6.5\;{\times}\;10^3$ cells/follicle by two step enzyme digestion method with dispase (1.2 U/ml) and trypsin (0.1%)/EDTA (0.02%) solution. So we could achieve three times higher primary cultured ORS cell yield. Secondly, we could obtain total $2\;{\times}\;10^7$ cells in serum free medium and even more total $6\;{\times}\;10^7$ cells in modified E-medium with mitomycin C-treated feeder cells during 17 days. Using the cultured ORS cells, and we could make bioartificial skin equivalent in vitro and concluded that ORS cells were progenitor cells for skin epithelial cell.

• Archives of Reconstructive Microsurgery
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• 제10권2호
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• pp.169-174
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• 2001

Purpose : The problems of late deterioration of sensation and a double sensibility phenomenon are a known deficiency of the original neurovascular island flap. To eliminate this problems, the authors was performed to assess the results of Thumb-pulp loss reconstruction with a heterodigital neurovascular island Flap Using a Nerve Disconnecting-Reconnecting Technique Material and Methods : Between July. 1987 and November. 2000, we have used a disconnecting-reconnecting technique for heterodigital island flaps in which divided nerve of the transferred island flap is sutured to original nerve of the thumb in 9 patients. 9 patients with a mean follow-up period of 3.6 years were examined, while 7 patients were follow-up for 2years or more. Evaluation of results was based on flap quality, donor site quality, classic two-point sensory discrimination(2PD), and location of sensation(double sensibility), donor site cold intolerance, neuroma formation, scar contractures, total active movement(TAM) of the thumb and donor digit and subjective results and objective results. Results : The two-point discrimination was average 6.7 mm. Donor site paresthesia was observed more frequently in a short postoperative period. Sensation was referred to the thumb in all cases and the recovery occurred over a period of a two months. There were no flap complication or failures and the length of the thumb tip was preserved in all cases. Conclusion : This technique was found to provide well-vascularized pulp of the thumb with proper cortical representation in one operative stage.