• 제목/요약/키워드: 구강악안면

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제주 지역 병원의 구강 악안면 간호 실태 (Hospital oral and maxillofacial nursing care in Jeju province)

  • 김성준;김세일;송효정;감세훈;이병진
    • 대한치과의사협회지
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    • 제53권1호
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    • pp.36-46
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    • 2015
  • Objectives: The objective of this work was to investigate the hospital nursing care of oral and maxillofacial health in jeju province. Methods: 438 Registered nurses(RN) who were working at each of secondary hospitals in Jeju province had responded to the questionnaire. The data were analyzed via frequency analyses and one-way ANOVA to assess the state of RN on hospital nursing care of oral and maxillofacial health. Results: The class of education on density in formal density that marked '0 hour' and '1-3 hours' were 73.5% and 19.9%, respectively. The class of refresher training on density that marked '0 hours' and '1-3 hours' were 92.9% and 6.6%, aggregately 99.5%. The nursing education on appearance after tumor of maxillofacial area that marked 'formal education' and 'none' were 45.2% and 52.1%, respectively. The score of question 'function, effect and side effect of hexamedin gaggle' was $2.68{\pm}0.95$ by Likert 5-point scale. Likewise, the scores were $2.82{\pm}0.88$ on question 'management of removal denture', $2.83{\pm}0.95$ on question 'preventive dental treatment before anticancer therapy', $2.88{\pm}0.86$ on question 'function of saliva', $2.96{\pm}0.99$ on question 'oral management of tube feeding patient', $3.13{\pm}1.00$ on question 'bacterial endocarditis from oral microflora', $3.36{\pm}0.89$ on question 'dysphagia' and $3.62{\pm}1.03$ on question 'aspiration pneumonia'. RN replied that 'lack of knowledge' and 'delay of cooperation' formed 53.7% and 33.3% respectively, on question 'problem in dental consultation other diseased patient'. Conclusions: From this study, it is necessary for RN and student of nursing science to be educated on the oral and maxillofacial nursing. Authors suggest further co-study and nation-wide research.

구강 편평세포암종에서 p53 단백과 Cyclin D1발현에 대한 면역조직화학적 연구 (THE IMMUNOHISTOCHEMICAL STUDY ON THE EXPRESSION OF p53 PROTEIN AND CYCLIN D1 IN ORAL SQUAMOUS CELL CARCINOMAS)

  • 김종엽;김경욱;이재훈;김창진
    • Maxillofacial Plastic and Reconstructive Surgery
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    • 제21권2호
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    • pp.139-148
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    • 1999
  • Oral cancer is a common neoplasm in humans and etiologic mechanism is not well known, so treatment and evaluation of oral cancer is difficult problem. Traditional TNM classification between prognosis of tumors and classification of histopathologic differentiation has problem like lack of objectivity through operators. In molecular biology, cancer is developed by alteration of activation of oncogene and/or inactivation of tumor suppressor gene. The p53 gene, one of the tumor suppresor genes, is believed to play an important role through mutation and overexpression in the progression of human cancers. The p53 mutation is most frequent genetic disorder in humans. The Cyclin D1 has tumor suppresion activity by regulation of cell cycle. The Cyclin D1 regulate activity of Rb tumor suppresor gene by stimulation of CDK4 The purpose of this study was to observe the expression of p53 protein and Cyclin D1 in oral squamous cell carcinoma, and to get expectation of the malignancy and prognosis of oral squamous cell carcinoma. Using the 15 cases of squamous cell carcinoma and the microscopic H&E and immunohistochemical stain. We divided it into 3 groups according to the stain extent, clinical stage and histologic differentiation. The results were as follows1.In the features of immunohistochemical stain of 15 cases of squamous cell carcinoma, positive reaction of p53 was identified in 8 cases (53.3%) and positive reaction of cyclin D1 was identified in 3 cases (20%). Both positive reaction of p53 protein and Cyclin D1 was show in only one case. 2.8 of p53 positive cases were linked in 87.5% of the end stage tumor, 62.5% of neck node involvement, 87.5% of poorly and moderately histopathplogic differentiation. 3. All 3 of Cyclin D1 positive cases were linked in the end stage tumor, neck node involvement, poorly and moderately histopathologic differentiation. From above results, expression of p53 protein was identified in 53.3% of 15 cases and these results mean oral squamous cell carcinoma was drived by mutation of p53 protein. Especially, highly positive reaction of p53 protein and Cyclin D1 was identified in cases that involvement of neck lymph node and the end stage tumors and it means that the evaluation of p53 protein and Cyclin D1 was useful for evaluation of malignant tumor as specific tumor marker.

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구강암 유전자 치료를 위한 재조합 HSCC-1 아데노바이러스의 개발 (CONSTRUCTION OF RECOMBINANT HSCC-1 ADENOVIRUS VECTOR FOR ORAL CANCER GENE THERAPY)

  • 김창현;김진우;김명진;표성운
    • Maxillofacial Plastic and Reconstructive Surgery
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    • 제27권2호
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    • pp.103-109
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    • 2005
  • In spite of the ongoing advances, standard therapies for oral cancer still has some limitations in efficacy and in ability to prolong survival rate of advanced disease and result in significant functional defect and severe cosmetic deformity. Currently gene therapy using tumor suppressor gene is considered as a potent candidate for new therapeutic approaches that can improve efficacy and reduce complications. The purpose of this research is to identify the role of adenoviral vector to transfer HCCS-1 tumor suppressor gene in oral cancer cells and to find out whether there is a possibility for it to serve in the field of gene therapy. The human SCC-25 cell line was used for transfection. To determine the efficiency of the adenovirus as a gene delivery vector cell line was transduced with LacZ gene and analysed with X-gal staining. Northern blot was performed to confirm the tranfection with HSCC-1 gene and cell viability was assessed by cell cytotoxicity assay. We had successfully construct the recombinant HSCC-1 adenovirus(Ad5CMV-HCCS-1). DNA extracted from Ad5CMV-HCCS-1 revealed HCCS-1 gene is incorporated. The transduction efficiencies were over than 50% of SCC-25 cells with a MOI of 2 and over 95% with a MOI of 50. Northern blot analysis showed that a single 0.6kb mRNA transcript was expressed in Ad5CMV-HCCS-1 transduced SCC-25 cells. There was no or very low transcription HCCS-1 mRNA in wild and Ad5CMV-LacZ transduced SCC-25 cells. Cells transduced with Ad5CMV-HCCS-1 showed significant growth inhibition. By day 6, Ad5CMV-HCCS-1 treated cell count was decreased to 30% of mock-infected cells, while that of Ad5CMV-LacZ treated cells was 90% of mock-infected cells (p<0.05). Finally, these result suggest that the Ad5CMV-HCCS-1 has potential as a gene therapy tool for oral cancer.

인간 무세포성 진피기질 위에 배양한 가토 구강각화상피세포의 중충화와 기저막 형성에 관한 연구 (FORMATION OF BASEMENT MEMBRANE AND STRATIFICATION OF RABBIT ORAL KERATINOCYTES CULTURED ON HUMAN ACELLULAR DERMAL MATRIX)

  • 김용덕;안강민;염학렬;정헌종;김성민;장정원;성미애;박희정;황순정;이종호
    • Maxillofacial Plastic and Reconstructive Surgery
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    • 제27권6호
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    • pp.510-522
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    • 2005
  • To assess the clinical applicability of bio-artificial mucosa which was made with autologous oral keratinocytes and human acellular dermal matrix, the formation of basement membrane and stratification of oral keratinocytes were evaluated. Six New Zealand white rabbits (around 2kg in weight) were anesthetized and its buccal mucosa was harvested (1.0 $\times$ 0.5cm size). Oral keratinicytes were extracted and cultured primarily with the feeder layer of pretreated NIH J2 3T3 fibroblast. These confluent cells were innoculated on the human acellular dermal matrix and cultured in multiple layer by air-rafting method. After 3, 5, 7, 10, 14 days of culture, each cultured bio-artificial mucosa was investigated the number of epthelial layer of by H&E stain and toluidine blue stain. The immuhohistochemical methods were used to evaluate the cell division capacity, the formation of basement membrane, and it's property of specific cells (PCNA, cytokeratin 14, laminin). Transmission electromicroscopy was used for the attachment between cells and matrix with the number of hemidesmosome. In result, the numbers of layer of stratified growth of oral keratinocyte cultured on the human acellular dermal matrix and the number of hemidesomal attachment between epithelial cells and human acellular dermal matrix were similar to the layers of normal oral mucosa after 10 days of culture. The cell division rate, basement membrane formation and proliferation rate increased as culture period increased. With these results, bio-artificial mucosa with autologous oral epithelial cells cultured on the acellular dermal matrix had clinically adaptable properties after 10 days' culture and this new bio-artificial mucosa model with relatively short culture time can be expected clinical applicability.

악골에서 발견된 multiple myeloma의 구강내 plasmacytoma 병소: 증례보고 (MULTIPLE MYELOMA IN THE MANDIBLE MANIFESTED AS ORAL LESION OF PLASMACYTOMA: A CASE REPORT)

  • 이정아;박지영;윤성훈;박민규;김창현;박재억
    • Maxillofacial Plastic and Reconstructive Surgery
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    • 제29권1호
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    • pp.85-90
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    • 2007
  • Plasma cell neoplasms are generally categorized into four groups; multiple myeloma(MM), solitary plasmacytoma of the bone(SPB), plasma cell leukemias, and extramedullary plasmacytomas(EMP). These tumors may be further described as localized or diffuse in presentation. Localized plasma cell neoplasms are rare occurrences and include solitary plasmacytomas of the skeletal system, which account for 2-5% of all plasma cell neoplasms and extramedullary plasmacytomas of the soft tissue, which account for approximately 3% of all such neoplasms. A plasmacytoma is defined as any discrete, most likely solitary mass of neoplastic plasma cells either in the bone marrow or in various soft tissue sites. Diffuse lesions include the other two groups, multiple myeloma and plasma cell leukemia. The relationship between these processes has not yet been definitively characterized, but there appears to be a continuum in which both SPB and EMP often progress to MM. The patient was referred who had continuous deep throbbing bone pain and swelling on the left posterior gingival area of the mandible after extraction of the first and second molar. The result of intraoperative excisional biopsy of the lesion was confirmed as a plasmacytoma. And it revealed systemic multiple myeloma through the further diagnostic work-up. It is worth to report because of a rare case of multiple myeloma found in oral cavity as a form of plasmacytoma.

구강 편평세포암종에서 Taxol과 Cyclosporin A의 세포사멸 상승 작용 효과 (SYNERGISTIC APOPTOTIC EFFECT OF TAXOL ON ORAL SQUAMOUS CELL CARCINOMA BY CYCLOSPORIN A)

  • 서민정;한세진;이재훈
    • Maxillofacial Plastic and Reconstructive Surgery
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    • 제29권5호
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    • pp.394-404
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    • 2007
  • Oral squamous cell carcinoma is the most prevalent oral cancer, which is characterized by its high metastasis and recurrent rates and poor prognosis. Taxol is an anticancer agent which is microbial products extracted from jew tree. It combines with the tubulin and induces apoptosis by inhibiting mitosis of cell with microtubule stabilization. Recently, it was reported to be effective in various solid tumors, but only very slight effect has been seen in oral squamous cell carcinomas due to its cell-specific potencies. Cyclosporin A is used as immune suppressant and is being applied in anticancer therapy as its mechanism of induction of change of apoptotic process in various cells have been known. In this study, oral squamous cell carcinoma HN22 cell line was used for in vitro experiment and as for the experimental group taxol and cyclosporin A were applied alone and to observe the synergistic effect of apoptosis, Taxol and cyclosporin A were coadministered with different concentration of taxol for comparison. The results were obtained as follow: 1. There was no difference in Bcl-2, Bax, caspase 3, 8, 9 mRNA expression when cyclosprin A or taxol was applied alone to HN 22 cell line. 2. Caspase 3, 9 mRNA expression was prominently increased when cyclosprin A and taxol were applied together to cancer cell. 3. No significant difference was observed when cyclosporin A and taxol($1{\mu}g/ml$ and $3{\mu}g/ml$) were applied together to cancer cell line. 4. No significant difference was seen in Bcl-2, Bax, and caspase 8 mRNA expression in all the groups of in vitro experiments. 5. When cyclosporin A was applied alone in vivo study on the nude mice, histopathologi cal findings was similar to those of the control group. Oral squamous cell carcinoma induced by inoculation of HN 22 cell line was not reduced after treatment of cyclosporin A. 6. When taxol was applied alone, the islands of squamous cell carcinoma still remained, which meant insignificant healing effect. There was a lesser volume increase compared with the cyclosporin A alone. 7. When taxol and cyclosporin A were applied together, the connective tissue and calcification were seen in the histopathologic findings. Oral squamous cell carcinoma was decreased and cancer cell was disappeared. In observing the tumor mass change with time, there was a gradual decreased size and healing features. As the results of the in vitro experiment, it could conclud that only when the two agents are applied together, mitochondria-mediated apoptosis occurred by considerable increase of caspase 3, 9 mRNA expression, irrespectable of the concentration of taxol. In vivo experiment, there was a discrete synergistic effect when the two agents were applied together. But single use of cyclosporin A was not effective in this study. Based on the results of this experiment, if further clinical studies are done, taxol and cyclosporin A could be effectively used in treatment of oral squamous cell carcinomas.

COX 억제제에 의해 유도되는 구강편평세포암종 세포주의 성장 억제 효과 (GROWTH INHIBITION OF ORAL SQUAMOUS CELL CARCINORMA CELL LINE INDUCED BY COX INHIBITOR)

  • 박광진;한세진;이재훈
    • Maxillofacial Plastic and Reconstructive Surgery
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    • 제30권4호
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    • pp.333-344
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    • 2008
  • The objectives of this study was to explore the growth pattern of the oral squamous cell carcinoma when overexpressed COX was inhibited, explore the pathway that COX inhibitors suppressed the proliferation of cancer cells, and then hereafter investigate the potential of COX as chemopreventive target for oral squamous cell carcinoma. For confirming the COX-dependent effect and mechanisms on growth of the oral cancer cells, we treated the nonselective NSAID, Mefenamic acid and COX-2 selective inhibitor, Celecoxib in HN4 cell line. And then the cell line was evaluated with MTT assay and growth curve, the production of PGE2, total RNA extraction and RT-PCR analysis, and TEM The results were obtained as follows: 1. After administration of medication, in the result of MTT assay, Celecoxib inoculated group inhibit the cell growth rather than Mefenamic acid inoculated group. 2. The growth curve of cell line showed as time passes by there was a dramatic cell growth in the control group, and gradual growth inhibition was found in medication inoculated group and, in Celecoxib inoculated group there was more inhibition of cell growth. 3. After the administration of medication, Celecoxib tend to inhibit the synthesis of PGE2 more than Mefenamic acid. Mefenamic acid inhibit the synthesis of PGE2 more as the concentration gets high, but Celecoxib inhibited the synthesis of PGE2 even in low concentration. 4. After the administration of medication, the revelation of COX mRNA in cell line, there was a 50% decrease in COX-1, 60% decrease in COX-2 as in $50{\mu}M$ Mefenamic acid, and in Celecoxib $50{\mu}M$ there was not much difference in COX-1 and 90% decrease in COX-2 was found. 5. HN4 cell line showed broken nucleus and tangled cytoskeleton bundles in cytoplasm which meant apoptotic features after the treatment of Celecoxib in TEM view. Depending on the above results, we estimate that the inhibition of the expression of COX-2 cause the growth suppression of the oral squamous cell carcinoma, and it get achieved through pathway of reduced PGE2 production and increased apoptosis. In addition to, because COX-2 selective inhibitor specifically act to COX-2, it is considered that COX-2 selective inhibitor has the adequate potential as chemopreventive agent for oral squamous cell carcinoma.

비정복성 관절원판 전위와 연관되어 발생된 전치부 개교합 환자의 측방 두부방사선 계측 (Cephalometric Characteristics of the Patients with Developed Anterior Open Bite Following Anterior Disc Dislocation without Reductions)

  • 허윤경;최재갑
    • Journal of Oral Medicine and Pain
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    • 제31권3호
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    • pp.255-263
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    • 2006
  • 임상적으로 비정복성 관절원판전위로 진단된 3명의 환자에서 이들은 모두 물리치료, 약물치료만이 행해진 환자로 내원 중에 갑작스런 교합변화 및 전치부 개교합을 나타내었다. 종래에 알려진 개교합의 발생은 류마티즘 관절염이나 양측과두의 심한 퇴행성 변화가 있는 경우에 상당한 과두지지의 상실로 후방지지를 잃게 되어 구치들이 과도하게 접촉하고 전치 개교합이 발생될 수 있는 것은 이미 잘 알려진 사실이나, 과두지지의 상실이 없는 비정복성 관절원판전위만으로 특정 환자에서는 개교합의 발생이 가능하며 이는 구치부 치아의 증출에 의한 전치부 개교합이라 볼 수 없으며, 하악의 후하방 회전의 결과로 볼 수 있다. 이들 3환자들의 전체적인 골격적 특징은(1)구치부 앵글씨 1급 교합관계와 천피개 교합,(2)높은 하악하연각,(3)높은 하악각 등으로 봐서 상하악의 골격적 형태가 II급과 III급에 관계없이 수직적 성장이 강한 안모형태에서 갑작스런 개교합이 발생될 수 있으리라 생각된다. 앞으로 개교합이 발생되는 관절원판전위 환자에서 하악의 후하방 회전의 원인을 밝히고, 이러한 골격적인 특징이 측두하악장애의 원인 인자가 될 수 있는 지 더 많은 연구가 필요하리라 생각된다.

가토 두개골 결손부에 이식된 ${\beta}$-TCP의 골치유과정에서 맥동전자기장의 영향에 관한 연구 (THE EFFECT OF PULSED ELECTROMAGNETIC FIELDS ON ${\beta}$-TCP GRAFT IN RABBIT CRANIAL BONE DEFECT)

  • 김상우;황경균;임병섭;박창주;정일혁;백승삼;심광섭
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • 제32권4호
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    • pp.360-373
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    • 2006
  • The purpose of this research was to investigate whether pulsed electromagnetic field (PEMF) stimulation applied to the rabbit cranial defects grafted with ${\beta}$-tricalcium phosphate (${\beta}$-TCP) could affect the new bone formation. With 16 New Zealand white rabbits under the same condition, bilateral calvarial bone defects were formed around the sagittal suture line. The defect on the left side was grafted with ${\beta}$-TCP, while on the right side was grafted by harvested autogenous bone. PEMF was applied to 8 rabbits for 8 hours per day. The bony specimen were divided into 3 groups, the group 1 was autogenous bone grafted specimen, the group 2 was ${\beta}$-TCP grafted with PEMF, and the group 3 was ${\beta}$-TCP grafted without PEMF. We investigated the bone regeneration & growth factor expression at 2, 4, 6, and 8 weeks. As a result, BMP 2 was expressed in the group 1 from 2 weeks, the group 2 from 4 weeks, and the group 3 from 6 weeks. BMP 4 was expressed in the group 1 from 2 weeks, in the group 2 and the group 3 from 4 weeks. 4. There was no significant difference in expression pattern of BMP 7, PDGF, VEGF, and TGF-${\beta}$1 during grafted bone regeneration in group 1, 2, and 3. According to our results, PEMF stimulation could be effective on the new bome formation in animal study, and have a feasibility of clinical use.

비관형 천연 셀룰로오스막 도관을 이용한 말초신경 재생에 대한 실험적 연구 (EXPERIMENTAL STUDY OF PERIPHERAL NERVE REGENERATION BY USING NON-TUBULAR NATURAL CELLULOSE MEMBRANE NERVE CONDUIT)

  • 김성민;이종호;이석근
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • 제32권4호
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    • pp.295-307
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    • 2006
  • Styela clava, called non-native tunicate or sea squirt, is habitat which include bays and harbors in Korea and several sites in the sea faced world. We fabricate cellulose membrane nerve conduit (CMNC) from this native sea squirt skin, and evaluate the capacity of promoting peripheral nerve regeneration in the rat sciatic nerve defect model. After processing the pure cellulose membrane from the sea squirt skin as we already published before, CMNC was designed as a non-tubular sheet with 14 mm length and 4 mm width. Total eleven male Spraque-Dawley rats (12 weeks, weighing 250 to 300g) were divided into sham group (n=2), silicone tube grafted control group (n=3) and experimental group (n=6). Each CMNC grafted nerve was evaluated after 4, 8 and 12 weeks in the experimental group, and after 12 weeks, sciatic function was evaluated with sciatic function index (SFI) and gait analysis, and histomorphology of nerve conduit and the innervated tissues of sciatic nerve were all examined using image analyzer and electromicroscopic methods in the all groups. The regenerated axon and nerve sheath were found only in the inner surface of the CMNC after 4 weeks and became more thicker after 8 and 12 weeks. In the TEM study, CMNC grafted group showed more abundant organized myelinated nerve fibers with thickened extracellular matrix than silicone conduit grafted group after 12 weeks. The sciatic function index (SFI) and ankle stance angle (ASA) in the functional evaluation were $-47.2{\pm}3.9$, $35.5^{\circ}{\pm}4.9^{\circ}$ in CMNC grafted group (n=2) and $-80.4{\pm}7.4$, $29.2^{\circ}{\pm}5.3^{\circ}$ in silicone conduit grafted group (n=3), respectively. And the myelinated axon was 41.59% in CMNC group and 9.51% in silicone conduit group to the sham group. The development of a bioactive CMNC to replace autogenous nerve grafts offers a potential and available approach to improved peripheral nerve regeneration. As we already published before, small peptide fragment derived from the basement membrane matrix proteins of squirt skin, which is a kind of anchoring protein composed of glycocalyx, induced the effective axonal regeneration with rapid growth of Schwann cells beneath the inner surface of CMNC. So the possibilities of clinical application as a peripheral nerve regeneration will be able to be suggested.