심혈관계 질환으로 관상질환 집중치료실에 입원한 환자들의 혜후 측정을 위한 APACHEⅢ점수 체계의 임상적 유용성

이공섭,이창선,최현주,홍종서,강지향,김도형,이민영,오인균,김병엽,김상억,김학찬,한승혜,이재용,지영우,안경주 대한순환기학회 2000 Korean Circulation Journal Vol.30 No.8

관상동맥 시술 도중 발생한 좌주간부 관상동맥 박리에 대한 스텐트 삽입 치료의 단장기 임상 결과 : acute and long-term results

이세환,이승환,홍명기,김영학,이철환,한기훈,송종민,강덕현,송재관,김재중,박성욱,박승정 대한내과학회 2004 대한내과학회지 Vol.66 No.6

목적 : 심도자 사용 시술과 관련된 좌주간부 관상동맥박리에 대한 적절한 치료는 아직 확실히 정립되지 않은 상태이다. 이에 본 연구는 좌주간부 관상동맥 박리에 대한 스텐트 삽입술의 단장기 임상결과를 후향적으로 분석하였다. 방법 : 좌주간부 관상동맥 박리에 대한 치료로 즉각적인 스텐트 삽입술을 시행하는 것이 안전하고 효과적인 방법임을 가설하였고, 이러한 즉각적인 스텐트 삽입을 시행한 10명의 환자를 대상으로 단장기적 임상경과를 의무기록 고찰과 전화 면담을 통해서 평가하였다. 결과 : 전체 환자 모두 처음부터 좌주간부 관상동맥에 유의한 협착을 가진 환자는 없었으며, 8명의 환자는 심도자의 조작으로 인한 박리가 발생한 경우였고(진단적 혈관 조영술 중에 3명, 유도 도자 조작 중에 5명), 나머지 2명은 다른 병변에 스텐트 삽입시술을 하는 중에 박리가 발생하였다. 이 10명의 환자에서 모두 즉각적인 스텐트 삽입술이 시행되었고, 4명의 환자에서 시술 도중 혈압 저하로 Intra-aortic Ballon Pump (IABP)를 장착하였다. 모든 환자에서 성공적으로 스텐트가 삽입되었고, 병원내 사망은 1명도 없었다. 6개월 추적 관상동맥 조영술은 8명의 환자에서 시행되었다. 혈관 조영상의 재협착(직경 협착 50% 이상)은 8명 모두에게서 관찰되지 않았으며, 퇴원 후 평균 31±25개월의 추적관찰 결과 주요 심장사건은 1건도 발생하지 않았다. 결론 : 비록 대상 환자가 적은 연구였지만 좌주간부 관상동맥 박리에 대한 스텐트 삽입술은 기술적으로 안전하고 빠르게 시행 할 수 있으며, 훌륭한 단장기적인 치료 효과를 보여준다. Background : The optimal treatment of patients with left main coronary artery (LMCA) dissection during catheter-based procedure remains uncertain. We retrospectively analyzed the acute and long-term results of bail-out stenting for LMCA dissection. Methods : In cases with significant LMCA dissection occurring during catheter-based procedure, prompt stent implantation may be safe and associated with favorable clinical outcome. We evaluated the acute and long-term results of bail-out stenting for LMCA dissection occurring during catheter-bases procedure in 1- patients. Results : Initially, there was significant stenosis of LMCA segment in these patients. Catheter-induced dissection occurred in 8 patients (during diagnostic angiography in 3 patients and guiding catheter manipulation in 5 patients). Two patients suffered dissection in the setting of stent deployment in other vessels. Therefore, bail-out stenting LMCA dissection was performed in a total of 10 patients. In 4 patients, hypotension developed and intra-aortic balloon pump was placed during procedure. Stents were successfully deployed in all patients. There was no in-hospital mortality. Six-month angiographic follow-up was performed in 8 patients. Angiographic restenosis(diameter stenosis 50%) was not observed in all patients at follow-up study. During a mean follow-up of 31±25 months after hospital discharge, there was no major adverse cardiac event (death, myocardial infarction, and target lesion revascularization). Conclusion : Bail-out LMCA stenting is technically feasible, and showed good acute and long-term results in a small series of patients.

Ⅲ급 부정교합의 수술-교정 치료시 상악 소구치 발치가 치열궁 폭경 변화에 미치는 영향

이신재,홍성준,김영호,백승학,서정훈 대한치과교정학회 2005 대한치과교정학회지 Vol.35 No.1

본 연구에서는 Ⅲ급 수술-교정 치료 방법에 영향을 미치는 치열 상의 요소를 파악함으로써 술전 교정시 상악 소구치 발치와 비치의 판단에 필요한 임상적 정보를 얻고자 골격성 Ⅲ급 부정교합 환자의 수술-교정 치료시 흔히 선택되는 상악 제1소구치 발치로 치료된 군과 비발치로 치료된 군 간의 치료전/후 상/하악 개별 치아 이동 양상과 치열궁 폭경의 변화 양상을 비교 분석하였다. 이를 위하여 비발치로 Ⅲ급 수술-교정 치료를 마친 환자 (24명) 와 술전교정 치료시 상악 제1소구치가 발치된 환자 (31명) 의 치료 전/후 모형 상에서 개개 치아의 근원심/협설측 각도변화와 상/하 치열궁 폭경의 변화를 측정한 후, 두 군 사이의 교정적 치아 이동 양상을 비교 분석한 후 상/하 치열궁의 조화를 이루는데 필요한 치열궁 폭경의 변화와 이에 기여하는 치아 변위와의 관계를 분석하기 위하여 상관 분석과 회귀 분석을 시행한 결과 발치 군은 비발치 군에 비하여 상악 치열궁 폭경의 감소가 컸으며, 이는 상악 구치의 inclination 감소에 크게 영향 받은 것으로 관찰되었다. 하악 치열에서는 inclination의 증가와 폭경의 증가가 있었으나, 비발치/발치군간의 차이는 유의하지 않았다. 본 연구의 결과 결론적으로 Ⅲ급 수술-교정 치료시 술전 상악소구치 발치는 상악 구치부 치열궁 폭경의 감소에 크게 영향을 미치므로, 상악 소구치 발치에 대한 판단은 상/하악 치열궁의 폭경 및 구치부 경사도 문제와 연계하여 고려해야 할 사항으로 생각되었다. Collective changes caused by orthodontic tooth movement evaluated in a specific treatment modality could give suggestive information on the specific treatment strategy. The aim of this study was to investigate retrospectively the characteristics of the orthodontic tooth movement during surgical-orthodontic treatment in order to provide an effective presurgical orthodontic treatment planning for the maxillary premolar extraction modality in the skeletal Class Ⅲ malocclusion patient. Pre- and post-treatment dental casts of skeletal Class Ⅲ malocclusion patients with nonextraction (N=24) and the maxillary premolar extraction (N=31) were collected. The angulation and inclination measuring gauge (Invisitech Co. Seoul, Korea) was used to evaluate the orthodontic tooth movement. The changes in the maxillary and mandibular dental arch widths were also measured from the canines to the second molars. As a result, more palatal Inclination change in the maxillary dentition was found with the premolar extraction modality than with the nonextraction modality. Linear regression analysis showed that the inter-arch width coordination was mainly due to the inclination changes of maxillary posterior teeth. We conclude that the indications and proper treatment planning for surgical-orthodontic treatment in skeletal Class Ⅲ malocclusion with maxillary premolar extraction could depend partly on the magnitude of the transverse inter-arch coordination especially in the maxillary dentition.

상악동 후비공 용종에서 줄기의 경로에 따른 상악동구 전산화단층촬영 소견

이승훈,박동우,이승로,함창곡,이학수,김용수,박충기 한양대학교 의과대학 2002 한양의대 학술지 Vol.22 No.2

Purpose: We evaluate the pathway of the stalk of antrochoanal polyp on the coronal and axial computed tomography scans (CT), comparing with operative findings. Materials and Methods: Fourteen patients (7∼40 years old, median= 12.5 years old, ratio of male to female: 8/6) with antrochoanal polyp were examined, who took the orbitomeatal unit (OMU) CT including both coronal and axial scans as well as the operation. The CT findings and clinical findings were analyzed for the pathway of the stalk of antrochoanal polyp, comparing with the operative findings. Results: The antrochoanal polyps were mostly located on the left side (12/14, 85.7%) and equally passed through the natural and accessory ostia (7/14, 7/14) in our cases. Those that were passing through the accessory ostium were located more inferiorly and posteriorly, with preserving the natural ostium on CT scans, comparing to those via the natural ostium. However, those passing through the natural ostium had a larger stalk that eroded the uncinate process widely. So each ostium was hardly discriminated on CT scans. Conclusions: The pathway of the stalk of the antrochoanal polyp could be more specifically evaluated on both coronal and axial OMU CT scans. So, it could be more hilpful in the presurgical planning.

한국인 부정교합자의 하악 치열궁의 크기와 형태

이성준,백승학,김상철,국윤아 대한치과교정학회 2005 대한치과교정학회지 Vol.35 No.1

본 연구의 목적은 한국인 부정교합자에서 하악 치열궁간의 형태적 차이를 알아보고자 하였다. Ⅰ급 114명. Ⅱ급 119명, Ⅲ급 135명의 부정교합자를 대상으로 하악 모형의 교합면을 복사한 후 13개의 접촉점 중에서 가장 협측면으로 위치한 부분을 digitize 하였고 각 치아의 브라켓 위치에 해당하는 점을 하악치아의 두께에 의거하여 4개의 선계측과 2개의 비율을 측정하였다. 치열궁의 형태는 square ovoid, tapered형으로 분류하여 그 빈도를 조사한 결과 Angle 분류와 남녀 성별에 따른 특별한 치열궁 형태가 존재하지 않았으나, 특정 치열궁 형태의 빈도는 Angle 분류에 따라 다르게 나타났다. 치열궁 크기의 계측항목에서는 대구치간 폭경에서만 남녀 성별 차이를 보였으며, 치열궁 크기에 있어서 Ⅰ급과 Ⅲ급, Ⅱ급 부정교합군간에는 유의한 차이가 있었다. 치열궁 형태의 분포는 Ⅰ급과 Ⅲ급 부정교합군에서는 square, ovoid, tapered 형태 순이었고, Ⅱ급 부정교합군은 square, tapered ovoid 형태 순이었다. 치열궁 형태의 빈도분포에 있어서는 남녀간의 차이는 없었다. The purpose of this study was to clarify morphological differences among mandibular dental arch forms in Korean malocclusion patients. The sample in this study consisted of 114 Class Ⅰ, 119 Class Ⅱ, and 135 Class Ⅲ malocclusion cases. The most facial portions of 13 proximal contact areas were digitized from photocopied images of the mandibular dental arches. Clinical bracket points were calculated for each tooth based on the data of the mandibular tooth thickness. Four linear and two proportional measurements were undertaken. The dental arches were classified into square, ovoid, and tapered forms to compare the frequency distributions. Our results suggested that there was no single arch form specific to any particular Angle classification or sex. It appeared to be the frequency of a particular arch form that varies among the Angle classifications. In comparison of arch measure between male and female, there was no statistical difference except in the intermolar width. In comparison of arch size measurements among the different Angle classifications, there were statistically significant differences between Class Ⅰ and Class Ⅲ malocclusion groups and between Class Ⅱ and Class Ⅲ malocclusion groups. In comparison of frequency distribution of arch forms in Class Ⅰ and Ⅲ malocclusion groups, the square form demonstrated the highest distribution followed by the ovoid and tapered forms in that order. In the Class Ⅱ malocclusion group, the square form showed the highest distribution, followed by the tapered and ovoid forms in that order. There was no statistical difference in the frequency distribution of arch forms between male and female groups.

대유행 인플루엔자(H1N1 2009) 급성호흡곤란증후군에 대한 체외막 산소화 장치의 조기적용 1예

이경학,이길수,오원섭,유숙원,천성빈,이승준 대한감염학회 2010 감염과 화학요법 Vol.42 No.2

Despite advanced technologies in intensive care, pandemic influenza (H1N1 2009) can rapidly progress to acute respiratory distress syndrome (ARDS) and cause death in a small subset of patients. Extracorporeal membrane oxygenation (ECMO) is expected to provide adequate gas exchange, to reduce ventilator-induced lung injury and, eventually, to improve outcome in these patients. A previously healthy, young female received mechanically ventilatory support because of rapidly progressive respiratory failure caused by 2009 H1N1 influenza. As she failed to respond to high ventilatory support, ECMO was instituted at 6 hours after admission. We describe detailed course of case and literature review on ECMO, helping physicians make a decision to initiate ECMO in patients with influenza-related ARDS.

Ar 플라즈마 아크 용해공정에서 용철의 흡질반응에 미치는 가스 유량의 영향

이광학,박승민,김영홍 울산대학교 2000 공학연구논문집 Vol.31 No.1

Ar-plasma arc용해공정에서 용철의 흡질 반응을 조사하였다. Ar-plasma arc하에서의 흡질 반응에 미치는 가수 유속의 영향을 조사한 결과, 흡질에 대항 Ar 가스유속이 증가함에 따른 속도상수의 변화가 너무 작기 때문에 기상이난 액상에서의 물질이동은 용철의 흡질 반응에 영향이 없으며 따라서, 율속단계는 용철표면에서의 화학반응에 의해 지배됨을 알 수 있었다. The kinetics of nitrogen absorption into iron melts with the Ar-N₂plasma arc were investigated. The mathematical model for nitrogen absorption under Ar-N₂plasma arc and effect of gas flow rate was determined. Because change of rate constant according to increasing Ar gas flow rate for absorptio under Ar plasma arc was too small, mass transfer ingas and liquid phase was not affect to kinetics of nitrogen absorption of the melt. Therfore, the rate determining step is dominated by the chemical reaction of the melt surface.

생체분해성 고분자의 특성 및 의학적 응용

이진호,최선웅,강길선,노승무,민병무,김용백,김학용 충남대학교 의과대학 지역사회의학연구소 1998 충남의대잡지 Vol.25 No.1

"Biomaterials" are nonviable materials used in medical devices, intended to interact with biological systems. They should have "biocompativility", which is defined as the ability of materials to perform with an appropriate host response in a specific application. It includes many materials that are often classified as biomaterials. Metals, ceramics, polymers, glasses, carbons, and composite materials are some examples. Among them, biodegradable polymers are discussed in this revies article. Since a biodegradable polymeric implant does not have to be removed surgically once it is no longer needed, biodegradable polymers are of value in short-term applications that require only the temporary presence of a polymeric implant. Main short-term medical applications of biodegradable polymers include the temporary tissue scaffold, the temporary adhesion barrier, the drug delivery device, and the multifunctional implant. In this article, the properties, processing methods, and medical applications of the biodegradable polymers are reviewed.

歷史地理硏究 : 新羅行政凶域

李聖學 경북대학교 문리과대학 지리학회 1981 洛東地理 Vol.- No.6

(1) Administrative districts of unification period of Shilla dynasty were transformed to chinese style, and their system was the stem of administrative districts in Korea and lee dynasty. (2) Concerning to the relationships of northern boundary in local administrative district in this period, the southern area of Korea peninsular from northern area of Dae-Dong River and duck-Won area of Ham-Nam province, in spite of unification of Sam-Guk (three nations: Kogure, Shilla and Bakje) by Shilla, was not more than two third aarea of Korea peninsular. (3) U-San-Kuk and Tam-La-Kuk were not belong to Gun-Hyn system of Shilla, but they were only the colony which submited to tax to the mother county, Shilla. (4) Military occupied area, different from administrative district, was established over-lap in order to protect from other invations. (5) Land lords of villages who livied in living units had to take charge of administrative offices and this system, so we can say that they took the autonomy of family community in ancient period.

위암 환자의 복강내 투여를 위한 Activated Charcoal-Alginate Bead 제형으로부터 Mitomycin C의 용출 거동

이진호,최선웅,서중기,김동민,정경수,오정연,김진향,노승무,민병무,김용백,김창식,박근성,강대영,송규상,양준묵,조준식,정현용,김학용,인현빈 충남대학교 의과대학 지역사회의학연구소 1998 충남의대잡지 Vol.25 No.1

Locoregional recurrence is the most common type of recurrence in surgical operation of gastric adenocarcinoma, and peritoneal dissemination is one of the most difficult problems in advanced gastric adenocarcinoma treatment. Because the peritoneal cavity is the most common site of the first recurrence after gastric cancer resection, intraperitoneal chemotherapy seems a logical choice for cancer chemotherapy. In this study, Mitomycin C (MMC)-activated charcoal (CH)-alginate (ALG) beads were prepared by the mixtures of CH particles adsorbed with MMC as an anti-cancer drug and aqueous alginate solution. The alginate is recognized as biodegradable, nontoxic, and biocompatible. The release of MMC from the beads in 0.1 M Tris buffer was stable and continuous until about 1 week. The MMC-CH-ALG beads can be applied in the peritoneal cavity for intraperitoneal chemotherapy since they provide a good adhesiveness on the tissue and controlled release pattern of the drugs.