비골 골절의 임상적 고찰

변웅래,여환호,양인석,김영균 大韓顎顔面成形再建外科學會 1994 Maxillofacial Plastic Reconstructive Surgery Vol.16 No.4

Because of the prominence of the nose and its central location, it is the most frequently encountered fractures in the face. Yet reports about the nasal bone fractures are virtually rare in the oral and maxillofacial surgical literatures. This sis a retrospective study on 19 nasal bone fractures treated in Chosun university hospital Department of Oral & Maxillofacial Surgery from Jan. 1991 to Sep. 1993, under admission to our Dept. and the obtained results were as follows. 1. Of the 240 patients with facial bone fractures, 28 patients suffered nasal fractures(12%) and male to female ratio was 5.3:1. 2. The most frequent cause was traffic accidents(39%)m, the next fall down(36%), first blow(4%). 3. The age frequency was the highest in the fifth decade (32%). 4. Clinical classification of nasal fractures was simple fractures(74%), comminuted fractures(26%), and single fractures(37%), combined fractures(63%). 5. The most frequently combined site was msxilla(50%). 6. Treatments of nasal fractures were closed reduction(63%), open reduction(5%), and secondary rhinoplasty(32%). 7. The initial treatment time from accident was 1.7 days in single fractures, and 3.5 days in combined fractures, and the period of splint retained was about 8.2 days in single fracture, about 8.7 in combined fracture. 8. It was necessary to treat secondarily in delayed treatment, and all treatment methods showed relatively good prognosis. 9. Closed reduction was treated under local anesthesia, but open reduction & secondary rhinoplasty was treated under general anesthesia except 1 case. 10. The complications were disturbance of swellings 5 cases, eithetic problem 5 cases, epiphora 3 cases, abnormal sensation 6 cases in relation with other fractures.

치아회분과 석고혼합제재 매식과 자가골 동시 이식후 치유과정에 관한 실험적 연구

김영균,김흥중,이상호,여환호,임성철,설인택,정재헌 大韓顎顔面成形再建外科學會 2000 Maxillofacial Plastic Reconstructive Surgery Vol.22 No.1

The purpose of this study was to evaluate the efficacy of adding autogenous bone to the toothash-plaster mixture in the healing process of bone. Full-thickness round osseous defects with the diameter of 20mm were made at the calvarial bone of adult dogs (n=19) bilaterally, which were thought to be critical size defect. The right defects were repaired with the toothash-plaster mixture plus autogenous bone (compressed volume 0.3cc) and the left defects with only toothash-plaster mixture. At 2-, 4-, 8-, 12- and 20- week after implantation, dogs were sacrificed and evaluated the osseous healing of bony defects clinically, radiographically, and microscopically. The results were as follows : 1. At the clinical observation, the wound healed very well without any problem except severe swelling in the early period after operation. Slight depression was recognized at the both sides when the portions of cranial defect were palpated. 2. There were statistically significant differences between toothash-plaster mixture groups and autogenous bone added groups at the same period, and among the groups in the bone density of the digital radiograms (P<0.001).There was a tendency that bone density was increasing with time. 3. In light microscopic examination, new bone formation was more active in the autogenous bone added groups than toothash-plaster mixture groups at the early period after mplantation but there is little difference at 20-week after implantation. 4. In fluorescent microscopic examination, the fluorescent band could be observed at the area of active bone formation and the band was more distinct in the autogenous bone added groups then toothash-plaster mixture groups. 5. In transmitted electron microscopic examination, organelles such as rER, Golgi complex and secretory granule and osteoblast were observed. In summary higher volume ratio of autogenous bone is needed to improve the bone healing in that there is little difference between toothash-plaster mixture group and autogenous bone added group at the 20-week after implantation in spite of new bone formation was more active in the autogenous bone added groups than toothash-plaster mixture groups at the early period after operation.

팬텀투과계수와 유효조사면 개념을 이용한 종양선량 확인에 관한 연구

김유현,여인환,권수일,Kim, You-Hyun,Yeo, In-Hwan,Kwon, Soo-Il 대한방사선기술학회 2002 방사선기술과학 Vol.25 No.1

The aim of this study Is to develop a simple and fast method which computes in-vivo doses from transmission doses measured doting patient treatment using an ionization chamber. Energy fluence and the dose that reach the chamber positioned behind the patient is modified by three factors: patient attenuation, inverse square attenuation. and scattering. We adopted a straightforward empirical approach using a phantom transmission factor (PTF) which accounts for the contribution from all three factors. It was done as follows. First of all, the phantom transmission factor was measured as a simple ratio of the chamber reading measured with and without a homogeneous phantom in the radiation beam according to various field sizes($r_p$), phantom to chamber distance($d_g$) and phantom thickness($T_p$). Secondly, we used the concept of effective field to the cases with inhomogeneous phantom (patients) and irregular fields. The effective field size is calculated by finding the field size that produces the same value of PTF to that for the irregular field and/or inhomogeneous phantom. The hypothesis is that the presence of inhomogeneity and irregular field can be accommodated to a certain extent by altering the field size. Thirdly, the center dose at the prescription depth can be computed using the new TMR($r_{p,eff}$) and Sp($r_{p,eff}$) from the effective field size. After that, when TMR(d, $r_{p,eff}$) and SP($r_{p,eff}$) are acquired. the tumor dose is as follows. $$D_{center}=D_t/PTF(d_g,\;T_p){\times}(\frac{SCD}{SAD})^2{\times}BSF(r_o){\times}S_p(r_{p,eff}){\times}TMR(d,\;r_{p,eff})$$ To make certain the accuracy of this method, we checked the accuracy for the following four cases; in cases of regular or irregular field size, inhomogeneous material included, any errors made and clinical situation. The errors were within 2.3% for regular field size, 3.0% irregular field size, 2.4% when inhomogeneous material was included in the phantom, 3.8% for 6 MV when the error was made purposely, 4.7% for 10 MV and 1.8% for the measurement of a patient in clinic. It is considered that this methode can make the quality control for dose at the time of radiation therapy because it is non-invasive that makes possible to measure the doses whenever a patient is given a therapy as well as eliminates the problem for entrance or exit dose measurement.

동종 골수이식 후 만성 이식편대숙주질환과 동반된 그레이브스병

황호인,이제중,조상희,김여경,이병환,정익주,김형준 대한조혈모세포이식학회 2002 대한조혈모세포이식학회지 Vol.7 No.1

저자들은 중증 재생불량성빈혈로 동종 골수이식 및 추가적인 동종 말초혈액 조혈모세포이식을 시행 받은 후 만성 이식편대숙주질환이 발생하여 면역억제제로 조절되었으나 자가면역성 갑상선기능항진증이 병발한 1예를 경험하였기에 이를 보고하는 바이다. Chronic graft-versus-host disease (GVHD), which is a frequent complication following bone marrow transplantation (BMT), is characterized by fibrosis of the skin, liver, lungs, and gastrointestinal tract, immunodeficiency, and the production of autoantibodies. Endocrine dysfunction, in particular thyroid disease, has been described following BMT, but this has previously meant hypothyroidism secondary to total body irradiation or transfer of autoimmune hyperthyroidism from a donor with Graves’ disease rather than in association with chronic GVHD. We report a case of a 26-year-old man who developed Graves’ disease eight years after BMT and who had remission of chronic GVHD. He received an allogeneic BMT for severe aplastic anemia. Eighteen months after BMT, diarrhea and chronic GVHD developed and were treated with cyclosporine and steroid. Four years after ceasing the cyclosporine, the patient developed weight loss, palpitations, fever, and anterior neck swelling, and was diagnosed with Graves’ disease based on typical thyroid function tests. The signs and symptoms in the patient improved with propylthiouracil and propranolol.

조직병리학적으로 진단된 상피 이형성증의 임상적 치료 및 예후 : 증례보고

박인순,김영균,여환호,김수관 大韓顎顔面成形再建外科學會 1995 Maxillofacial Plastic Reconstructive Surgery Vol.17 No.4

The information concerning epithelial dysplasia of the oral cavity has been relatively little published. Of the histolgic grades, most of the cases were classified as moderate and severe category. Their ages ranged from 27 to 78 years(mean 57 years). The developmental incidence by sex was superior in male by ratio of 6 : 1. Epithelial lesions were located in the buccal mucosa, Floor of the mouth, the gingiva and the tongue. It is generally believed with a few exceptions that mild degree of epithelial dysplasia do not indicate any great danger for the patient. But severs dysplasia indicates that there is a very considerable risk of malignant transformation. Surgical excision is the effective method of controlling epithelial dysplasia. The authors investigated 7 cases of epithelial dysplasia histopathologically, 2 patients of them had malignant transformation. We discuss the clinical feature, treatment, prognosis, and histopatholgic analysis with literature reviews.

넙치 (Paralichthys olivaceus)에서의 급격한 수온변화 스트레스에 관한 생리학적 연구

양정환,여인규 한국어류학회 2004 韓國魚類學會誌 Vol.16 No.1

본 연구에서는 넙치(Paralichthys olivaceus)를 이용하여 급격한 수온 변화 스트레스에 의한 혈액 및 항산화효소 변화에 대하여 조사하였다. 실험구는 각각 10, 15, 20(대조구), 25 및 30℃로 설정하였으며, 측정 시간은 1, 2, 3, 4, 6 및 8시간 후에 측정하였다. 그 결과, 혈액 중에 He-matocrit(Ht), Hemoglobin(Hb) 및 Red blood cell(RBC) 농도는 수온상승 시 증가하였다. 또한, 혈장에서의 코티졸 농도는 20℃와 비교하여 15℃에서는 감소하였고, 10 및 30℃에서는 상승 후 일정시간이 경과함에 따라 회복되었으나, 25℃에서는 장시간 코티졸 농도가 높게 유지되었다. 신장에서의 SOD활성은 25℃에서 높게 나타났으며, 10 및 15℃에서는 그 활성이 감소하였다. 간장에서의 CAT활성은 10℃를 제외한 실험구에서 유의하게 높은 수치를 나타내었다. 이러한 결과들로 볼 때, 25℃의 수온에서 사육하였을 때 스트레스 반응이 높게 장시간 지속되는 것으로 판단된다. 하지만, 장기간 또는 단계별 온도의 영향에 대해서 수행되어져야 할 것으로 생각된다. This study was carried out to investigate variation in blood and antioxidant enzyme activity due to acute changes in water temperature in the flounder(Paralichthys oliuaceus). The groups were cultured at 10, 15, 20, 25 and 30℃, for 1, 2, 4, 6, and 8 hours. The hematocrite(Ht), the hemoglobin(Hb) and red blood cell(RBC) concentrations tend to increase when the water temperature rises. The cortisol concentration of plasma was decreased at 15℃ when the starting temperature was 20℃ and recovered to starting level after increased at 10 and 30℃, but was maintained for a longer period at 25℃. The superoxide dismutase(SOD) activity in the kidney increased at high water temperatures(25℃), and decreased at low water temperatures(10 and 15℃), Catalase(CAT) activity in the liver was observed to increased in all groups except at 10℃. Thus, according to our study, when flounder is cultured at 25℃, high stress remained for a longer period. However, further analysis should be performed involving the physiological effects of temperature over longer periods and at different life stages.

하악과두 골절 치료에 있어 보존적 치료와 외과적 치료의 비교

박인순,이철우,여환호,이효빈,김영균,변웅래 大韓顎顔面成形再建外科學會 1994 Maxillofacial Plastic Reconstructive Surgery Vol.16 No.1

The authors investigated the 17 patients with the condylar fractures of the mandible who were admitted in Dept. of Oral and Maxillofacial Surgery, Chosun University, Dental hospital from 1990 to 1993 and could be taken follow-up above 6 months. Helkimo's clinical dysfunction index and mandibular mobility index were applied to the evaluation of the patients and the obtained results were as follows. 1. Mean maximal mouth opening was 38.4mm in the conservative group, 41.3mm in the surgical group and that showed no statistically significant difference.(P>0.05) 2. Clinical dysfunction index was higher in the surgical group than in the conservative group but .that showed no statistically difference.(P>0.05) 3. The extent of maximal mouth opening was increased gradually throughout the follow-up period. 4. Both groups didn't show severe clinically dysfunction.

이차구순열 결손의 치료

임석균,박인순,여환호,지재휴,김영균,김수관 大韓顎顔面成形再建外科學會 1997 Maxillofacial Plastic Reconstructive Surgery Vol.19 No.2

Despite the current accomplishments with the repair of cleft lips, the surgical management of the nasal deformity remains a functional and aesthetic dilemma for patients, their families, and reconstructive surgeons. Recent improvements in the understanding and technical execution of te primary cleft lip repair have significantly reduced secondary sequelae and the consequent need for secondary surgical correction. But, secondary surgical corrections are necessary according to numerous factors. Such factors include the secondary surgical corrections are necessary according to numerous factors. Such factors include the severity of the initial deformity, the surgical plan, precision of execution of the primary repair, and success of the postoperative management. We preformed the secondary correction of cleft lip and palate in 11 patients via various methods. In conclusion, primary repair of cleft lip and palate patients is the most important to prevent the secondary deformities, and most of cleft lip and palate with secondary deformities must be treated with combined cheiloplasty and rhinoplasty.

악골결손 재건을 위한 탈회 및 비탈회 동결건조 동종골의 이용

이기혁,박인순,김영균,김수관,엄인웅,여환호,이병준 大韓顎顔面成形再建外科學會 1996 Maxillofacial Plastic Reconstructive Surgery Vol.18 No.3

Bone graft has been used to repair one defect caused by disease and trauma, congenital and acquired deformities. Graft materials are autogenous bone, allogenic bone, xenogenic bone, synthetics. Autogenous bone graft is the most superior to other materials for immunologic reaction, compatibility to host tissue, and revascularization. However, autogenous bone graft is required for additional operation and the amount of taking is limited. Autografts are obtained at own expense and also limited in size, shape. In order to compensate these problems, allogenic bone graft has been used increasingly. But allogenic bone graft encounters immunologic complications. Therefore, it has been used after freezing, lyophilization, or demineralization. Allogenic bone processed by only lyophilization includes potential antigenic properties on its surface, therefore it is demineralized to deplete immunologic reaction. Demineralized bone releases BMP and helps the mesenchymal cells transform to the chondroblast to produce cartilage and bone. This reaction is called osteoinducation. Many authors have reported that mineralized lyophilized bone had less antigenicity clinically and favorable bony consideration with host bone. In our department from 1995 to now, we have used banked allogenic bone graft that has been prepared from Wonkwang Bone Bank in 5 cases and mineralized lyophilized bone graft in 2 cases to reconstruct the maxillofacial bone defect after tumor resection and cyst enucleation and cleft alveolus. We will report with literature review that the result is favorable functionally and esthetically.

Creep Property and Correlation of Diffusion-Welded Alloy 800H Tubes for Printed Circuit Heat Exchangers and Steam Generators

Dong‑Ha Kim,Sunghwan Yeo,Jun‑Hwan Kim,In‑Jin Sah,Jong‑Bae Hwang,Sang‑ji Kim,Young‑Kook Lee 대한금속·재료학회 2023 METALS AND MATERIALS International Vol.29 No.10

Thermal creep tests were conducted on diffusion-welded Alloy 800H tubes at 700 °C under various hoop stresses between 70 and 140 MPa using an in-situ creep measurement system. The tube-type creep specimens obtained from diffusion-welded Alloy 800H plates at 1150 °C and 10 MPa for 2 h achieved a uniform thickness with only 1.8% variation. The primary and secondary creep regimes were clear in the stain curves, while tertiary creep and subsequent material rupture were not observed due to the premature leakage of Ar gas at the interface of diffusion welding. The acquired creep strain data do not match well with the reference creep data of the Alloy 800H, which requires further work to explain the whole details. In such a context, a modified Garofalo correlation was used to fit the acquired creep data resulting in the meaningful parameters for primary creep strain and secondary creep rate. The Ar gas leakage at the interface of diffusion welding was confirmed by leakage test and microstructure investigations. The current study points to the requirement for a better diffusion welding process for Alloy 800H for use in printed circuit heat exchangers and steam generators.