고관절 전치환술에서 하지 길이의 변화(수술전 예상 측정치와 수술후 실제 측정치 사이의 차이에 대하여)

원중희 ( Choong Hee Won ),장관환 ( Kwan Whan Chang ),신건 ( Geon Shin ),전경철 ( Kyung Chul Jeon ) 대한고관절학회 1994 Hip and Pelvis Vol.6 No.2

We reviewed 40 cases of cementless primary total hip arthroplasty (THA) to see the leg length changes after THA and analysed the factors that could affect the discrepancies of preoperative estimation and postoperative measurement. The cases with severe preoperative leg length discrepancy such as untreated CDH were not included in our series. Inserted femoral components were CLS(Protek) or Omnifit(Osteonics) stems. All the acetabular cups were HG g (Zimmer) cups. Preoperatively the acetabular template was mounted on the film and the center of the acetabular cup was marked with pencil. Femoral template was also mounted on the femoral side and the center of the femoral head was marked. The distaoce between the two centers was a basis for preoperative estimation. Postoperatively the leg length change was measured by the change of the distance from interteardrop line to the greater trochanter tip. Leg length change estimated by preoperative templating was 5mm lengthening in average. Postoperative leg length change was 10mm lengthening in average. The discrepancies of pre and postoperative measurement were attributed to following factors. Standardization of taking the X-ray views was an important factor. Magnification, center of X-ray beam and the accurate position of the hip should be considered in taking preoperative X-rays. Templating technique was another factor. Postoperative acetabular center shifted frequently compared with preoperative estimation. Templating does not always tell accurate postoperative leg length change. To minimize the discrepancy of pre and postoperative measurement above factors should be considered in preoperative estimation.

가토 악골에 매식된 Apatite-Wollastonite Glass Ceramic의 생체반응에 관한 실험적 연구

任昌俊,金慶勖,申承澈,金豪建,申建澈 단국대학교 1992 論文集 Vol.26 No.-

The authors implanted the Apatite Wollastonite Glass Ceramic(AWGC) powders in the rabbit maxillae to evaluate the possibility of clinical use as an artificial bone substitute material. Firstly we made AWGC and analized powder X-ray diffraction pattern of glass after crystalization. Secondly we made animal experiment with New Zealand white rabbits. The rabbits were sacrificed at the day of opstoperative 2 weeks and 4 weeks after implantation. We took the radiography of the maxillae block specimens, each of which includes the AWGC, at the day of sacrifice. And the block specimens were routinely prepared for the SEM and EDX study. We observed the attitudes at the border between the bone and the material with the SEM, and we searched the components such as Ca or P by use of EDX and compared the periodic changing data. The obtained results are as follows : 1. On SEM findings, silica band-like zone was found between the bone and the implanted materials at 2-week specimen, and this zone was found diffusely mingled between the bone and the implanted meterials at the 4-week specimen. 2. On intraoral X-ray findings, the border line was definitely found between the bone and the the material just after implantation of AWGC, but the border line became difused and fusion was occasionally found at the border area. 3. There was a little change in the natural bone components at the border area, and Ca or P was drawn out from Awgc at the border area. 4. Si of AWGC was increased as the time being, and AWGC was dissolved with leakage of Ca and P. So it is suggested that the intermediate zone of Calcium Phosphate Apatite was formed at the border area by Ca and P from AWGC dissolution, and it makes AWGC further tightly bonded to the bone.

전치의 후방견인에 따른 입술과 주위 연조직의 수직적 변화

강창수,김경호,최광철 대한치과교정학회 2000 대한치과교정학회지 Vol.30 No.2

입술의 돌출을 해소하고자 하는 환자들은 자신의 안모 개선을 안모의 측면보다는 거울로 볼 수 있는 정면을 통하여 느끼는 것이 보편적이다. 안모의 정면에서 평가가 이루어질 때에는 입술이 후방으로 들어간 정도와 함께 입술과 그 주위 조직의 수직적 변화에 의해서도 큰 영향을 받을 수 있으므로 교정치료 진단이나 치료 후 평가를 위한 측모두부방사선 사진 분석 시 전통적으로 중요시되고 있는 입술의 시상적 이동뿐만 아니라 흔히 간과하기 쉬운 수직적인 변화에 관해서도 평가가 이루어져야 한다. 따라서 본 연구에서는 입술 돌출을 주소로 내원한, 성장이 완료된 성인 여성 61명을 대상으로 측모두부 방사선 사진을 촬영하여 전치의 후방견인시 나타나는 입술과 주위 연조직의 수직적 변화를 계단식 다중 회귀 분석법을 이용하여 조사한 결과 다음과 같은 결론을 얻었다. 1.상, 하순의 philtrum길이 (SnLs, LiB') 는 전치의 후방견인 후 증가하였고, 상, 하순의 vermilion height (LsStms, StmiLi) 와 vermilion length (LsLi) 는 감소하였다. 2.상, 하순의 길이 (SnStms, StmiB')와 연조직의 하안면 고경 (SnMe')은 치료 후 유의성 있는 변화를 보이지 않았다. 3.상순의 philtrum길이 증가에 상악 전치의 정출 △UIV 이 가장 큰 영향을 주었으며 하순의 philtnlm길이 증가에는 치료 전 overjet이 가장 큰 영향을 주었다. 4.상, 하순의 vermilion height감소에 상순의 두께 감소가 가장 큰 영향을 주었다. Patients who want to reduce their lip protrusion usually estimate the severity of the lip protrusion on the frontal aspect. Most orthodontists have a perplexed experience of a reduced thin line of vermilion border on the frontal aspect as incisors are retracted, even though the lip protrusion is thought to be reduced favorably on the sagittal aspect. Some patients also look older after orthodontic treatment because of severe lip thinning. This unaesthetic reduction of vermilion border urges us to study the vertical lip change during orthodontic procedure. The purpose of this study was to evaluate the vertical lip and perioral soft tissue changes in respect to incisor retraction in an effort to analyze which factors might be responsible for their vertical changes, using the multiple regression analysis. The results were as follows. 1.Upper and lower lip philtrum length(SnLs, LiB') were increased after retraction of anterior teeth, where as upper and lower vermilion height(LsStms, StmiLi), and vermilion length(LsLi) were decreased. 2.Upper and lower lip length(SnStms, StmiB'), and soft tissue lower anterior facial height(SnMe') did not show any significant difference after treatment. 3.The increase of the upper lip philtrum length was mainly influenced by the extrusion of upper anterior teeth(△UIV), and the increase of the lower lip philtrum length was mainly influenced by the initial overjet before treatment. 4.The decrease of the upper and lower lip vermilion height was mainly influenced by the decrease of upper lip thickness.

자궁비대가 있는 여성에서의 질식자궁적출술

정철권 ( Chul Gwon Chung ),주장오 ( Jang Oh Joo ),김창운 ( Chang Woon Kim ),엄상탁 ( Sang Tak Eum ),박경도 ( Kyung Do Park ) 대한산부인과학회 2004 Obstetrics & Gynecology Science Vol.47 No.6

Objective : The purpose of this study was to evaluate the relationship between uterine size and surgical outcomes in women undergoing total vaginal hysterectomy. Methods : We revieres the medical records of the 170 patients who underwent total vaginal hysterectomy from February 2001 to November 2003. These patients were stratified into two groups; Group I, patients with uterine weight of between 300 gm to 1000 gm; GroupII, patients with uterine weight of <300 gm. The two groups were compared for ages, parity, uterine weight, previous abdominal operations, concurrent surgical procedures, postoperative discharge day, bleeding amount, perioperative hemoglobin concentration change and operative time. Results : 1. There were no significant difference between the two groups with respect to postoperative discharge day, concurrent surgical procedures, bleeding amount and perioperative hemoglobin concentration change. 2. The rate of surgical complications were similar in the two group (Group I 12.5%; GroupII 1301%) (p=.660). 3. Operative time for vaginal hysterectomy was slightly longer for women in Group I than Group II (Group I 78.4±27.1 minutes; GroupII 62.9±22.7 minutes) (p=.176), but the difference between the two groups in operative time was not statistically significant. Conclusion : The vaginal hysterectomy is as safe and effective for the woman with enlarged uterus (300-100 gm) as for the woman with uterine weight of <300 gm. Uterine enlargement (Uterine weight>300 gm) is not an absolute contraindication to vaginal hystrectomy.

악성종양에서 골수면역신티그라피를 이용한 골수전이의 평가 : 99mTc-MDP 뼈스캔과의 비교

고창순(Chang Soon Koh),김노경(Noe Kyeong Kim),김병국(Byoung Kook Kim),최창운(Chang Woon Choi),정준기(Jun Key Chung),방영주(Yung Jue Bang),이경한(Kyung Han Lee),정홍근(Hong Keun Chung),이명철(Myoung Chul Lee) 대한핵의학회 1994 핵의학 분자영상 Vol.28 No.1

N/A Although bone scan is a highly sensitive test for detecting bone metastasis, its findings are often limited in specificity and cannot be used for assessing the bone marrow. Bone marrow scintigraphy may provide useful information but previous experience with radiolabelled colloid has been disappointing. Recently, 99mTc labeled anti-granulocyte rnonoclonal antibody (anti-NCA-95 MAb) has been introdueed as a new bone marrow imaging agent. To evaluate the usefulness of 99mTc anti-NCA MAb bone marrow scans for detecting skeietal metastasis, bone marrow scans of 44 malignant tumor patients were evaluated and compared with bone scan fmdings. Bone scan showed abnormal lesions in 26(59%) cases, and 18 of these patients also had an abnormal bone marrow scan. Seven of the 8 patients who had normal bone marrow scan despite bone scan lesions were confirmed to be free from metastasis. There was one case with a marrow defect despite normal bone scan but the presence of metastasis was not determined due to loss of follow up. Bone scan demonstrated a total of 64 lesions while bone marrow scan showed 38 lesions. Fifty percent (32/64) of the bone scan lesions had matching marrow defects while the rernaining 50% did not. Most of these non matched lesions were suggested to be nonspecific 1esions such as rib fractures or degenerative change. Meanwhile bone marrow scan was able to detect 6 new lesions not detected by bone scan, but metastasis in each lesion was not confirmed. Bone marrow scan was also helpful in assessing equivocal bone scan lesions to be of metastatic nature in 10 patients by demonstrating a matched marrow defect. Thus 99mTc anti-NCA MAb bone marrow scan can help exclude metastasis in patients with nonspecific bone scan lesions and may be able to detect metastatic lesions not seen with bone scan. It appears useful as a complementary study to bone scan in evaluating malignant tumor patients.

장기간 수영훈련이 중년여성의 혈장 지질 및 아포단백질에 미치는 영향

김영준,장성동,어경철 동아대학교 스포츠과학연구소 2000 스포츠科學硏究論文集 Vol.18 No.-

The purpose of this study is to analyze the effects of long-term swimming excercise on thefat and aplipoprotein of middle-aged women. For the purpose, 14 middle-aged women who have no disease and do not any regular excercise are selected. They are divided into two groups. One is an exercise group(swimming group, Age : 39.0±2.12) consisting of seven members who are to make swimming exercise for eight weeks, and the other is a control group(control group, Age : 38.3±3.12). The effects of the exercise on fat and aplioprotein in blood are then examined. In terms of exercising method, the period, time and frequency of the swimming are determined as eight weeks, fifty minutes a day and five days a week respectively, The result of the study is as follows. 1.FFA, TG, TC and TC/HDL in blood plasma significantly decrease than before swimming, but LDL-C and HBL-C show no changes. 2.Aplipoprotein a and b in blood plasma show no changes over the eight weeks' exercise. Consequently, swimming exercise for eight weeks does not have an influence on LDL-C and HDL-C but on FFA, TG, TC and TC/HDL. The intensity, period and frequency of exercise should be maintained for change in cholesterol.

상백피봉약침요법(桑白皮蜂藥鍼療法)을 포함한 한방치료(韓方治療)로 증상(症狀)은 소실(消失)되었으나 CT추적관찰상(追跡觀察上) 변화(變化)가 없는 요추(腰椎) 추간판(椎間板) 탈출증(脫出症) 1예(例)

이병훈,김철홍,서정철,윤현민,송춘호,안창범,장경전,Lee, Byung-Hoon,Kim, Cheol-Hong,Seo, Jung-Chul,Youn, Hyoun-Min,Song, Choon-Ho,Ahn, Chang-Beohm,Jang, Kyung-Jeon 대한약침학회 2001 Journal of pharmacopuncture Vol.4 No.2

By process of treatment for a case which diagnosed as HNP of left posterolateral aspect of L4/5 disc and treated from the 10th, May 2001 to the 23rd, Jun 2001, the results are as follows. Method & Results : This patient was medicated Hwallaktang-gami, taken acupuncture, phototherapy, TENS, electric acupuncture, exercises, Mori Cortex-bee venom acupuncture. As a result, the patient's clinical symptom were improved but a computed tomagraphy confirmed L4/5 and L5/S1 HNP was not changed as seen on repeated CT scanning. Conclusion : These results suggest that among conservative therapies the oriental medical treatments including Mori Cortex-bee venom acupuncture improve clinical symptom effectively. But in this case, the structure of herniated disc was not changed.

정신분열병에 대한 리스페리돈의 효과 및 안정성

이민수,김용구,김영훈,연병길,오병훈,윤도준,윤진상,이철,정희연,강병조,김광수,김동언,김명정,김상훈,김희철,나철,노승호,민경준,박기창,박두병,백기청,백인호,손봉기,손진욱,양병환,양창국,우행원,이정호,이종범,이홍식,임기영,전태연,정영조,정영철,정인과,정인원,지익성,채정호,한상익,한선호,한진희,서광윤 大韓神經精神醫學會 1998 신경정신의학 Vol.37 No.1

연구목적 : 본 시험의 목적은 임상시험 시작전에 연구자들을 대상으로 PANSS Workshop을 통하여 PANSS, ESRS에 대한 국내에서의 표준화 작업을 구축하고 새로운 정신병 치료제인 리스페리돈의 효과와 안정성을 재확인하여 리스페리돈 사용에 대한 적정화를 이루는데 있다. 연구방법 : 1996년 4월부터 1996년 9월까지 국내 39개 대학병원 정신과에 입원중인 혹은 증상이 악화되어 입원하는 정신분열병 환자 377명을 대상으로 다시설 개방 연구를 시행하였다. 1주일간의 약물 배설기간을 가진후, 리스페리돈을 8주간 투여하였고, 기준점, 1주, 2주, 4주, 그리고 8주후에 평가되었다. 용량은 제1일에는 리스페리돈 1mg씩 1일 2회, 제2일에는 2mg씩 1일 2회, 제3∼7일에는 3mg씩 1일 2회 투여하였다. 이후 환자의 임상상태에 따라 임의로 증량할 수 있으며, 최대 일일 16mg을 초과하지 않도록 하였다. 추체외로 증상을 조절하기 위한 투약을 허용하였다. 임상증상 및 부작용의 평가는 PANSS(Positive and Negative Syndrome Scale), CGI(Clinical Global Impression) 그리고 ESRS(Extrapyramidal Symptom Rating Scale)을 사용하였다. 연구결과 : 377명중 343명(91%)이 8주간의 연구를 완결하였다. 치료 종결시점인 8주후 PANSS 총점수가 20% 이상 호전된 경우를 약물 반응군으로 정의할때, 약물반응군은 81.3%였다. 리스페리돈에 반응하는 예측인자로는 발병연령, 이전의 입원 횟수, 유병기간이 관련 있었다. 리스페리돈은 1주후부터 PANSS양성, 음성, 및 일반정신병리 점수상에 유의한 호전을 보여 효과가 빨랐다. CGI의 경우도 기준점에 비해 1주후부터 유의한 감소를 나타내었다. ESRS의 경우, 파킨슨 평가점수는 기준점과 비교해 투여 1주, 2주, 4주후 유의하게 증가되었다가 8주후 기준점과 차이가 없었다. Dystonia 평가점수는 1주후만 유의한 증가를 보였으며, dyskinesia 평가점수는 유의한 차이가 없었다. 혈압, 맥박수의 생명징후 및 일반 혈액학 검사, 생화학적 검사, 심전도 검사에서 유의한 변화는 없었다. 결 론 : 이상의 다시설 개방 임상 연구를 통해 리스페리돈은 정신분열병 환자에서 양성증상뿐만 아니라 음성증상 및 전반적인 증상에도 효과적인 것으로 사료된다. 보다 명확한 평가를 위해서는 다른 항정신병약물과의 이중맹검 연구가 필요할 것으로 생각되며, 또한 장기적 치료에 대한 평가도 함께 이루어져야 하겠다. Objective : The purpose of this study was to investigate the efficacy and safety of risperidone in the treatment of Korean schizophrenic patients. Method : This multicenter open study included 377 schizophrenic patients drawn from 39 university hospitals. After a wash-out period of 1 week, the schizophrenic patients were treated with risperidone for 8 weeks and evaluated at 5 points ; at baseline, and 1, 2, 4 and 8 weeks of treatment. The dose was increased from 2mg/day(1mg twice daily) to 6mg/day(3mg twice daily) during the first week and adjusted to a maximum of 16mg/day over the next 7 weeks according to the patient's clinical response. Medication to control extrapyramidal symptoms was permitted. The psychiatric and neurological status of the patients was assessed by PANSS, CGI, and ESRS scales. Results : 343(91%) of 377 patients completed the 8-week trial period. Clinical improvement, as defined by a 20% or more reduction in total PANSS score at end point, was shown by 81.3% of patients. The predictors of response to risperidone were associated older age, shorter duration of illness, fewer previous hospitalization. Risperidone had rapid onset of action ; a significant decrease of the total PANSS and three PANSS factor(positive, negative, general), and CGI was already noticed at the end of first week. For the ESRS, parkinsonism rating scores were significantly increased until week 4 comparing with baseline. Dystonia rating scores were significantly increased until week 1, and dyskinesia rating scores were not significantly changed during the study. Laboratory parameters including vital sign, EKG, hematological, and biochemical values showed no significant changes during the trial. Conclusions : This study suggests that risperidone is generally safe and effective against both the positive and negative symptoms in our group of patients.

한국인 직무 스트레스 측정도구의 개발 및 표준화

장세진,고상백,강동묵,김성아,강명근,이철갑,정진주,조정진,손미아,채창호,김정원,김정일,김형수,노상철,박재범,우종민,김수영,김정연,하미나,박정선,이경용,김형렬,공정옥,김인아,김정수,박준호,현숙정,손동국 大韓産業醫學會 2005 대한직업환경의학회지 Vol.17 No.4

Background and Purposes: Over the past three decades, numerous studies performed in Korea have reported that job stress is a determinant risk factor for chronic diseases and work disability. Every society has its own culture and occupational climate particular to their organizations, and hence experiences different occupational stress. An occupational stress measurement tool therefore needs to be developed to estimate it objectively. The purpose of this study is to develop and standardize the Korean Occupational Stress Scale (KOSS) which is considered to be unique and specific occupational stressors in Korean employees. Subjects and Methods: Data were obtained from the National Study for Development and Standardization of Occupational Stress (NSDSOS Project: 2002-2004). A total of 12,631 employees from a nationwide sample proportional to the Korean Standard Industrial Classification and the Korean Standard Occupational Classification were administered. The KOSS was developed for 2 years (2002-2004). In the first year, we collected 255 items from the most popular job stress measurement tools such as JCQ, ERI, NIOSH and OSI, and 44 items derived from the a qualitative study (depth interview). Forty-three items of KOSS, in the second year, were retained for use in the final version of the KOSS by using Delphi and factor analysis. Items were scored using conventional 1-2-3-4 Likert scores for the response categories. Results: We developed eight subscales by using factor analysis and validation process: physical environment (3 items), job demand (8 items), insufficient job control (5 items), interpersonal conflict (4 items), job insecurity (6 items), organizational system (7 items), lack of reward (6 items), and occupational climate (4 items). Together they explained 50.0% of total variance. Internal consistency alpha scores were ranged from 0.51 to 0.82. Twenty-four items of the short form of the KOSS (KOSS-SF) were also developed to estimate job stress in the work setting. Because the levels of the subscales of occupational stress were gender dependent, gender-specific standard norms for both the 43-item full version and the 24-item short form using a quartile for the subscales of KOSS were presented. Conclusion: The results of this study suggest that KOSS might be an appropriate measurement scale to estimate occupational stress of Korean employees. Further and more detailed study needs to be conducted to improve the validity of this scale.

계약자 보호와 판매채널의 선진화 방안

정세창,안철경 동의대학교 경제경영전략연구소 2009 經濟經營硏究 Vol.4 No.2

The purpose of this paper is to suggest advanced distribution channel in respect of directivity for customer, expertise, and transparency. We find out the problems of distribution channel in Korea and benchmark cases of the US and the UK. The conclusion is summarized as follow. Firstly, Open architecture is needed and also regulation for protecting customers should be strengthened for customer directivity. Secondly, the examination of qualifications for selling insurance products enhanced in order to improve expertise of solicitors. Finally, disclosure and financial soundness are easily understandable to the policyholders. The information is easily informed to them for transparency.