Benoist씨 장치를 이용한 소아의 하악 과두 골절의 치험례 : A CASE REPORT

박상욱,최형준,차인호,김성오,최병재 大韓小兒齒科學會 2004 大韓小兒齒科學會誌 Vol.31 No.3

소아에서의 하악 골절은 성인에서보다 드물다. 그러나, 어릴수록 강직과 성장장애의 가능성이 크며 성인만큼 악간고정을 잘 견뎌내지 못한다. 반면에, 골절은 소아에 있어 더 빨리 치유되고 합병증도 적다. 소아에서 하악 골절은 종종 하악의 acrylic splint therapy 단독 또는 eyelet wire 와 악간 고정을 같이 사용하여 성공적으로 치료될 수 있다. 발생할 수 있는 심각한 합병증으로는 유착과 성장장애가 있다. 이러한 합병증의 빈도와 심 각성은 좀더 짧은 기간의 악간고정과 긴밀한 술 후 관리에 의해 감소될 수 있다. 특히 소아 환자가 악간고정을 잘 견디지 못하는 경우, 악간고정의 기간이 길어지는 경우, 환자의 자발적인 운동요법이 어려운 경우, 악간고정이 불필요하고 개구장애 만을 일으킨 미약한 증상의 경우에는 동기부여에 의한 물리적 하악 운동요법이 사용될 수 있다. 본 증례에서는 하악 정중부의 외상으로 인하여 양측성 과두 골절이 일어난6세 여자 환아를 대상으로 상,하악에 elastic을 이용하여 하악의 개구, 측방 전방운동에 대해 훈련을 가능하게 하는 Benoist씨 장치를 이용한 능동적 하악 운동 요법으로 7개월 간의 정기 검진을 통하여 하악 운동량의 증진, 과두 유착의 방지, 골개조의 치료효과를 보였다. Mandibular fracture is less common in children than in adults. However children are more susceptible to ankylosis and developmental disorders, and don't respond as well to intermaxillary fixation compared to adults. On the other hand, bone fracture is healed more quickly in children and complications are scarce. Mandibular fracture in children is usually treated successfully with acrylic splint therapy with or without the use of eyelet wires and intermaxillary fixation. Severe complications that include ankylosis and developmental disorders may occur. The frequency and severity of such complications can be mitigated with a shorter duration of intermaxillary fixation and good post-operative care. Encouraging mandibular physical therapy by increasing patient motivation may be necessary in such cases where the patient's response is poor and the duration of intermaxillary fixation increases; when the patient is unable to undergo physical therapy, or when intermaxillary fixation is not necessary with the patient showing only minor symptoms such as trismus. In this case report, a 6 year-old girl with bilateral condylar fracture was treated with elastic in both the upper and lower jaws to allow mandibular physical therapy using a Benoist's appliance, which allows opening, lateral, and protrusive retrusive movements of the mandible. A 7-month follow-up showed beneficial therapeutic effects such as increased mandibular movement and prevention of condylar ankylosis.

초음파 에코파형의 웨이브렛 변환과 비파괴평가에의 응용

박익근,박은수,안형근,권숙인,변재원 한국비파괴검사학회 2000 한국비파괴검사학회지 Vol.20 No.6

초음파 에코파형의 시간-주파수해석법으로 Wigner 분포와 웨이브렛 변환 등과 같은 새로운 신호처리 기법이 비파괴평가 분야에 널리 응용되고 있다. 본 연구에서는 웨이브렛 변환(Wavelet transform)에 의한 음속과 감쇠계수의 주파수의존성과 초음파 결함신호의 잡음제거의 유용성 유무를 실험적으로 검증하였다. Gabor 함수를 웨이브렛의 기본 함수로 사용하였다. 초음파의 에코파형에 포함된 각 주파수성분의 속도와 감쇠계수의 주파수의존성을 추정할 수 있었으며, 초음파탐상에서 결함의 검출능 향상과 결함크기 산정의 정량화에 접근하기 위해 웨이브렛 변환에 의한 S/N 비신호처리 시뮬레이션 결과를 오스테나이트강 스텐인레스 용접부에 가공한 EDM 노치의 초음파 결함신호에 적용한 결과 임상에코를 저감하고 S/N 비를 개선하는 것이 가능하였다. Recently, advanced signal analysis which is called "time-frequency analysis" has been used widely in nondestructive evaluation appications. Wavelet transform(WT) and Wigner Distribution are the most advanced techniques for processing signals with time-varying spectra. Wavelet analysis method is an attractive technique for evaluation of material characterization nondestructively. Wavelet transform is applied to the time-frequency analysis of ultrasonic echo waveform obtained by an ultrasonic pulse-echo technique, In this study, the feasibility of noise suppression of ultrasonic flaw signal and frequency-dependent ultrasonic group velocity and attenuation coefficient using wavelet analysis of ultrasonic echo waveform have been verified experimentally. The Gabor function is adopted the analyzing wavelet. The wavelet analysis show that the variations of ultrasonic group velocity and attenuation coefficient due to the change of material characterization can be evaluated at each frequency. Furthermore, to assure the enhancement of detectability and flaw sizing performance, both computer simulated results and experimental measurements using wavelet signal processing are used to demonstrate the effectibeness of the noise suppression of ultrasonic flaw signal obtained from austenitic stainless steel weld including EDM notch.

작업장 특성에 따른 톨루엔 노출 근로자의 마뇨산 배출 특성

박흥재,김형준,정성욱,이병호 한국환경과학회 2005 한국환경과학회지 Vol.14 No.2

This study was carried out to investigate the correlation between toluene in air and hippuric acid in human urine, which is based in the results of the health check-in and measure of working environment, was investigated for five years. Toluene in air and hippuric acid in urine were checked 116 workers who exposed to toluene in five type of industry. The Mean concentration of toluene in air by type of industry and every year and sex distinction, had positive correlation.(p<0.01) The Mean concentration of hippuric acid in urine by type of industry, every year, sex distinction, disparity of age and term of duty had positive correlation.(p<0.01)

조갑진균증에서 Ciclopirox Nail Lacquer의 치료효과

박경찬,김정애,방형돈,조광현,윤재일,김병수 대한감염학회 1995 감염 Vol.27 No.3

배경 및 목적:조갑진균증의 치료에 있어 국소용 항진균제는 조갑판을 통과하지 못하기 때문에 치료율이 낮은 것으로 알려졌으나 최근 조갑판을 통과하여 조상에서도 높은 치료농도를 유지할 수 있는 국소용 항진균제인 ciclopirox nail lacquer가 개발되었다. 이에 본 저자들은 8% ciclopirox nail lacquer 단독 도포의 조갑진균증에서의 치료 효과와 안전성을 알아 보기 위한 연구를 수행하였다. 방법:표적 조갑판의 감염된 면적의 비율이 50%이하인 경증의 조갑진균증 환자 27명을 평가 대상으로 하였으며 8% ciclopirox nail lacquer 1일 1회 도포요법으로 6개월간 치료하였다. 매 방문시마다 감염면적 비율을 기록하였고 치료 전과 치료 후 진균 검사를 시행하였다. 결과: 1)표적조갑판의 감염 면적이 치료 전 평균 28.9%에서 치료 종료시 4.7%로 통계적으로 유의하게 감소하였다(p<0.001). 2)KOH 직접 도말 검사와 진균 배양 검사에서 모두 음성인 진균학적 완치율은 치료 종료시 77.8%였다. 3)부작용으로는 3명(11.1%)에서 일시적 작열감, 조갑 감입 등을 호소하였다. 결론:경증의 조갑진균증 치료에 있어 8% ciclopirox nail lacquer는 비교적 좋은 치료 효과를 보이며 부작용이 적은 약제로 생각된다. Background: Topical antifungal agents have been ineffective in the treatment of onychomycosis because they could not reach the infected nail bed. 8% ciclopirox nail lacquer is a new topical antimycotic which is characterized by excellent penetration into the nail plate. We performed a study to assess the therapeutic efficacy and safety of 8% ciclopirox nail lacquer in the treatment of onychomycosis. Methods: We assessed 27 onychomycotic patients whose affected area of target nail plate was not more than 50%. The patients were instructed to apply 8% ciclopirox nail lacquer once daily and evaluated monthly for 6 months. Mycological examinations were done before and after the treatment. Overall efficacy, tolerability, cosmetic acceptance and adverse effects were assessed at the end of 6 months' treatment. Results: The mean percentage of affected area decreased from 28.9% to 4.7%. Mycological cure rate was 77.8% at the end of the treatment. Overall efficacy assessed by physician and patients were similar and evaluated as complete cure in 48% and 44%, respectively. Tolerability and cosmetic acceptance were excellent or good in most of the patients. No systemic adverse effects were found, but 3 patients complained of mild prickling sensation or ingrowing toe nail. Conclusions: These data suggest that 8% ciclopirox nail lacquer is safe and effective in the treatment of mild onychomycosis.

Hypophosphatasia 환아의 치료 증례

최병제,최형준,이제호,김기덕,박수정 大韓小兒齒科學會 1998 大韓小兒齒科學會誌 Vol.25 No.3

1. Hypophosphatasia 는 골조직 및 치아조직의 비정상적인 석회화를 나타내는 대사장애로, 특징적구강내 소견 인 우치의 조기탈락 양상으로 치과에서 조기진단이 가능하다. 2. 본 증례에서 상악궁 확장을 동반한 의치 제작으로 심미적, 기능적으로 양호한 결과를 얻었으며, 영구치열기 까지 장기적 관찰 및 치료가 필요할 것으로 사료된다. hypophosphatasia is a rare metabolic disorder which manifests characteristics such as abnormal mineralization of bone and dental tissues, diminished serum and tissue alkline phosphatase, and increased urinary secretion of PEA. It ingerited as an autosomal recessive or dominant trait and occurs in all races. In general, hypophosphatasia can be classified in 4 subtypes which are the perinatal, infantile, childhood, adult type depending upon the age at presentation and severity. In young children with Hypophosphatasia the long bones show irregular defects, and the skull showes poor calcification. In older children with premature closure of the skull sutures there may ve multiple lucent area called gyral or convolutional markings, described as resimbling beaten copper, presumably resulting from increased intracranial pressure,Examination of the jaws reveals a generalized lucency of the maxilla and mandible, the cortical bone and lamina dura are thin, and the alveolar bone may be deficient. Clinical features of Hypophosphatasia imclude premature loss of deciduous teeth, especially incisors, hypoplasia of aplasia of root cementum, enamel hypoplasia, irregular calcification of dentin, large pulp chamber, and resorption of marginal alveolar bone and roots. Our report involves a patient with a chief complaint of early loss of both Mx. and Mn. deciduous ncisors. after conducting a through clinical and radiographic examination this patient was referred to pediatrics under the suspicion of hypophosphatasia, the diagnosis proved to be correct and successful results were accomplished through a denture made to improve esthetics and function.

백내장 환자의 시기능지표 : 사전 연구를 중심으로 Pilot study

강형곤,박은철,최윤정,김한중,홍영재,조우현,손명세,임승정 한국의료QA학회 1998 한국의료질향상학회지 Vol.5 No.1

Background : There is increased recognition that rigorous approach to functional assessment will complement the assessment of clinical status. This study is to develop the appropriate visual function index in Korean patients with cataracts by the assessment of the reliability, validity of visual function indexes including VF-14. Methods : An prospective study was performed with 92 patients who had undergone either one eye or both eye cataract surgery by 3 ophthalmologists practicing at a university-hospital. Patients were interviewed, and clinical data were obtained. Doctors were questioned with self-entered questionnaire forms. Medical record was examined to understand surgery-process. The survey was conducted at 1-2 days before cataract surgery. Results : We used following measures : 7 visual function indexes, global measures of patients' trouble and satisfaction with vision, and best-corrected visual acuity (VA) in each eye. 7 visual function indexes showed a high internal consistency reliability (Cronbach's alpha coefficients ≥0.86). The better visual acuity(operated eye. better eye), the higher patient satisfaction with vision, the lower symptom score, the lower patient trouble with vision was correlated with preoperative visual function index scores. Among 7 indexes, VF-12 with the exclusion of 2 items drivings from VF-14 is a high Cronbach's alpha coefficient and correlation coefficient and the highest R². Conclusion : We conclude that VF-12 is reliable and valid in Korea. So we suggest that in Korea, all items of VF-14, the visual function index, which is in use internationally, ought to be surveyed and VF-12 which has been excluded by 2 items of drivings from VF-14 ought to beused for analysis.

구순 구개열 환아의 수유 보조 장치에 대한 증례보고

최형준,손흥규,최병재,박동석 大韓小兒齒科學會 1995 大韓小兒齒科學會誌 Vol.22 No.2

Cleft lip, cleft palate, cleft lip and palate are the most common congenital anomalies in cranio-orofacial region. These anomalies lead to esthetic problem as well as to difficulties in feeding and speech and also to chronic infection of upper airway and to disturbance of jaw growth during growing up. Especially, some difficulties during feeding make parents to be confused and puts infants in dangerous position. But these difficulties can be controlled by proper feeding methods according to pattern of cleft lip and palate. Among these feeding methods, feeding appliance is the most safe and relatively easy to manufacture. Early wearing of this appliance makes cleft lip and palate infants to a normal feeding and weight gain. As a member of team approach for the treatment of cleft lip and palate, a pediatric dentist should solve the feeding problems which cleft lip and palate infants and its parents are confronted and help in receiving further treatment.

석유화학공업 종사자의 유전독성 위험성 평가

안기원,박정선,서순팔,문재동,조진형 大韓産業醫學會 1998 대한직업환경의학회지 Vol.10 No.1

In order to evaluate the genotoxic hazard among workers potentially exposed to low level petrochemical substances, the analyses of micronuclei(MN) and sister chromatid exchanges(SCEs) in lymphocytes were performed in 46 male workers(as exposed group) and 46 nonexposed subjects(as control group). Mean frequencies of MN and SCEs(respectively, 12.9/1000 cells and 6.5/cell) in exposed group were very significantly higher than those(10.2/1000 cells and 5.4/cell) in control group. And there were also significant differences in mean frequencies of MN and SCEs adjusted for age, employment duration, smoking, and drinking between two groups. Median frequencies of MN and SCEs in exposed group were very significantly higher than those in control group. Frequencies of SCEs were higher in smokers than in non-smoker. Frequencies of MN in smokers, however, were similiar to those of non-smoker. Interaction between exposure and smoking on MN and SCEs induction was not observed. The results suggest that there is genotoxic hazard in high risk group like workers handling carcinogens in petrochemical plants and the analyses of MN and SCEs are useful biomarkers for the exposure to hazard substances even at the level below the exposure limit.

감압 효소 침투에 의한 표피의 광범위 분리

장충현,이두형,홍성표,박재경,이경노 大韓成形外科學會 1993 Archives of Plastic Surgery Vol.20 No.1

Previously, a new method of negative-pressure-assisted DISPASE splitting into various thicknesses and sizes of surgically obtained human or animal skins into the epidermal and dermal layers was invented. Good penetration of the enzyme into the skin tissue was obtained by applying negative pressure in a liposuction apparatus and then rapidly aerating the skin tissue to the room air pressure when the pressure pushed the enzyme solution deep into dermal tissue. The procedure was repeated every 3 minutes under 750mmHg negative pressure assisted dispase(100IU/ml). The earist time for separation of the viable epidermal sheet was measured. Negative pressure(-750mmHg), numbers of repeat(7times), incubation time(37℃,25mins)were the factors for the earlist separation of the epidermal sheet. We suggested that this was a good method for the treatment of tattoos and nevus. Advantages were that the donor site morbidity was less and the time required for healing of the wound was markedly shortened.

CASE REPORT : Simultaneous Bilateral Fracture of Femoral Neck in Korea: A Case Report

( Jai Hyung Park ),( Hwa Jae Jeong ),( Hun Kyu Shin ),( Eugene Kim ),( Taeg Su Ko ),( Young Min Choi ) 대한고관절학회 2015 Hip and Pelvis Vol.27 No.1

Unilateral femoral neck factures are common and their incidence is increasing. However, simultaneous bilateral femoral neck fractures are rare. Although cases of simultaneous bilateral femoral neck fractures have been reported, most were caused by strong muscle contractions during electroconvulsive therapy. Simultaneous bilateral femoral neck fractures caused by a simple fall are an extremely rare injury; therefore, limited literature is available, and no case has been reported in Korea. We report herein a case of simultaneous bilateral femoral neck fractures caused by a simple fall. An 83-year-old woman visited the emergency department with bilateral hip joint pain and gait disturbance, which developed 1 day after a fall. Tenderness and severe limitation in left hip joint range of motion and mild limitation in right hip joint range of motion were observed on a physical examination. A Garden type IV femoral neck fracture in the left hip joint and a Garden type I femoral neck fracture in the right hip joint were observed on plain radiography. She underwent right screw fixation and left bipolar hemiarthroplasty 2 days after admission. The patient could walk using a walker 4 weeks postoperatively. Bone union in the right femoral neck was observed at the 3 month follow-up. No specific findings were observed at the left hip hemiarthroplasty site.