경북 최초의 신장이식 1례

이중현,김용섭,이정호,이창우,김상욱,이문섭,오민구,하달봉,이경섭 동국대학교 의학연구소 2000 東國醫學 Vol.7 No.-

신장이식은 환자의 삶의 질을 높이고 거의 정상적인 사회생활을 가능하게 함으로써 말기신부전 환자의 3가지 신대체 요법(혈액투석, 복막투석, 신장이식) 중에 가장 효과적이고 각광받는 치료법이라 할 수 있다. 최근 들어 의료기술과 의학의 발달로 신장이식의 성공률은 과거에 비해 비약적으로 높아지고 있으며 국내에서도 점차 신장이식수술을 받는 환자가 증가하고 있으나 서울이나 다른 대도시에 비해 의료환경이 열악한 중소도시나 지방의 병원에서는 아직도 시행하지 못하고 있는 형편이다. 이에 저자들은 경북 최초로 자체 의료진에 의해 고혈압과 말기 신부전으로 동국대 포항병원에서 혈액투석을 받고 있던 32세의 남자환자에게 부인으로부터 신장을 제공받아 신장이식을 성공적으로 시행하였기에 문헌고찰과 함께 보고하고자 한다. Kidney transplantation is the preferred treatment modality for many patients with end-stage renal disease (ESRD), because it offers improved quality of life over both hemodialysis and peritoneal dialysis. Patients who do well after transplantation generally report improvement in vitality and freedom to return to the style of life that they experienced before their progression to ESRD. Recently, the success rate of kidney transplantation is greatly being increased as the surgical technique and immunosuppressive drugs are developed. Kidney transplantation is also popular in Korea which has good result. But, until now the general hospitals which are located at small city can't try the kidney transplantation because they don't have proper facilities and experts. We firstly experienced a case of kidney transplantation in a 32 years old man with hypertension and chronic renal failure at KyoungBuk province. So we report this case with references.

교합면 소와 열구에서 산부식 제재의 효과적인 침투 방법에 대한 연구

이성룡,이상호,이창섭,이난영 大韓小兒齒科學會 2005 대한소아치과학회지 Vol.32 No.3

치면열구전색술의 우식예방효과는 전색제의 유지력과 밀접한 연관이 있으며, 이는 전 단계 과정인 산부식제의 열구 내 침투율에 따라 달라질 수 있다. 본 연구에서는 교합면 소와 및 열구에 산부식제의 효과적인 침투를 위해 여러 가지 방법을 적용하여 비교 분석하였다. 이를 위해 발거된 상악 제 1,2 소구치 40개를 각각 10개씩 4개의 군으로 나누었다. Ⅰ군은 교합면 소와 및 열구 부위에 통법에 따라 산부식제를 도포하였고 Ⅱ군은 각 치아의 교합면 소와 및 열구부위에 산부식제 도포와 함께 초음파 진동을 주었다. Ⅲ군은 각 치아의 교합면 소와 및 열구부위에 열구성형술(Fissurotomy)를 시행한 후 산부식제를 도포하였고, Ⅳ군은 각 치아의 교합면 소와 및 열구부위에 열구성형술후 산부식제 도포와 초음파 진동을 동시에 시행하였다. 이상의 실험 후 각 군의 산부식제 침투도를 비교 연구하여 다음과 같은 결과를 얻었다. 1. 각 군의 산부식제 침투도를 비교한 결과, 각각 Ⅲ군과 Ⅳ군에서 Ⅰ군에 대해 향상된 침투도를 관찰할 수 있었다(P<0.05). 2. 부위별 군에 따른 침투도를 비교한 결과, 근심 소와부위와 원심 소와부위에서는 Ⅲ군과 Ⅳ군이 Ⅰ군에 대해 향상된 침투도를 보였으나(P<0.05), 열구 중앙부위는 각 군 간에 차이가 없었다(P>0.05). The purpose of this study was to investigate the effective penetration methods of acid etching agents in the pit and fissures on the occlusal surface. Extracted maxillary first and second premolars were divided into 4 groups : to Group Ⅰ only acid etching agent was applied, to Group Ⅱ ultrasonic scaler as well as acid etching agent were applied, to Group Ⅲ after fissurotomy acid etching agent was applied, and to Group Ⅳ after fissurotomy the same process performed with Group Ⅱ. The comparison between the 4 groups by the use of scanning electron microscope showed the results as follows : 1. Comparing each groups with regard to the penetration rate(%) of acid etching agents, Group Ⅲ and Group Ⅳ showed improved penetration rate(%) compared with Group Ⅰ. Group Ⅱ made no significant different results from Group Ⅰ, but had somewhat better penetration rate(%). 2. Comparing each groups with regard to the penetration rate(%) of acid etching agents according to regions within fissures, Group Ⅲ and Group Ⅳ showed more improved penetration rate than Group Ⅰ in the mesial pit and distal pit. However, no significant difference between each groups was showed in the middle fissure.

치아종을 동반한 석회화 치성낭에 관한 증례보고 : CASE REPORT

이난영,이선숙,이창섭,이상호 大韓小兒齒科學會 2006 대한소아치과학회지 Vol.33 No.1

석회화 치성낭은 상악 전치부에 호발하는 발육성 치성낭이나 조직학적 소견이 다양하고 따라서 분류 체계도 다양하다. 악골 내에서 느리게 진행되는 무통성 종창이 일반적이며 24-30%에서 매복치 및 치아종과 연관되어 나타난다. 피복 상피에 나타나는 유령세포는 결합 조직에 노출되어 석회화 조직을 형성한다. 이 증례는 14세 여아의 상악 견치부에 발생한 치아종을 동반한 석회화 치성낭으로, 매복된 상악 좌측 견치 치관 주위로 경계가 명확한 방사선 투과성 병소와 다발성의 방사선 불투과성 석회화 물질이 혼재된 병소였다. 조직병리학적으로 중층 편평상피로 이장되어잇고 상피 내에 유령세포가 관찰되었다. 석회화된 물질은 복합 치아종의 소견을 보여 Preatorius의 조직학적 분류에 의한 석회화 치성낭 Type IB로 진단되었다. 병소의 적출 및 병소에 이환된 견치 발치를 시행하였다. 현재 염증 소견이 관찰되어 병소에 이환된 상악 좌측 제1소구치는 치수치료를 시행하였으며 환아 및 보호자가 포괄적인 교정 치료를 원하여 현재 공간 유지 장치를 장착 중이다. The calcifying odontogenic cyst(COC) predominantly affected Maxillary anterior segment and it is developmental cyst. But COC showed diverse terminology or classification, clinicopathologic features as well as its biologic behavior. COC usually presents as slowly enlarging but otherwise symptomless swelling. Association with impacted teeth and odontoma is described in 24~30%. The epithelial lining of COC(ghost cell) appears to have ability to induce the formation of dental tissues in the asjcents connective tissue wall. This case is a COC associated with a odontoma involving an impacted left maxillary canine in 14-year old female child. Radiographic examination revealed a well-demarcated radiolucent lesion partially occupied by a radiopaque mass, involving the left canine. The histologic sections showed cystic cavity lined with ameloblastic epithelium containing ghost cell masses with regular and irregular shape odontoma. The final pathologic diagnosis was calcifying odontogenic cyst with odontoma(Type IB by Preatorius). Enucleation and elimination of the included tooth were performed. Now endodontic treatment was preformed on the 1st premolar of the upper left jaw, which had a lesion. And the patient and their parents want to have the orthodontic treatment performed and would like to keep the space maintainer.

치아 교환기 어린이에서 근단변위부분층 판막술을 이용한 하악 거대 협소대의 위치

이성룡,오유향,이난영,이창섭,이상호 大韓小兒齒科學會 2004 大韓小兒齒科學會誌 Vol.31 No.4

영구치의 맹출 지연이 발생하는 원인은 다양하다. 유치의 만기 잔존과 조기 상실, 과잉치나 치아종과 같은 이형물의 존재등과 같이 비정상적인 경조직 인자에 의해 발생할 수 있고, 치은 판개 조직(opercula)과 같은 상부 치은 조직의 섬유성 비후나 소대의 과증식과 같은 연조직성 인자에 의해 발생하기도 한다. 영구치의 맹출 지연시의 공간의 상실 및 영구치의 비정상적인 맹출, 그리고 그에 따른 치열궁의 비대칭과 같은 교정적 문제와 대합치의 정출 등에 의한 교합적인 문제등이 발생할 수 있어 조기에 진단하여 처치하는 것이 중요하다. 본 증례에서는 12세 남자 아이가 충치가 많고 치아가 나오지 않는다는 것을 주소로 내원하여 진단한 결과, 하악 좌측 소구치들이 맹출하지 못하고 매복되어 있는 것을 알 수 있었다. 원인은 맹출 공간이 부족하였고 동시에 거대 협소대가 치아의 맹출을 방해하는 것으로 파악되었다. 이에 대한 처치로 우선 공간을 획득하고 난 후, 부착치은의 회복과 맹출 촉진을 위해 근단변위부분층 판막술을 시행하였다. The mandibular buccal frenum becomes a problem when its attachment is too close to the marginal gingival. Heavy buccal frenum mucogingivally results in insufficient attached gingiva, inadequate vestibular depth and also difficulty in eruption of mandibular premolar. The aim of this study is to demonstrate the effectiveness of apically positioned partial-thickness flap as adequate mothod in order to remove heavy buccal frenum and expose impacted teeth. The author presents the case of a 12-year-old boy. He had problems that was prolonged eruption of #34, #35 due to high pull buccal frenum. After space regaining for normal eruption of #34, #35, we performed apically positioned partial-thickness flap on #34,35 area. As a results, we confirmed that eruption of #34, #35 has been processed normally. And vestibular depth, position of buccal frenum and width of attached gingival was within a normal range. Decrease in muscle pull, adequate width of attached gingiva and increased vestibular depth can be expected from this treatment.

외상에 의한 근관내 석회화 변성 치아의 처치

이성룡,이난영,이창섭,이상호 大韓小兒齒科學會 2004 대한소아치과학회지 Vol.31 No.2

외상 치아에서 일반적으로 발생할 수 있는 합병증으로는 치수 충혈, 내출혈, 근관내 석회화 변성, 외흡수, 치수괴사, 유착 등이 있다. 치아의 근관내 석회화 변성은 치아가 외상을 받았을 경우, 발생할 수 있는 이러한 합병증의 하나이다. 석회화 변성은 여러 요소에 의해 확인될 수 있는데 임상적으로는 치관의 황색 계통의 변색과 방사선학적으로는 치수강을 포함한 근관의 부분적, 혹은 전체적인 협착을 특징으로 한다. 이러한 석회화 변성이 발생할 경우, 치수 괴사로 이행되기도 하는데, 모두 치수 괴사로 이행되는 것은 아니며 따라서 근관 치료에 앞서 적절한 검사 및 관찰이 필요하다. 본 증례는 만 9세의 여아가 놀던 중 친구의 머리에 부딪혀 상악 중절치의 외상(subluxation)을 받고 내원한 경우로 지속적인 임상적, 방사선학적 검사를 시행한 결과 근관내 석회화 변성이 관찰되었다. 검사 초기에는 임상적으로 경미한 치관의 변색만 보였을 뿐, 전기 치수 검사(EPT)에서는 특이한 소견은 보이지 않았다. 그 후 전기 치수 검사를 이용한 지속적인 검사 결과, 그 반응의 정도가 점차 감소되었으나, 근관 치료는 좀 더 유보하고 관찰하기로 하였다. 외상 후 20개월 정도 지나서는 전기 치수 검사를 이용한 검사에 거의 반응을 보이지 않았고, 근관의 완전 협착과 치관의 황색 계통의 변색이 관찰 되었다. 이에 치수 괴사로 이행되는 것을 막고 치관의 변색술을 시행하기 위하여 근관 치료를 시행하고 그 결과를 보고하는 바이다. Pulp canal obliteration(PCO) is seen commonly in dental pulp after traumatic tooth injuries and is recognized clinically as early as 3 monthly after injury. Pulp canal obliteration is characterized by deposition of hard tissue within the root canal space and yellow discoloration of the clinical crown. Opinion differs among practitioners as to whether to treat these cases upon early detection of PCO or to observe them until symptoms or radiographic signs of pulpal necrosis are detected. PCO may make root canal treatment necessary because of the development of apical periodotitis, is or for cosmetic reasons. If carefully executed, root canal treatment in teeth with an PCO is hightly successful and may act as a basis for internal bleaching. During a game. a 12-year-old girl was hit in the face. At that time, she was diagnosis a subluxation of the maxillary right central incisor. At the 24-month recall examination, a root canal of the tooth had been calcified and discolored gradually. We performed endodontic treatment to prevent perfect pulp canal obliteration and internal bleaching.

수완부 골성숙에 따른 경추의 화골형태에 대한 두부방사선계측학적 연구

이상호,이창섭 大韓小兒齒科學會 1992 大韓小兒齒科學會誌 Vol.19 No.1

The purpose of this study was to investigate the ossification patterns of cervical vertebras in association with bone maturites of hand-wrist and determine the possibility whether these assesments can be used for evaluation of craniofacial skeletal growth. The subjects, consisted of 142 males and 133 females aged from 8 to 17 years with normal occlusion and general health, were divided into 6 stages by the skeletal maturation of hand-wrist on hand-wrist radiographs. In cephalogram, the concavity of inferior border, height difference between anterior and posterior border, and vertico-horizontal ratio of cervical vertebras were measured. The measurements were analyzed statistically by SAS(Statictical Analysis of Science) computerized program. The results were as follows; 1. The skeletal maturation occurred earlyer in female than in male, and mean chronologic age at the skeletal maturation stage 4(the time of maximum growth period) was 14 years in male, 12.4 years in female and showed greatest age difference(P<0.05). 2. The concavity of inferior border and the vertico-horizontal ratio of cervical vertebrae were increased according to skeletal matruation of hand and wrist(P<0.05), and the height difference between anterior and posteior border was decreased but not showed significance. 3. Correlation coefficient between the skeletal maturation of hand-wrist and the concavity of inferior border, the vertico-horizontal ratio of cervical vertebrae were 0.7039∼0.7918 and 0.7093∼0.7918, thereby showed close correlation in each order(P<0.05), but little correlation was showed between height different of cervical vertevrae and skeletal maturation of hand-wrist(γ=0.1623∼0.3226). 4. The concavity of inferior border and the vertico-horizontal ratio of each cervical vertebrae were decreased signicantly(P<0.05) with descending, but the height difference between anterior and posterior border did not show any significant difference among different vertebrase. 5. The assesments of the concavity of inferior border and the vertico-horizontal ratio of cevical vertebrae on cephalogram showed possibility to use for evaluation of craniofacial skeletal growth.

전기침이 구강동통에 미치는 영향에 관한 연구

이창섭,송형근,이상호,최용성 大韓小兒齒科學會 1996 대한소아치과학회지 Vol.23 No.3

The effects of electro-acupuncture on the pain threshold and the amplitude of dEMG(digastric EMG) evoked by the noxious electric stimulation on teeth and gingiva in dogs were studied. Experiments were carried out with 10 dogs weighing 5-8kg. Each animal was anestheticed with Entobar given intraperitoneally in an initial dose of 30㎎/㎏. Maintenance dose of 5㎎/㎏/hr was given through a cannula, in the femoral vein, as required to keep up light anesthesia. Bipolar stimulating wire electrodes, 0.1mm in diameter, insulated except for tips, were inserted into the upper canine and palatal gingiva. Rectangular aluminium plate electrodes (15×5mm) were placed on acupuncture points, called Yin-Hsiang, located at both sides of the upper jaw. Rectangular biphasic current pulses of 2Hz, with a 250μsec duration,were delivered for 15 minutes. The dEMG activities were recorded from the anterior belly of the digastric muscle(one of the jaw opening muscles) using bipolar wire electrodes. The magnitude of the jaw opening reflex at different intensties of electro-acupuncture(1volt 4volt and 10volt) was estimated by averaging the 30 superimposed dEMGs recorded on an oscilloscope and audiomonitor. Data were analysed statistically with ANOVA and paired t-test. The obtained results were as follows : 1. Pain thresholds were increased 7.7%, 15.4%, 17.3% in the teeth and 11.1%, 19.0%, 25.4% in the gingiva as the intensities of electro-acupuncture increased incrementally. 2. Amplitudes of dEMG were decreaed 8.3%, 22.4%, 27.4% in the teeth and 9.8%, 36.5%, 42.2% in the gingiva as the intensities of electro-acupuncture increased incrementally. 3. Inhibition of pain responses by the electroacupuncture was more effective in the gingiva than in the teeth.

청소년의 연령별 체격 발달에 관한 연구

이창섭,김재운,남상우 충남대학교 체육과학연구소 2000 體育科學硏究誌 Vol.18 No.1

The purpose of this study was to analyze the tendency of physical development by age in adolescence. For this study, the health documents including 400 students' records were selected from the 4 highschools in Deajon city. In order to analyze the records in health documents, mean and standard deviation were used on SPSS window version 9.0. The results of the study were as follows; First in the growth of height men's Height was greater than that of women by an average of 6.03㎝ during at the age of 8 and 18, but at the age of 11(4th grade in elementary school) and 13(6th grade), women's height surpassed that of men only once. In the case of men, the quantity of annual maximum development(QAMD) was shown at the age of 12 and 13 by an average of 8.03㎝ and that of women, QAMD was shown at the age of 10 and 11 by 6.85㎝. Second, in the growth of weights the weight of men was more than that of women by an average above 10㎏, but there was no case that women's weight surpassed that of men like result of height. In the case of men, the QAMD was shown at the age of 14 and 15 by an average of 7.05㎏, and at the age of 10 and 11 by an average of 6.85㎏ in women. Third, in the growth of chest girth, the size of men was bigger than of women by an average of 4-8㎝, but when women were 14 years old(1 st gade in middle school), they surpassed men's size of chest girth only once. In the case of men, the QAMD was shown at the age of 17(1st grade in highschool) and 18(2nd grade) by an average of 4.56㎝ and in women, during 13(6th grade in elementary school) and 14(1st grade in middle school) by an average of 4.76cm. These results could be interpreted as follow. When the men enter highschool, they have more activities than in middle school to show off their "masculinity". On the Contrary, women' activities in highschool decrease from the middle school. Because they want to keep their "femininity". And Lastly, in the growth of sitting height, the sitting height of men and women increased annually by an average of 2.31㎝ and 3.23㎝. In the case of men and women, the QAMD was shown at the age of 13 and 14 by an average of 3.76㎝ and 5.92㎝. Women's sitting height surpassed that of men at the age of 12(5th grade in elementary school) and 14(1st grade in middle school).

고등학교 체육수업의 재미거리와 걱정거리에 대한 연구

이창섭,남상우 忠南大學校體育科學硏究所 2001 體育科學硏究誌 Vol.19 No.1

The purpose of this study was two-fold : (1)to search the level of the enjoyment and worry in PE class perceived by high school students and (2)to analyze the sources of the enjoyment and worry in PE class. Specifically. First, this study was performed to find out the differences between boys and girls or among the grades in high school in the level of the enjoyment and worry in PE class. Second, it was also performed to search the differences between boys and girls or among the grades about preferred sources of enjoyment and worry by high school students in PE class. A grade-gender stratified quota sample was used to select 1,200 high school students from eight high school in each grade category in Daejon. Those students answered questions from Physical education Class Enjoyment Source Questionnaire(PCESQ) and Physical education Class Worry Source Questionnaire(PCWSQ) developed by Lee & Nam(2001). To analyze collected data, a Chi-square test, an independent t-test, and One-way Analysis of Variance(ANOVA) were performed. The major findings of this study were as follows; 1. With regards to the level of enjoyment and worry in PE class, boys showed higher level of enjoyment and lower level of worry than girls. This is thought to be because more boys prefer the PE class than girls. 2. The level of enjoyment and worry in PE class was significantly different between boys and girls in high school; boys felt more fun and less worry about PE class than girls. 3. With regards to the enjoyment source of PE class, boys and girls have tendency to recognize PE class as a tool for maintaining their health, a useful method to develop sociality, and subject requiring less efforts on cognitive domain. The results of worry source suggested physical educators have some problems related to stressful events that were indicated by both boys and girls, such as unsatisfactory class events, annoying preparatory proceedings before starting class, trouble with friends during class, and displeasure about teacher's teaching method. 4. With regards to the enjoyment source of PE class by grades, the result that boys differently recognized PE class as a factor supporting their health by grades was apparent and boys in third grade accepted that social skills could be developed by participating in PE class. Otherwise, the aspect that girls' systematical development of cognitive content performed in-class was important was thought to be result of the fact that the most favorable enjoyment source for girls is less effort on cognitive domain of physical education than other subjects. 5. with regards to the perception of worry source in PE class by grades, the finding were that students perceived dissatisfaction with the events of PE class in the first and third grades and dissatisfaction with the events of PE class in the second grade as the most stressful aspect of PE class. This is thought to be the result of the fact that teachers should consider managing the conditions of the students and improving environment of the class in PE class.

소아에서의 치과전기마취 : 증례보고

이은영,이상호,이창섭 大韓小兒齒科學會 1994 大韓小兒齒科學會誌 Vol.21 No.2

The purpose of this report was to evaluate the effect of Dental Electronic Anesthesia on pain inhibition for clinical use. The subject for this study were 30 children whose Frankl behavioral rate is positive. The subjects was divided into two groups, the first group described by control group and the second group described by experimental group anesthetized with Dental Electronic Anesthetic device. And then three kind of treatments were done : extraction of deciduous teeth, application of rubber dam, cavity preparation for preventive resin restoration. 3M Dental Electronic Anesthesia System was used for this study : its electric impulse stimulate the skin surface by external electrode pads. The results were as follows. 1. Degree of the pain & the apprehension decreased in experimental group. 2. Degree of the pain & the apprehension showed statistical differences among three treatments procedures in the control group but, not showed statistical differences in the experimental group.