40세 이하 관상동맥 질환자에서 장기적 임상 관찰

이승욱,정명호,박종철,박형욱,조상희,김원,김계훈,이상현,강경태,조장현,김남호,김건형,안영근,조정관,박종춘,강정채 全南大醫大 2001 전남의대학술지 Vol.37 No.2

유성견에서 교정적 치아이동에 따른 치주조직 변화에 관한 연구

강남용,윤영주,김광원 대한치과교정학회 1997 대한치과교정학회지 Vol.27 No.4

교정력에 의한 치주조직의 변화를 알아보기 위해 성장중인 유성견에서 단기간의 교정력이 가해진 직후와 보정기간 동안 일어나는 치아와 골조직의 변화양상을 조직학적으로 관찰하였다. 본 연구에서는 생후 4-6개월된 유성견 3마리를 이용하여, 각 실험동물의 하악 좌측 견치와 제1대구치는 실험군으로, 우측 견치와 제1대구치는 대조군으로 하였다. 하악견치와 제1대구치에 치관사이에서 최초 교정력이 200mg이 되도록 0.018"X0.022" S.S closed coil spring(Dentarum Co)의 길이를 조절하여 치아에 결찰시키고 장치는 1주간 활성화기간을 갖는 후 14일, 28일의 보정기간을 거쳐 희생시켜 하악골을 절제하여 통법에 따라 H-E염색군, 연마표본군, ALP염색군, TRAP염색군등으로 나누어 염색을 시행하여 다음과 같은 결과를 얻었다. 1. 교정력을 종료한 직후 견인측 치주인대 폭경이 대조군보다 더 증가된 상을 보이고, 반대로 압박측은 폭경이 감소된 소견을 보이며 치주인대의 섬유들이 치축에 수직으로 압축되며 초자양 변성이 관찰되었다. 대조군에서 관찰되는 다수의 규칙적인 배열을 보였던 조골세포가 견인측에서는 간혹 관찰되었다. 2. 교정력 종료후 14일 보정기간 경과군 치주인대내 섬유아세포들이 증식되어 초자지질대가 회복되는 소견이 관찰되었고 견인측 치주인대의 폭경이 교정력을 종료한 직후군보다 감소하였으며, 소수의 ALP(+) 조골세포와 함께 신생골형성도 관찰되었다. 압박측 치주인대의 폭경은 교정력을 종료한 직후군보다 다소 증가하였으며 골흡수도 증가되었다. 3. 교정력 종료후 28일 보정기간 경과군 치주인대섬유는 정상적으로 회복되어 대조군과 유사한 양상을 보였고 견인측 치조골내 다수의 ALP(+)조골세포와 활발한 신생골형성이 관찰됨과 더불어 압박측 치조골은 다수의 TRAP(+)파골세포와 왕성한 골흡수양상을 보였다. 이상의 결과를 종합해 볼때 교정력을 7일간 가한 직후 유리질화가 관찰되었고 교정력을 종료후 28일 보정기간 경과군에서 압박측에서는 파골세포 견인측에서는 조골세포의 활성과 함께 각각에서 왕성한 골 흡수와 신생골형성이 관찰됨을 알 수 있다. For orthodontic tooth movement, optimal orthodontic force should be maintained without periodontal breakdown and alveolar bone should be remodeled physiologically. Therefore, To obtain proper occlusion through tooth movement within alveolar bone, we should know the biomechanics of teeth and supporting tissues. The present study was performed to observe histologic changes of periodontal tissue immediately after application of orthodontic force and during the retention period in growing young adult dogs. In this study, of same animal. The 0.18"X0.22" stainless steel closed coil spring(Dentaurum Co.) was ligated on the experimental teeth at initial 200gm-force from mandibular canine to 1st molar. The animals(4 to 6 months aged young adult dogs)were sacrificed on 0, 14, 28 days after the finish of appliance activation, and the tissue samples were divided into himatoxylin-eosin(HE) staining section, groud section, alkaline phosphatase(ALP) staining section, and tartrate-resistant acid phosphatase(TRAP) staining section. Thereafter, the proparations were examined under light microscopy. The following results were obtained: 1. Immediately after the finish of appliance activation, the periodontal space was increased in tension side, but decreased in pressure side compared to that of control. The hyalinized zone was also observed in the periodontium. 2. After the 14-day retention, peridontal space was decreased in tension side ans slightly increased in pressure side compared to that of immediately after the finish of appliance activation. The hyalinized zone was repaired and a few osteoblasts showing slightly new bone formation were seen. Osteoblasts were scarcely observed along the alveolar bone. 3. After the 28-day retention, peridontal fibers are normally repaired. A lot of TRAP(+) osteoclasts and increased alveolar bone resorption were observed in pressure side, and AP(+) osteoblast and increased new bone formation were observed in tension side.

남성화를 보이는 여성에서 발견된 난소의 Steroid Cell Tumor 1예

조인호,정대훈,박영미,서영진,손영실,정철회,강영미,정수전,김영남,이경복,성문수,김기태 인제대학교 2006 仁濟醫學 Vol.27 No.-

Steroid cell tumor is a rare ovarian sex cord-stromal tumor which accounts for 0.1% of all ovarian tumors. Until now, only 4 cases have been reported in domestic literatures. Steroid cell tumor often secrets testosterone and presents virilization in adult women or precocious puberty in children. Treatment is often performed by surgical removal, adjuvant chemotherapy and radiation, but completely accepted treatment was not existed. We experienced a case of steroid cell tumor, which was manifested by typical virilization in a 43-year old patient, who was previously performed hysterectomy and unilateral oophorectomy. So, we present with a brief review of the literatures.

외상으로 유착된 영구 전치에서의 치관 절제술

강유진,김영진,김현정,남순현 大韓小兒齒科學會 2010 大韓小兒齒科學會誌 Vol.37 No.2

외상으로 치주 인대의 손상이 심한 치아에서는 치아-치조골 유착이 흔히 나타난다. 성장기 아동에서의 치아 유착의 경우 치조골의 성장 중단을 초래하여 저위 교합이 나타나며 이로 인하여 청소년기에 심미적 불만족이 생길 뿐 아니라 인접치의 경사가 발생한다. 이는 교정 또는 보철 치료를 어렵게 만들 수 있으므로 유착된 치아는 비교적 조기에 치료한다. 하지만 저위 교합된 치아를 발치할 경우 치조제의 상당한 소실을 유발할 수 있으며 특히 상악 전치부의 앓은 순측골의 위축을 가져와 심미적인 보철물을 형성하기가 어려워진다. 이러한 치조골의 소설을 방지하기 위하여 치아의 치관부는 제거하고 유착된 치근은 골에 의해 대체되도록 치조골에 남겨두는 치관절제술을 행하는 것이 바람직할 것으로 생각된다. 본 증례에서는 만 9세와 10세에 상악 전치부 치아의 외상을 받은 후 치근 유착이 발생하여 저위 교합을 보이는 성장기 남아에서 추후 예상되는 보철적, 교정적 합병증의 가능성을 감소시키기 위하여 치관절제술을 시행하였다. 저위교합이 2-3 mm정도 진행되었을 때 술식을 행하였으며, 환아의 성장을 고려하여 한국인의 최대 성장 완료 시기인 16세 이전에 술식을 행하였다. 계속적인 임상적, 방사선학적 검사 결과 수평적 치조골의 소실이 방지될 뿐 아니라, 치조골의 수직적 증가를 보이며, 남겨진 치근은 서서히 흡수되는 양상을 보였기에 이를 보고하고자 한다. Trauma commonlyleads to ankylosis for the tooth whose periodontal ligaments have been injured. In growing patients, an ankylosed tooth can disrupt alveolar development, resulting in infraocclusion of the affected tooth. Consequently, this causes aesthetic problems during adolescence, interferes with prosthetic treatment due to th.e inclination of adjacent teeth, and complicates orthodontic dental movement. When the infraoccluded ankylosed tooth is extracted, a considerable amount of alveolar bone is lost, especially in the maxillary anterior region. Moreover, depression of the thin buccal alveolar bone compromises aesthetic restoration. In order to prevent alveolar bone loss, the ankylosed tooth should be treated by decoronation. In the present study, the traumatically injured maxillary incisors of 9-year-old and 10-year-old patients that present infraocclusion accompanied by ankylosis were treated with decoronation procedures. Decoronation procedures were performed when the affected teeth were 2-3 mm below relatively to the adjacent teeth. Moreover, the patients were treated before they get to 16 years old considering the maximum growth peak of the korean adolescents. As the results, there are favorable clinical results associated not only with preservation of horizontal alveolar volume but also with increase in vertical alveolar height after decoronation in growing individuals.

융모성 질환의 임상적 연구

남상륜,손영선,이영일,노흥태,강길전 충남대학교 의과대학 지역사회의학연구소 1989 충남의대잡지 Vol.16 No.2

Seventy nine cases of trophoblastic disease were analyzed at the Department of Obstetrics and Gynecology, Chungnam National University from January, 1985 to October, 1989. The results are as follows: 1. Incidence of trophoblastic disease was one per 31.8 deliveries(3.15%), and it was pathologically consisted with partial mole(27.8%), complete mole(45.6%), invasive mole (17.7%), choriocarcinoma(8.9%). 2. Age group of 26 to 30 was found most frequent(40.5%) and primipara was the most frequent group(43.0%). There was no increase for the persistent disease according to age and para. 3. Clinical manifestations were vaginal bleeding(91.1%), the most common, nausea and vomiting(20.3%), abdominal pain(10.1%) and etc. 4. Molar pregnancies with excessive uterine enlargement were found in 35.6% and were at increased risk for the persistent disease. 5. Antecedant pregnancies prior to trophoblastic disease were abortion(43.0%), term pregnancy(16.5%) and molar pregnancy(16.5%). 6.β-hCG concentration before November, 1986 was significantly lower than after ten. And the first postevacuation β-hCG level was increased in cases of the persistent disease. 7. The treatment regimens in molar pregnancies were suction curettage with prophylactic Act-D(41.4%) and without Act-D(43.1%), hysterectomy with Act-D(13.8%), and hysterotomy(1.7%). There was no difference in complication persistent disease between with and without prophylactic chemotherapy. 8. Non-metastatic and metastatic low risk patients were treated with hysterectomy with or without MTX-CF(66.7%), curettage with MTX-CF, Act-D or MAC(33.3%) to attain remission without failure. All metastatic high risk patients were treated with hysterectomy with 1-6 courses of MAC triple chemotherapy except 1 case of death from respiratory failure and 1 lost case. 9. Side effects after chemotherapy include gastrointestinal symptoms(91.1%), fever(57.8%), leukopenia(49.0%), hepatotoxicity(46.9%), stomatitis(40%), alopecia(28.9%), thrombocytopenia(15.3%) and etc, in order of frequency.

외상으로 실활된 미성숙 영구치에서의 계속된 치근 형성

강유진,김혜영,김영진,김현정,남순현 大韓小兒齒科學會 2009 大韓小兒齒科學會誌 Vol.36 No.4

치아에 외상을 받은 경우 치수 생활력의 상실은 흔한 일이다. 치수 생활력을 검사하는 방법으로는 임상적, 방사선학적으로 여러 가지가 있지만, 미성숙 외상치의 경우 일시적 현상과 가성 반응이 나타날 수 있으므로 치수 괴사에 대한 정확한 진단은 매우 어렵다. 생활력을 상실한 치아는 염증성 치근흡수, 치근단 낭종 등의 발생을 방지하기 위하여 치수 치료를 시행한다. 그러나 미성숙 영구치의 경우, 치수 치료를 시행 후 치근 성장이 정지될 수 있어 결과적으로 얇고 짧은 치근이 형성되어 장기적인 예후는 좋지 않다. 본 임상 증례에서는 외상으로 인하여 실활된 초기 영구치에서 치근단부의 최소한의 침습적 치근단 형성술로 계속된 치근 형성을 보여 이에 보고하는 바이다. In case of luxation injuries, loss of tooth vitality is common. And in case of trauma in the immature permanent teeth, precise diagnosis of pulp necrosis is very difficult. That is because limitation in distinguishing between normal dental papilla in immature permanent teeth, transient apical breakdown(TAB), which is part of normal healing process, and apical radiolucency in pulp necrosis. Especially in non-vital immature permanent tooth, the treatment is complex and requires long time. This clinical case report shows that severely infected immature teeth with periradicular periodontitis can undergo healing and apexogenesis or maturogenesis with no definative treatment or after conservative treatment. In the cases reported, we emphasize the considerable power of regeneration of the tooth, probably due to its large number of undifferentiated mesenchymal cells in the dental papilla, pulp tissue, periodontal ligament tissues. Thus, when endodontic treatment in immature permanent teeth, over instrumentation is not recommend for preserve the apical vital stem cells.

변위 매복된 상악 중절치의 맹출유도

강근영,양규호,최남기,김선미 大韓小兒齒科學會 2005 大韓小兒齒科學會誌 Vol.32 No.3

매복치아란 어떤 원인에 의하여 구강점막이나 약골내에서 치아의 맹출이 중지된 상태를 말하며, 악궁내의 어떠한 치아도 매복될 수 있으나 가장 흔하게 이환되는 치아는 상, 하악 제 3대구치, 상악 견치, 상, 하악 제 2소구치, 상악 중절치의 순으로 나타난다. 이 중 상악 영구 전치의 매복률은 0.1-0.5%정도이며 매복 원인으로는 여러 가지가 있으나 유전치의 외상, 과잉치, 치근단 병소로 인한 매복이 흔하며 조기에 적절히 치료되지 못하면 정중선의 변위, 인접치에 의한 맹출공간 감소, 치조골 높이의 차이 등의 결과를 유발한다. 치료로는 주기적 관찰방법, 매복치의 맹출로가 정상이며 치근이 미완성일 경우 상부 연조직과 경조직을 단순히 제거하여 맹출을 유도하거나 외과적 노출 후 매복치를 교정 하는 방법, 치아이식술, 발치 등을 시행할 수 있다. 본 증례들은 상악 중절치의 맹출 지연을 주소로 본원에 내원한 환아들로 상악 중절치의 변위 배복을 외과적 노출과 교정적 견인을 시행하여 양호한 결과를 얻어 보고하는 바이다. Tooth impaction is defined as a cessation of the eruption of a tooth at the level of the oral mucosa or alveolar bone by any causes. Any tooth in the dental arch can be impacted, but the teeth frequently involved in a descending order are the mandibular and maxillary third molars, the maxillary canines, the mandibular and maxillary second premolars, and the maxillary central incisors. In these teeth, impaction of maxillary incisor occurs in about 0.1-0.5% and major causes are trauma, supernumerary teeth and periapical inflammation of primary maxillary incisor. Delayed eruption of a maxillary central incisor results in midline shift, the space's being occupied by an adjacent tooth and different levels of alveolar height. Treatment options are observation, surgical intervention, surgical exposure and orthodontic traction, trans-plantation and extraction. These cases were about the patients with delayed eruption of maxillary central incisor. We surgically exposed impacted tooth and guided it into normal position by the orthodontic traction. At the completion of traction, the maxillary central incisor was positoned fairly within the arch and complications such as root resorption were not observed.

광주시 환경오염에 관한 조사연구 (Ⅰ) : 대기오염 및 소음에 관하여 A Study on Air Pollution and Noise Level

남현근,류일광,이치영,강영식 광주보건대학 1978 論文集 Vol.4 No.-

Air pollution in Gwangju area was examined for six months from August, 1977 to January. 1978. The surveyed area was divided into four; Industrial, Commercial, Residential and Park area. 'Ten surveying sites which were representing the characteristics of each area were selected. The measuring methods were; the Lead dioxide cylinder method for Sulfur oxides, Triethanolamine plate method for Nitrogen dioxide, Deposit Gauge method of Dustfall, and the Rion noise meter for Noise level. The results we obtained are as follows. 1. SULFUR OXIDES The mean of Sulfur oxides was 0.355㎎SO₃/day/100㎠PbO₂, ranging from 0.12 to 0.57㎎SO₃/day/100㎠PbO₂. The mean value of Sulfur oxides was 0.57㎎SO₃/day/100㎠PbO₂ for Reidential area, 0.51㎎SO₃/day/100㎠PbO₂ for Commercial area(Keumnam-Ro 3 Ka), 0.34㎎SO₃/day/100㎠PbO₂for Industrial area (Im-Dong), and 0.21㎎SO₃/day/100㎠PbO₂ for Park area, respectively. 2. NITROGEN DIOXIDES The mean value of Nitrogen dioxides was 40.75㎍/NO₂/day/100㎠, ranging from 29.79 to 40.75㎍ NO₂/day/100㎠. At Commercial area where the value was the highest, the range of Nitrogene dioxides level was 35.32~50.88㎍ NO₂/day/100㎠. 3. DUSTFALL The mean value of dustfall was 12.8ton/㎢/month, ranging from 5.032 to 24.11 ton/㎢/month. The dustfall for Commercial area was higher than any other area. 4. NOISE The mean value of noise level was 58 dB(A) ranging from 43.3 to 64.4 dB(A). The noise of 64.4 dB(A), at Commercial area was higher than any other area.

돌발성 난청의 임상적 분석

남부현,강갑진,성열웅,송영복 충남대학교 의과대학 지역사회의학연구소 1995 충남의대잡지 Vol.22 No.2

Sudden hearing loss is an abrupt onset of sensorineural hearing loss over a period of hours or a few days without definite cause. The cause and its pathophysiology have not been fully determined, and the treatmnet is controversial at present. The purpose of this study is to seek the best modality of treatment by clinical and stastical analysis of 48 patients (28 male and 20 female) diagnosed as a sudden hearing loss from January 1993 to October 1995. The therapeutic results of the 48 patients were 20 cases (41.7%) of complete recovery, 3 cases (6.2%) of partial recovery, 4 cases (8.3%) of slight recovery and 21 cases (43.8%) of no improvement. Early treatment within a week of onset, ascending or flat types of audiogram, and normal ABR were favorable prognostic factors in recovery of hearing. The presence of accompanying vestibular symptom (ie, vertigo) and profound hearing loss on initial audiogram were poor prognostic factors. However, the gender and the age of the patients did not affect on the hearing result.

기관지천식 환자에서 Furosemide, Disodium cromoglycate 및 Heparin 흡입이 고장액 식염수 기관지유발검사에 미치는 영향

강천일,현상훈,남언정,김건우,윤종수,서영익,이종명,김능수 慶北大學校 醫科大學 1996 慶北醫大誌 Vol.37 No.3

목적 : 기관지천식 환자에서 고장액 식염수의 흡입은 기도수축을 유발할 수 있으며 이는 운동유발성 천식반응과 밀접한 관계가 있는 것으로 알려져 있다. 저자들은 알레르겐 흡입이나 운동에 의해 유발되는 천식에 예방효과가 있는 것으로 알려진 disodium cromoglycate(DSCG), furosemide 및 heparin 흡입이 4.5% NaCl 기관지유발검사(BPT)에 미치는 영향을 조사하였다. 대상 및 방법 : 4.5% NaCl BPT에서 양성반응을 보이는 기관지천식 환자 13명을 대상으로 하였으며 사용된 약물은 furosemide 40㎎, DSCG 40㎎ 및 heparin 1,000μ/㎏이었다. 먼저baseline 4.5% NaCl BPT를 시행한 다음 이들 약물로 전처치후 다시 4.5% NaCl BPT를 시행하여 약물의 효과를 관찰하였다. 결과 : Furosemide 40㎎, DSCG 40㎎및 heparin 1,000μ/㎏의 흡입 전처치는 고장액 식염수에 의한 기도수축 반응에 뚜렷한 예방효과를 보였다. Furosemide와 DSCG로 전처치한 군(n=6)에서 이들의 기도수축 방어율은 각각 100.6±6.6%, 91.1±17.2%였으며 furosemide와 heparin으로 전처치한 군(n=7)에서는 각각 58.7±29.2%, 59.0±51.1%로서 각 군에서 이들 약제간의 방어율에는 유의한 차이가 없었다. 결론 : Furosemide(40㎎), DSCG(40㎎) 및 heparin(1000μ/㎏)의 흡입 전처치는 고장액 식염수에 의한 기도수축 반응에 뚜렷한 예방효과를 보였으며, 적어도 이 용량에서 기도수축 예방 정도에는 유의한 차이가 없음을 알 수 있었다. Background: Hypertonic saline (4.5% NaCl) inhalation is known to induce broncho-constriction by affecting mast cell, epithelial cell and vagal afferent pathway in some asthmatics. Disodium cromoglycate (DSCG) is known to have a preventive effect on allergic asthma and exercise induced asthma, and recently it was reported that furosemide and heparin had similar effect. The purpose of this study was to evaluate the effects of furosemide, DSCG and heparin on hypertonic saline provocation test in asthmatics. Methods: Thirteen asthmatics with a positive response to hypertonic saline challenge were enrolled. Hypertonic saline and test drugs were generated by ultrasonic nebulizer. After taking baseline 4.5% NaCl challenge, subjects were rechallenged with 4.5% NaCl after inhalation of furosemide 40㎎, DSCG 40㎎ or heparin 1,000μ/㎏. Results: 1. There was a significant positive relationship between PC_20-methacholine and PTM-4.5% NaCl(r=0.5575, p = 0.024). 2. Furosemide, DSCG and heparin had no direct bronchodilating effects. 3. Premedication of furosemide and DSCG(n=6) showed significant protective effects on 4.5% NaCl induced broncho-constriction. The average protection rate were 100.6±6.6% and 91.1±17.2%, respectively. 4. Premedication of furosemide and heparin(n=7) showed significant protective effects on 4.5% NaCl induced broncho-constriction. The average protection rate were 58.7±29.2% and 59.0±51.1%. respectively. Conclusions: Furosemide(40㎎), DSCG(40㎎) and heparin(1.000μ/㎏) had significant protective effects on hypertonic saline induced broncho-constriction in asthmatics, and there were no significant differences in their potency of protection rate.