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.

유치의 치근단 병소에 의해 변위된 영구치의 자발적 맹출

강동균,양승덕,김태완,김현정,김영진,남순현 대한소아치과학회 2007 大韓小兒齒科學會誌 Vol.34 No.2

The infection of primary teeth occurs by caries or trauma. But, if it is not treated on time, the complication may occur such as enamel hypoplasia, discoloration, impaction, displacement and dilaceration of permanent successors. The periapical lesion on primary tooth could displace the permanent successors in any direction. Treatment options of displaced tooth are observation after extracting the primary teeth, surgical exposure, orthodontic traction, transplantation and extraction. In these cases, displacement of permanent central incisor caused by the periapical lesion of primary teeth was observed. The spontaneous eruption after extraction of primary teeth was expected considering degree of displacement, development of root and direction of eruption. This case report shows spontaneous eruption of displaced permanent tooth germ was achieved with periodic examination after extraction of primary teeth.

조대술에 의한 하마종의 치료

강동균,황경문,김은정,김현정,김영진,남순현 大韓小兒齒科學會 2006 大韓小兒齒科學會誌 Vol.33 No.1

하마종은 구강저에 발생하는 점액 남종으로 주로 설하선과 관련된다. 즉, 하마종은 설하선 분비도관의 파열로 인하여 타액이 분비도관에서 빠져나와 주위의 연조직 내에 저류됨으로써 발생하는 가성 낭으로 정의 되며, 원인은 설하선 도관의 파열이나 폐색이다. 하마종의 임상소견은 청색의 투명한 종창이 구강저의 소대를 중심으로 편측으로 발생하며, 무통성이며, 촉진시 파동성을 나타낸다. 조직소견은 결합 조직 내 와동이 형성되지만, 낭 벽은 상피세포가 아닌 육아조직으로 구성되는 가성 낭을 관찰할 수 있다. 하마종의 첫 번째 치료법으로는 하마종의 내벽이 구강점막의 일부가 되도록 만들어 주는 조대술을 고려할 수 있다. 본 증례는 특징적인 하마종의 임상소견을 보이는 환아에게 gauze-packing등을 동반한 조대술을 이용하여 치료한 증례로써 양호한 치료결과를 보여 보고하고자 한다. Ranula is a mucocele which occurs at the mouth floor and mostly related to sublingual gland. In other words ranula is definded as a pseudocyst which occurs as the secretion duct of sublingual gland is destructed there as the saliva from the the secretion duct flows out and retention in the soft tissue. The cause of ranula is destruction or obstruction of the duct. The clinical findings of ranula is a painless, unilateral bluish transparent swelling around the frenum and shows fluctuation when palpated. Histological finding represent a formation of cavity inside the connective tissue. but a pseudo-cyst can be seen which the wall of the cyst is composed of granulation tissue rather than epithelial cells. The first treatment of ranula can be considered as marsupialization. which induces the inner wall of the Ranula to be a part of oral mucosa. This case report shows a treatment of marsupialization with gauze packing in a young patient representing a clinical finding of characteristic ranula.

치아 석회화 단계와 골 성숙도 단계간의 상관관계에 대한 연구

강동균,김태완,김영진,남순현,김현정 大韓小兒齒科學會 2008 大韓小兒齒科學會誌 Vol.35 No.2

본 연구는 성장 중인 부정교합 환자의 진단이나 치료계획의 수립,치료방법 및 시기,예후 등을 결정하는데 중요한 판단 지침이 되는 치아 석회화 단계와 경추 및 수완부골 성숙도간의 연관성을 규명하여 개인의 보다 정확하고 효율적인 사춘기 성장 정도를 평가하기 위해 시행하였다. 전신 질환이 없고 교정 치료 경험이 없는 7-16세의 여아 154명,남아 179 명,총 333명의 파노라마 방사선사진,측모 두부규격 방사선사진,수완부 방사선사진을 분석하여 평가하였다. 연구 결과,파노라마 방사선사진의 치아 석회화 단계를 통하여 사춘기 성장 정도를 평가하는 것은 부정교합 환자의 진단 및 치료계획을 수립하는데 임상적으로 유용한 정보를 제공할 것으로 판단되었다. The purpose of this study was to investigate the relationship between the stages of calcification of various teeth and skeletal maturity stages among Korean individuals. The study subjects consisted 154 female and 179 male ranging from 7 years to 16 years of age. A total of 333 hand-wrist, cephalo-lateral and panoramic radiographs were obtained and analyzed. The tooth development of the mandibular canines, first, second premolars, and second molars were assessed according to the Dermijian' s system. Skeletal maturity stages were determined from hand-wrist radiographs by using the SMI system and cephalo-lateral radiographs by using the CVMS, respectively. The results were as follows 1. The mean ages of each stage of skeletal maturity were consistently younger in female subjects. 2. There was a high correlation between skeletal maturity of hand-wrist and cervical vertebrae in the both sexes. 3. There was a high correlation between skeletal maturity and dental calcification stage of mandibular canines, first premolar, second premolars, and second molar. 4. The mandibular second molar was tooth showing the highest correlation. 5. Percent distributions of the relationship between calcification stages of individual teeth and stages of skeletal maturity were obtained in both sexes. In summary, this suggests that tooth calcification stages from panoramic radiographs might be clinically useful as a maturity indicator of the pubertal growth period.

이대생의 체력 및 건강도에 관한 조사 연구

강지용,김종선,윤남식,이희순,한성일 梨花女子大學校 韓國生活科學硏究院 1975 韓國生活科學硏究院 論叢 Vol.15 No.-

The following results were obtained from the survey of health status and the measurements of physical fitness of 914 students of Ewha Womans University by means of CMI, which were conducted from October 7 to October 27 for three weeks. The purpose of the research mainly consists in the improvement of university health adiministration and of physical education. A. Survey of Health Status 1. The average Number of Complaints are 26.8 for items A-L, 15.3 for items M-R, and 42.1 for items A-R. In terms of classes, the Numbers of Complaints are revealed on a decreasing scale as follows: sophomores, 44.0, the highest; seniors, 42.6; freshmen, 42.1; and juniors, 40.5. 2. Among all the items, the following figures of average Numbers of complaints per person are conspicuous: the seniors have shown 5.3 for item D, which is the highest; and the sophomores, 0,7, which is the lowest. Among the physiological item, D, which corresponds to the ailments of digestion system, shows the highest rate; and among the items for mental diseases, item M, which corresponds to non­adjustment, is 5.2, the highest. 3. The percentiles on the lower echelons of the Number of Complaints are the following: 26.1% for freshmen is the highest; 22.2% for sophomores, the lowest. The sophomores have shown 27.1%, the highest figure, of students who have Number of Complaints of four or above. 4. The percentile figures of 10 or above of Number of Complaints are displayed by seniors with 2.4% and by sophomores with 1.5%. On the other hand, the percentile figures of 80 or above are revealed by seniors with 5.4% and by sophomores with 5.3%. B. Physical Fitness Measurements The figures for the physical fitness measurements are found as given below: 1. Pull­up Freshmen 18.4 seconds Juniors 9.3 seconds Sophomores 7.5 seconds Seniors 7.0 seconds 2. 100 Meters Dash An approximation of 19 seconds is recorded by freshmen, and the tendency is to be slower as the years go up. 3. Sit­ups The freshmen recorded 13 sit­ups, and the tendency is to be fewer as the years go up. 4. Throwing An approximation of 19 meters is marked by freshmen, and the tendency is to be shorter as the years go up. 5. Long Jump The freshmen marked 249.5 centimeters, and the tendency decreases as the years go up. 6. 800 Meters Run 4'1"8"'(4 minutes 1 seconds 8 points) is obtained for freshmen, and the tendency is to be slower as the years go up. 7. Shuttle Run 12.5 seconds is recorded for freshmen, and the tendency is to be slower as the years go up. 8. Trunk Flexion 18 centimeters is marked by freshmen, and the tendency is to be decreasing as the years go up.

전국 단위 감시체계의 현황과 전망

강성규,안연순,지영구,김형옥,하미나,권호장,백남종,김성아,홍윤철,김재용,강대희,정혜선,하은희 대한산업의학회 2001 대한직업환경의학회지 Vol.13 No.2

Vibrio 균 증식에 있어서 sodium-citrate 의 영향

남상재,이강순 순천향의학연구소 1995 Journal of Soonchunhyang Medical Science Vol.1 No.1

The efficiency of selective isolation of V. vulnificus with current various agar plate media seemed to be significantly poor. So far, TCBS agar been most widely used for Vibrio species. The fact that several ingredients of TCBS agar inhibit growth of other contaminated organisms and ultimately enhance selective growth of Vibrio species could also inhibit Vibrio vulnificus should not be oversighted. Moreover differentiation between V. vulnificus and V. parahaemolyticus by morphology of colony grown on TCBS found to be quietly difficult. On these regards, the effect of each ingredient of TCBS agar including sodium citrate on the growth of V. vulnificus was needed to examine carefully in order to develop a better selective medium for V. vulnificus. A good many characteristics could be found through this experiment and these data could be applied for developing new medium. 1. V. vulnificus once transformed from opaque colony to translucent colony by given growth condition (in broth culture) was never changed 2. The growth of V. vulnificus appeared to be inhibited on agar plate medium by addition of low concentration of sodium citrate. The more concentration of sodium citrate was in medium, the poorer growth of V. vulnificus was observed. 3. Ferric ammonium citrate alone did not affect the growth of V. vulnificus. 4. Ferric nitrate and sodium thiosulfate markedly inhibited the growth of V. vulnificus. Conclusively, for the purpose of the growth of V. vulnificus there should be some modification of ingredients of TCBS agar or a newly designed medium other than TCBS agar, especially in case of V. vulnificus.

누두흉 환자에서 Nuss 금속막대 제거 전 · 후 폐 역학 변화

강규식,백남순,김천숙,안기량,권진형,김지은,유시현 순천향의학연구소 2003 Journal of Soonchunhyang Medical Science Vol.9 No.1

Nuss operation is one of the surgical procedure for pectus excavatum and it's method is the insertion of convex steel bar under the sternum through small bilateral thoracic incision. As the patients is growing, the thorax can be compressed gradually by steel bar. So Nuss bar needs to be removed two years after Nuss operation. This study was undertaken to assess the effect on the repiratory mechanics before and after the removal of the Nuss bar. Twenty patients with previous Nuss operation were allocated for the removal of Nuss bar. Lung mechanics (dynamic lung compliance, static lung compliance, and airway resistance), hemodynamic change (heart rate, systolic pressure, and diastolic pressure), and pulmonary gas exchange (arterial oxygen tension, arterial carbon dioxide tension, pulse oximeter saturation, and end tidal carbon dioxide tension) were measured before and after removal of Nuss bar. Respiratory mechanics (dynamic and static lung compliance, inspiratory airway resistance), pulmonary gas exchange and hemodynamic parameter were unchanged before and after the removal of Nuss bar. We concluded that lung mechanics were not changed before and after the removal of Nuss bar in the patients with pectus excavatum and the 95% patients were satisfied with operation.

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.

악성종양에 동반된 고칼슘혈증에 대한 연구

姜好耕,李順男 梨花女子大學校 韓國生活科學硏究院 1990 韓國生活科學硏究院 論叢 Vol.46 No.-

Tumor-associated hypercalcemia is a common and important clinical problem. Two major pathogenic mechanisms appear to be operative in this disorder:local osteolytic hypercalcemia and humoral hypercalcemia of malignancy. We experienced 20 cases of tumor-associated hypercalcemia from January 1987 to september 1989 and reviewed their clinical findings. The results were as follows; 1) The age ranged from 30 to 79 years with mean age of 57.5 and a male predominance was observed(M:F=3:1). 2. The frequent primary sites of tumor were lung(35%), kidney(20%), esophagus(10%), breast(10%), cervix(10%) and the pathologic findings were squamous cell carcinomas(50%) and renal cell carcinoma(20%). 3) Out of 20 cases, 18 were stage Ⅳ and 2 were Ⅲ. Bone metastasis was observed in 11 cases(55%) and out of 10 cases of squamous cell cancer, only 3 cases showed bone metastasis. 4) The most frequent earliest symptoms were anorexia(90%), constipation(50%), nausea/vomiting(40%) and abdominal pain(35%), and neurologic symptoms as muscle weakness, lethargy, confusion and coma were developed also. 5) Common laboratory findings were moderate to severe hypercalcemia(90%), normal phosphours level(80%), alkaline phosphatase elevation(50%), with 3 liver metastasis, 2 osteoblastic bone metastasis and 5 mixed bone metastasis. 6) On ECG, shortened QTc interval was noted in 35%. 7) Saline diuresis was initial therapy in all 20 cases, steroid was given concomitantly in 5 of them, calcitonin with oral phosphate were given concomitantly in 3 of them and mithramycin was given in only 1 case. 8) 14 cases were died and others were survived more than 6 months. The results suggest that squamous cell carcinoma, renal cell carcinoma, breast cancer and multiple myeloma are relatively common causes of malignancy associated hypercalcemia and hypercalcemia generally represents a late complication in the course of neoplasia as extensive tumor burden.