혈액 투석 환자에서 중심정맥 협착에 대한 스텐트 삽입술 : Wallstent Placement

임대승,노상필,이유선,정승현,김보영,이정우,강정아,김정희,이민수,정준용,최시완,정진옥,성인환,이강욱,신영태 충남대학교 의과대학 의학연구소 2002 충남의대잡지 Vol.29 No.1

Stenosis of central vein is a common complication arising after percutaneous subclavian vein catheter insertion performed for temporary vascular access in chronic renal failure patients undergoing hemodialysis. There are several treatment methods for the condition like percutaneous angioplasty(PTA), stent insertion, and surgery, but recent trend is toward PTA and stents. Among the patients diagnosed with chronic renal failure from March 1993 to May 2002 and undergoing hemodialysis through AV fistula, the 14 Patients in whom central vein stenosis arose were selected for the study. A total of 28 percutaneous interventions(5 PTA and 23 stent placement) were performed, and restenosis rate and the time taken till the restenosis in de novo lesions and instant lesions were compared. All 28 cases were operated successfully. The 14 cases that received both anigioplasty and stent placement initially. (de novo lesion : 14 cases), Among the 10 cases with de novo lesion that followed up more than 1 year, 3 cases are currently undergoing hemodialysis without restenosis, and the remaining 7 cases have recurred stenosis with the mean time to restenosis of 10.9 months. In the 7 cases in whom stenosis recurred, 11 interventions were done(instent lesion: 11 cases). 4 of these were using only ballon angioplasty with 100% restenosis rate and the mean time of 3 months until restenosis. The remaining 7 cases were using both balloon angioplasty and stent placement, also with 100% restenosis rate but with the mean time of 12 months until restenosis, which was later than the group receiving only balloon angioplasty. In treating the patients with central vein stenosis, stent placement seems to be more advantageous over PTA in terms of restenosis rate and the mean duration of patency. In the case of instent lesion, inserting the stent for the second time after stenosis recurred lengthened the duration of patency compared to performing balloon angioplasty alone.

위암 환자에서 세포성 면역 기능에 관한 연구

이재익,윤일국,이종선,김종완,장준,안정기,송민호,정현용,이헌영,김삼용,김영건 충남대학교 암연구소 1991 癌共同硏究所 硏究誌 Vol.1 No.1

We performed a variety of lymphocyte stimulation tests, delayed hypersensitivity skin tests, and enumeration of several lymphocyte subpopulations in 21 patients with gastric cancer who did not receive any form of anticancer therapy, and in 20 healthy controls. The gastric cancer patients had significantly decreased number and total score of positive reactions in delayed hypersensitivity skin tests compared with the healthy controls. The percent of CD_(4) positive lymphocytes in the gastric cancer patients was significantly decreased compared to the normal control subjects, but it had no correlation with the total score of delayed cutaneous hypersensitivity reactions. The ratio of helper to suppressor cells was lower in the cancer group. The uptake of 3H-thymidine was markedly depressed in cancer patients when stimulated with various mitogens. There was little correlation between any of the stimulation tests and any of the lymphocyte subpopulation proportions to delayed hypersensitivity cutaneous reactions. Optimal proliferative response was found in lymphocytes stimulated with 10 micrograms of concanavalin-A and 10 microgram of phytohemagglutinin. Advanced stage patients had greatly depressed delayed hypersensitivity skin reactions and proliferative responses to mitogens compared with localized diseases. These results suggest that gastric cancer patients have depressed cellular immune functions, which mainly result from the decreased helper cells and defects in functional proliferative response to mitogens. Interleukin-2 and interferon-gamma restored the in vitro proliferative response of lymphocyte in patients with gastric cancer.

위암 환자에게 세포성 면역 기능에 관한 연구

이재익,윤일국,이종선,김종완,장준,안정기,송민호,정현용,이헌영,김상용,김영건 忠南大學校 癌共同硏究所 1991 癌共同硏究所 硏究誌 Vol.1991 No.-

전국 10개 종합병원 중환자실 환자의 직장내 Vancomycin-resistant Enterococci(VRE) 보균율, 보균의 위험요인 및 유전적 다양성 조사

정희진,송준영,엄중식,김우주,최선주,최정현,이혁,정문현,이광미,신동현,손보라,최종성,우흥정,권정아,이경원,최강원,박승철 대한감염학회 2002 감염 Vol.34 No.5

백서에서 치아이동 후 보정기간 동안 교합이 치주조직 섬유의 재형성에 미치는 영향

정권희,이기헌,황현식,이석형 전남대학교 치의학연구소 2002 구강과학 Vol.14 No.2

The purpose of this study was to evaluate the effect of occlusion on the mechanical strength of periodontal fibers during retention periods after experimental tooth movement. In the Sprague-Dawley male rats weighing 200 g or more. The intraoral elastics was inserted into the interproximal space of upper the first and second molars. After 4th day of teeth movement, the left mandibular first, second, and third molars were extracted for differentiating the occlusal side from the non-occlusal side in the experimental groups. The intraoral elastics was removed and then light cured resin was placed in the interproximal space between the bilateral upper first and second molars following undercut was made for retention. From the day beginning retention, 7 rats were sacrified at 0, 4, 8, 12, 16, 20 days respectively. For evaluating of degree on the mechanical strength of periodontal tissue, maximal shear load of the bilateral upper first molars were measured by use of Instron Universal Testing Machine. The results of this study were obtained as follows: 1. In the occlusal side from no retention group to 4-day, 8-day, 12-day, 16-day, and retention 20-day group as time was going maximal shear load was increased and there was statistically difference from retention 12-day group(p<0.05). 2. In the non-occlusal side from no retention group to 4-day, 8-day, 12-day, 16-day, and retention 20-day group as time was going maximal shear load was increased slightly but there was no statistically difference(p>0.05). 3. The result compared with maximal shear load between occlusal and non-occlusal side showed no statistically difference until retention 8-daygroup(p>0.05), and showed statistically difference from retention 12-day to 20-day group(p<0.05). These results show that the occlusion had an effect on mechanical strength of the periodontal fibers during retention periods after experimental tooth movement; therefore, it is suggested that consideration of occlusion is required for the type and length of retention at the time of retention planning.

장상피화생과 Helicobactor pylori와의 상관 관계에 관한 연구

이복희,김대수,이현숙,진영주,윤세진,송형근,성노현,정현용,이동호 충남대학교 의과대학 지역사회의학연구소 1994 충남의대잡지 Vol.21 No.2

In 1965 Lauren divided advanced gastric carcinoma into two main types-namely, "intestinal" and "diffuse" type carcinoma, which differ not only morphologically but also in their clinical and epidemiological characteristics. Moreover, a different histogenetic process has been postulated by many authors that intestinal type gastric carcinoma might arise from areas with intestinal metaplasia. Since Warren and Marshall reported the presence of Helicobacter pylori in the stomach in 1983, strong evidence has been obtained that there is a close relationship between Helicobacter pylori and chronic gastritis, atrophic gastritis, intestinal metaplasia, and intestinal type gastric carcinoma. To study the relationship between intestinal metaplasia and Helicobacter pylori infection, we performed gastroscopic biopsies and CLO tests taken from patients with epigastric pain. Only 87 patients with macroscopically suspected antral gastritis were included. The prevalence of intestinal metaplasia in gastric antral biopsies increased from 33.3% in the age group<30 years to 63.6% in the age group 60 years. When all patients were divided into two age groups-namely, (i)<50 years(n=41) and (ii)≥ 50 years(n-=46), intestinal metaplasia was found significantly more often in patients ≥ 50 years. ((i) 39.2%, (ii) 54.3%, p<0.0001). The prevalence of Helicobacter pylori in gastric antral biopsies decreased from 66.7% in the age group<30 years to 62.5%, in the age group in the age group 50 to 59 years. When all patients were divided into the same two age groups-namely(i)<50 years and (ii)≥50 years, the prevalence of Helicobacter pylori did not differ between two groups in a statistically significant way. The mean age of intestinal metaplasia positive patients who were also Helicobacter pylori positive was 48±11.0(mean±S.D.)years, whereas the mean age of intestinal metaplasia positive patients who were Helicobacter pylori negative was 52±9.7(mean±S.D.)years. In conclusion. although our data do not prove a causal relationship between Helicobacter pylori infection and the histogenesis of intestinal metaplasia, we suggest that Helicobacter pylori plays an important role in the development of intestinal metaplasia in the gastric mucosa. Whether Helicobacter pylori has to be present at all times during this process or is only necessary as a 'trigger', needs further research.

전기도금을 이용한 스테인레스 스틸 각형 선재의 굵기 증가 후 물성 변화

이정석,이기헌,황현식 대한치과교정학회 2003 대한치과교정학회지 Vol.33 No.2

본 연구는 전기도금을 이용하여 각형 선재의 굵기를 증가시킨 후 기존의 선재와 물성을 비교함으로서 이의 임상적 적용 가능성을 알아보고자 시행되었다. 한 변의 길이가 0.016 인치인 정사각형 스테인레스 스틸 교정용 선재에 니켈 전기도금을 시행하여 굵기를 0.01 인치 증가시켜 한 변의 길이가 0.017 인치인 정사각형 선재로 만들었고 도금층의 밀착성을 증진시키기 위해 400℃의 전기로 에서 10분간 열처리를 시행하였다. 시편의 물성변화를 알아보기 위하여 전기도금을 이용하여 제작된 15개의 시편을 실험군(016P군)으로, 기존의 0.016인치(016), 0.017 인치(017군) 스테인레스 스틸 교정용 선재를 대조군으로 설정한 후 3점 굴곡 시험과 비틀림 시험을 시행하여 다음과 같은 결과를 얻었다. 1. 3점 굴곡 시험 결과 016P군에 비해 강성과 항복강도, 국한강도 모두 증가하는 경향을 보였으며, 강성과 극한강도는 통계적으로 유의한 차이가 있었다(p<0.05). 2. 3점 굴곡 시험 결과016P군이 017보다 강성과 항복강도, 극한강도 모두 낮은 경향을 보였으며, 강성은 통계적으로 유의한 차이가 있었다(p<0.05). 3. 비틀림 시험 결과 016P군이 016군에 비해 비틀림 모멘트, 최대 비틀림 모멘트 모두 높았으며, 통계적으로 유의한 차이가 있었다(p<0.05). 4. 비틀림 시험 결과 016P군이 017군에 비해 비틀림 강성과 항복 비틀림 모멘트, 최대 비틀림 모멘트 모두 낮은 경향을 보였으며, 이 중 항복 비틀림 모멘트와 최대 비틀림 모멘트에서 통계적으로 유의한 차이가 있었다(p<0.05). 이상의 결과를 요약해 보면 각형 선재에 도금을 시행하여 굵기를 증가시키고 물성이 증가될 수 있음을 알았다. 비록 도금을 시행한 016P군이 기존의 017군보다 강성이 낮았으나 이는 반대로 016P군이 017군보다 탄성이 높음을 나타내며 토크조절이 부족한 경우 브라켓 슬롯에 쉽게 삽입되어 교정력을 발휘할 것으로 기대된다. The purpose of this study was to evaluate clinical applications of electroplating method through investigation of the physical properties of orthodontic rectangular wires according to varying their cross section. For the study, it was accomplished to electroplate the 0.016-inched orthodontic rectangular stainless steel wire. The cross section of stainless steel orthodontic rectangular wire increased from 0.016 x 0.016 inch to 0.017 x 0.017 inch by electroplating. The wire was heat treated to improve an adhesion between the wire and electroplated metal. A three=point bending test and torsion test were conducted in order to compare physical properties among three wire groups; 0.016 X 0.016 wires (group 016), electroplated 0.016 x 0.016 wires (group 016P) and 0.017 x 0.017 wires (group 017). Through the investigation of each wire group, following results were obtained. 1. At three-point bending test, the group 016P showed higher tendency in the degree of stiffness, yield strength and ultimate tensile strength than the group 016. Stiffness and ultimate tensile strength showed statistically significant differences between two groups at three-point bending test (p<0.05). 2. Stiffness, yield strength, and ultimate tensile strength of the group 016P showed lower tendency than those of the group 017. Stiffness showed statistically significant differenced between two groups at three-point bending test (p<0.05). 3. Torque/twist rate, yield torsional moment, and ultimate torsional moment of the group 016P showed higher tendency than those of the group 016. All measurements showed statistically significant differences between two groups after torsion test (p<0.05). 4. Torque/twist rate, yield torsional moment, and ultimate torsional moment of the group 016P showed lower tendency than those of the group 017. Yield torsional moment, and ultimate torsional moment showed statistically significant differences between two groups after torsion test(p<0.05)

척추 주위근의 단면적과 등척성 요추부신전 근력간의 상관 관계

권정이,이강우,김현숙,김종문,안중모 大韓再活醫學會 2000 Annals of Rehabilitation Medicine Vol.24 No.2

Continuous wave of obturation technique에서 플러거의 다양한 적용 깊이에 따른 근단부 폐쇄효율 비교

이상진,박정길,허복,김현철 大韓齒科保存學會 2007 Restorative Dentistry & Endodontics Vol.32 No.6

이 연구와 목적은 continuous wave of obturation technique으로 근관 충전을 할 때, 다양한 heat source plugger의 깊이에 따른 근단부 근관 폐쇄능력을 비교하는 것이었다. 직전 형태 발거 소구치를 #35/.06크기까지 니켈티타늄 파일을 사용하여 성형 및 세정하였다. 성형과 세정이 완료된 치아를 heat source plugger의 적용 깊이에 따라 15개씩 5군으로 분류하였다: 3 mm, 4 mm, 5 mm, 6 mm, 7 mm. 양성 대조군을 제외한 모든 근관은 E&Q plus (Meta Biomed Co., Chungju, Korea)를 사용하여 #35/.06 gutta-percha cone으로 충전하였다. 모든 치아의 근첨공 주변 1 mm를 제외하고 nail varnish를 도포하였고 음성 대조군은 근첨공을 포함하여 전체 면을 도포하였다. 모든 시편을 1% 메틸렌블루 용액에 72시간 동안 보관한 다음 치근첨으로부터 1, 2, 3 mm 높이에서 수평으로 절단하였다. 각 단면을 12.5 x 2.5배 현미경하에서 관찰하고 디지털 카메라로 촬영하였다. 염색제 누출 평가를 위해 five-degree scoring system을 사용하였다. 각 절단면에서의 점수를 모두 합하여 한 시편의 점수로 사용하고 통계학적 분석을 하였다. 이 실험 조건하에서, 3 - 7 mm 까지의 heat source plugger의 적용 깊이는 근단부 폐쇄에서 유의한 차이를 나타내지 않았다. 5 - 7 mm의 Buchanan's protocol을 포함한 3 - 7 mm를 모두 임상 적용에서 받아들여질 만하다고 보인다. The purpose of this study was to compare apical sealing ability of continuous wave canal filling technique according to various heat source plugging depths. Eighty one extracted human premolars with straight root were cleaned and shaped to size 35 using .06 taper rotaiy NiTi file. After cleansing and shaping, the teeth were divided into 5 groups following the heat source probing depths from the apex ; 3, 4, 5, 6 and 7 mm. All specimens were filled using E&Q Plus with #35/.06 tapered gutta-percha cone. The positive control teeth were not filled. All teeth were coated with nail varnish except the apical 1 mm around the apical foramen. Negative control teeth were completely sealed include the apical foramen. All specimens were immersed in 1% methylene blue solution for 72 hours. Then the specimens were sectioned horizontally at 1, 2 and 3 mm from the root apex. Each sectioned surface was photographed using a digital camera attached to the stereomicroscope at 12.5 x 2.5 fold magnification. All points at 1, 2 and 3 mm were summed as final score of one specimen. Statistical analysis of the collected data was performed. Under the condition of this study, there was no significant difference between the heat source plugging depths of 3, 4, 5, 6 and 7 mm in apical sealing ability. All of apical heat source plugging depth from 3 to 7 mm including Buchanan's protocol -from 5 to 7 mm- seems to be acceptable in clinical application.

쐐기형 5급 와동과 근관와동을 복합레진으로 수복한 상악소구치에 대한 응력 분석 : 3차원 유한요소법적 연구

이선화,김현철,허복,김광훈,손권,박정길 大韓齒科保存學會 2008 Restorative Dentistry & Endodontics Vol.33 No.6

이 연구의 목적은 쐐기형 5급 와동과 근관와동을 복합레진으로 수복한 상악 제2소구치에 대한 응력 분포를 3차원 유한요소법으로 분석하여 평가하기 위한 것이다. 발치된 상악 제2소구치를 이용하여 Micro-CT로 스캔한 후 3D-D0C-TOR로 3차원 유한요소 모형을 제작하였다. 제작된 소구치 모형에 근관 와동을 형성하고 쐐기형 5급 와동과 글래스 아이오노머 기저재의 사용 여부를 구분하여 근관 와동을 혼합형 복합레진으로 충전하였다. 협측 교두 또는 설측 교두에 500 N의 하중을 가하고, ANSYS 8.0 프로그램으로 인장 응력의 분포를 분석하여 평가한 결과 베이스 사용유무에 따른 응력 분포의 차이는 없었다. 협측 교두에 하중이 가해질 때, 하중점과 교합면의 중심구, 구개측 백악법랑경계부에 과도한 인장 응력이 집중되었으며, 5급 와동이 없는 경우보다 5급 와동이 있는 경우에 약간 더 높았다. 설측 교두의 협측 경사면에 하중이 가해질 때, 하중점과 교합면의 중심구, 협측 치경부에 과도한 인장 응력이 집중되었으며, 5급 와동이 있는 경우가 5급 와동이 없는 경우보다 약간 더 낮았다. The purpose of this study was to investigate the distribution of tensile stress of canal obturated maxillary second premolar with access cavity and notch-shaped class Ⅴ cavity restored with composite resin using a 3D finite element analysis. The tested groups were classified as 8 situations by only access cavity or access cavity with notch-shaped class Ⅴ cavity (S or N), loading condition (L1 or L2), and with or without glass ionomer cement base (R1 or R2). A static load of 500 N was applied at buccal and palatal cusps. Notch-shaped cavity and access cavity were filled microhybrid composite resin (Z100) with or without GIC base (Fuji Ⅱ LC). The tensile stresses presented in the buccal cervical area, palatal cervical area and occlusal surface were analyzed using ANSYS. Tensile stress distributions were similar regardless of base. When the load was applied on the buccal cusp, excessive high tensile stress was concentrated around the loading point and along the central groove of occlusal surface. The tensile stress values of the tooth with class Ⅴ cavity were slightly higher than that of the tooth without class Ⅴ cavity. When the load was applied the palatal cusp, excessive" high tensile stress was concentrated around the loading point and along the central groove of occlusal surface. The ten-sile stress values of the tooth without class Ⅴ cavity were slightly higher than that of the tooth with class Ⅴ cavity.