.Pseudomonas stutzeri 감염에 의한 맥락총염에서 초래된 포착성 측뇌실 확장 1예

김남곤,권오영,박기종,최낙천,임병훈 대한신경과학회 1997 대한신경과학회지 Vol.15 No.2

전북지역 치과개원의의 열구전색제 사용실태에 관한 연구

김재곤,백병주 大韓小兒齒科學會 1994 大韓小兒齒科學會誌 Vol.21 No.2

Since the introduction of pit and fissure sealants in the early 1970's, many studies have been published amply documenting the efficacy of these materials as caries-preventive agents. However, the acceptance of the technique by dentist has been questionable. This survey was investigated the attitudes toward and use of pit and fissure sealants by dentist in Chonbuk area. The results were as follows: 1. Utilization of pit and fissure sealants is very high. Only 15% of dentists never use pit and fissure sealants, whereas 85% generally use pit and fissure sealants. 2. Most dentists reported that their knowledge of pit and fissure sealants was gained through dental schools education. 3. Concern about difficult to sell' to patient, poor retention of pit and fissure sealants and unsubstantiated by research were given as the main reasons why pit and fissure sealants was not used. 4. Patient demands and various educate program were given as important factors that would lead to increase use of pit and fissure sealants.

광중합형 복합레진과 법랑질간의 마모특성 평가

백병주,이승영,이두철,김재곤 대한소아치과학회 2001 大韓小兒齒科學會誌 Vol.28 No.2

본 연구에서는 최근 치과임상에서 이용되고 있는 7종의 복합레진을 시험재료로 선택한 다음 법랑질과 복합레진 충전재가 대합하는 경우의 마모 양상을 조사하기 위해 광중합형 복합레진과 제2소구치 교두를 핀-디스크 구동 방식의 전동식 마모시험기에 고정한 다음 68.6N의 하중을 가한 상태에서 30,000 회전시켜 1.3×103m의 미끄럼 접촉을 가하였다. 마모를 평가하기 위해 복합레진의 종류에 따른 제2소구치 교두의 수직고경 변화, 시편의 두께 감소와 체적 손실 및 마모시험 전후의 표면을 주사전자현미경으로 관찰하였고, 표면경도가 마모도에 미치는 영향을 평가하기 위해 누프 경도를 측정한 결과, 다음과 같은 결론을 얻었다. 1. 누프 경도는 Speotrum 군에서 70.4로 가장 높고 Heliomolar 군에서 19.8로 가장 낮은 값을 보였으며, Tukey 다중범위검증법에 의해서 각 군 사이의 통계적 유의성을 검중한 결과, Spectrum군, Z100군 및 Clearfil AP-X군을 제외한 나머지 모든 군들 사이에서 상호간에 통계학적으로 유의한 차이를 보였다(p<0.05). 2. 법랑질의 내마모성은 microfill 형인 Heliomolar 군과 대합하는 경우에 가장 높게 나타났으며, 구치부용에서는 구상의 zirconia silica 미세 입자를 복합화한 micro hybrid 형의 Palpique 군에서 가장 높게 나타났다. 3. 복합레진의 연마성 마모에 대한 저항성은 필러의 평균 입경이 작고 미세 필러를 고밀도로 분산시켜 복합화한 hybrid형 복합레진에서 높게 나타나는 경향을 보였다. 4. 주사전자현미경 관찰 결과, 마모면에서는 필러의 돌출, 마멸과 탈락 및 기질레진의 미세 균열 진전과 표면층의 박리 등이 관찰되었다. This study was perfsrmed to evaluate wear characteristics of light-cured composites when opposed by human enamel. Seven light-cured restorative composites were selected and enamel cusps sectioned from premolars. All samples were stored in distilled water at 37℃ for 10 days 68.6 N of weight was loaded during the teat. The measurements of vertical loss of enamel cusps, weight loss and volume loss of composites, and SEM observations of the polished and abraded surfaces were made after 30,000 cycles. The results obtained were summarized as follows; 1. The highest hardness vague of 70.4 was observed in the Spectrum group and the lowest value of 19.8 was observed in the Heliomolar group. Results of Tukey test showed that an overall significant difference was indicated except the Spectrum, Z10O and Clearfil AP-X groups(p<0.05). 2. Enamel showed the good abrasion resistance against the Heliomolar group of microfilled composite and the Palplque Toughwell group containing the submicron hybrid type spherical fillers. 3. The abrasive wear resistance of hybrid composites was improved with the decrease of mean particle size and hybrid of submicron particle filler. 4. SEM observation of worn surfaces revealed the protrusion, attrition and missing of fillers, clacks developing and delamination in the matrix.

소아의 악골내 발생한 낭종의 외과적 처치

김재곤,김영진,김미라,백병주 대한소아치과학회 2001 大韓小兒齒科學會誌 Vol.28 No.1

악골의 낭종은 크게 치성과 비치성으로 구분되며 치성낭은 치성기관이나 그 잔존 세포성분과 관련되어 주로 골내에서 발생한다. 비치성낭종은 과거에는 태아의 발육중 상피의 봉입이나 융합선을 따라 존재하는 상피잔사가 증식하여 낭성변형을 일으킨다는 설이 유력하였으나 현재에는 이러한 태아의 발육 동안 상피의 봉입은 일어나지 않는 것으로 보고 있다. 함치성낭은 미맹출 치아와 관련되어 발생하고 상피의 전암 가능성이 있으므로 가능한 빨리 제거하도록 하며 조대술이나 적출술이 이용될 수 있고 간혹 원인치의 발거가 추천된다. 비구개낭은 가장 일반적인 비치성낭으로 상악 중절치 사이에 경계가 명확한 방사선 투과상으로 나타난다. 적출술과 조대술로 치료할 수 있으며 전암 가능성이나 재발은 드물다. 본 증례에서는 전북대학교 병원 소아치과에 내원한 아동의 악골내 발생한 낭종을 외과적으로 제거한 후 다음과 같은 결론을 얻었다. 1.함치성낭의 환아에서, 원인 치아를 보존하고 완전 적출술로 병소를 제거한 후 경과를 관찰한 바 영구치의 정상적인 맹출이 이루어졌다. 2.비구개낭을 치료시, 인접치아의 생활력에 대한 정확한 진단과 그에 따른 치료법의 선택으로 불필요한 근관치료를 피할 수 있다. 3.향후 비구개낭의 환아의 관련치에 대한 계속적인 관찰이 필요하리 사료된다. 4.악골내 방사선 투과성의 병소를 치료시, 정확한 감별진단과 적절한 치료법의 선택이 중요하다. The Dentigerous cyst is reported to be one of the most common lesions of the jaw. It is derived from reduced enamel epithelium that surrounds the crown of an unerupted tooth. Dentigerous cysts usually remains asymptomatic and presents as well-circumscribed radiolucencies surrounding the crown of a tooth. Most dentigerous cysts are treated by surgical enucleation or marsupialization of the cyst to allow eruption of the permanent tooth. The nasopalatine duct cysts derived trom the islands epithelium remaining after closure of the embryonic nasopalatine duct. The cyst presents as a well-circumscribed oval or heart-shaped radiolucency located in the midline of the anterior maxilla between the roots of the central incisors. Treatments is by surgical enycleation, employing a paltal approach. This report present two cases. One case was diagnosed with dentigerous cyst and treated by enucleation. 12Months later, affected second premolar was erupted normally. The other case was diagnosed with nasopalation duct cyst. Histological examination of the enucleated cyst confirmed a nasopalatine duct cyst. There was no recurrence during follow up period.

불소함유 전색제 도포에 따른 인공 우식병소의 재석회화에 관한 연구

김재곤,백병주 大韓小兒齒科學會 1998 大韓小兒齒科學會誌 Vol.25 No.3

The purpose of this study was to evaluate the remineralization effects of fluoride-containing sealant on the artificially created enamel carious lesions. The fluoride release from the specimen of fluoride-containing sealants, the effect on enamel acid solubility and micro-hardness from the experimental sealants when applied to carious enamel surfaces were investigated. The obtained results were as follows; 1. fluoride was a rapid rate of release during the first day, with the amount diminishing with time. The amount of fluoride released from fuji Iype lll was higher than that from Teethmate-F and Helioseal-F and Helisoseal_f during the 28 days of days of immersion(P<0.05). 2. The enamel solubility of carious enamel surface was higher than that in the Teethmate-F, Helioseal-F, and Fuji Ionomer type lll(P<0.05), and there was no significant difference with Teethmate-A and Helioseal(P>0.05). 3. The microhardness value of carious enamel surface was lowest. However, there was no significant difference between the other sealants with respect to their effects on enamel hardness(P>0.05).

연마시 여러가지 수복재와 이장재의 사용에 따른 치수내 온도변화

백병주,이두철,김미라,김재곤 대한소아치과학회 2000 大韓小兒齒科學會誌 Vol.27 No.3

치아 수복시 마무리 과정에서의 연마는 수복물의 수명 및 심미성을 결정하는 중요한 과정으로서 연마시 마찰열의 발생으로 인하여 치수에 위해작용을 줄 수 있으므로 주의를 하여야 한다. 여러 가지 수복 재료를 연마하는 동안 치수내에서 발생하는 열의 변화를 수복물 종류, 이장재 종류, 잔존 상아질의 두께, 연마 시간의 차이에 따라 조사하고자 발치된 구치에 수복물을 충전한 후 aluminum-oxide coated disc를 이용하여 연마하는 과정에서 thermocouple을 이용하여 치수내 온도값을 측정하였으며, 이에 대한 통계적 분석을 시행하여 다음과 같은 결과를 얻었다. 모든 경우에서 연마 시간이 증가함에 따라 치수내 온도가 증가하였으며, 아말감 연마시 다른 수복 재료에 비해 큰 온도 증가치를 보였으나 composite resin, glass ionomer cement, 그리고 compomer에서는 연마에 따른 온도 변화차가 관찰되지 않았다. 아말감 하방에 이장재를 사용한 경우에 이장재를 사용하지 않았을 경우에 비해 온도 증가량이 적었으며, 다른 수복재에서는 이장재 사용여부에 따른 온도 증가량의 차이는 존재하지 않았다. 본 실험에서 사용된 이장재 중 glass ionomer cement와 zinc phosphate cement에 비해 zinc oxide eugenol cement의 열 차단 효과가 가장 작았다. 수복물에 간헐적인 연마를 시행한 경우, 지속적인 연마를 시행한 경우에 비해 온도 증가량이 작았으며, 아말감 하방의 잔존 상아질의 두께가 감소하면 온도 증가량이 더 커졌으나, 다른 세 종류의 수복재에서는 잔존 상아질의 두께에 따른 차이가 발생하지 않았다. 주요어 : 치수 온도변화, 연마, 복합레진, 아말감 An in vitro study was performed to evaluate the effect of four variables on the temperature rise produced by polishing of restorations. The foulr variables were : restorative material, base, thickness of remaining dentin, continuous polishing of'intermittent polishing. Class V cavities were cut on extracted molar and restored with composite resin , resin-modified glass ionomer cement. compomer, amalgam on the various bases (glass ionomer cement. zinc oxide eugenol cement, zinc phosphate cement) . Dentin thickness under the restoration was 0.5mm, 1.5mm. Polishing was done with an aluminum oxide-coated disc. Polishing time was continuous or intermittent fur up to 1 minute. Intra-pulpal temperature increased almost linearly in all cases. Amalgam produced highest temperature risesat the pulp, while the composite resin, resin-modified glass ionomer cement and compomer were not different for each other The rate and extent of temperature rising of amalgam restoration was reduced by presence of acement base. Zinc oxide eugenol cement bases showed the highest temperature rise, while glass ionomer cement, zinc phosphate cement were not different to the untreased tooth. Thickness of remaining dentin was only significant for the amalgam restoration. Continuous polishing produced higher temperature rise than intermittent polishing.

응급실에서 시행된 기관내 삽관의 현황

김병철,강보승,송형곤,이정훈,송근정,정연권 대한응급의학회 1999 대한응급의학회지 Vol.10 No.4

Background : The purpose of this study was to analyze the endotracheal intubation cases performed in the emergency department. Methods : We investigated retrospectively 326 cases of endotracheal intubation performed in the emergency department of a tertiary care center form April 1, 1998 to March 31, 1999. We focused on operators, medications used, its success rate and immediate complications, and the relationship between its success rate and medications. Results : Of 326 consecutive intubations, 193 patients(59.2%) were done by emergency medicine residents or attending physician. While 320 patients(98.2%) were successfully intubated, 6 patients could not be intubated and 2 patients underwent tracheostomy. Of 50 cases of intubations(15.3%) attempted with paralyzing agents, 48 cases were done with succinylcholine and 46 cases underwent by emergency physicians. Intubations with neuromuscular paralysis resulted in high success rates at the first attempt. Of 55 immediate adverse events were encountered in 47 patients(desaturation=17, bronchial intubation=15, hypotension=8, bradycardia=4, cardiac arrest=2, others=5). Conclusion : At this institution, paralyzing agents were used infrequently, but almost all of them were used by emergency physicians.

응급의료 헬리콥터를 이용한 환자이송에 대한 고찰

송형곤,김병철,송근정,정연권,신백효 大韓應急醫學會 1998 대한응급의학회지 Vol.9 No.4

Background: The first EMS helicopter was introduced to Korea in 1996 and from Dec. 1. 1997, it was used for transporting emergent patients. Authors, here upon, report the transporting experiences. Methods: From Dec. 1, 1996 to Dec. 31, 1997, Samsung Medical Center's EMS helicopter was used for air evacuation of critically ill patients. The patients data prospectively analyzed. Result: A total of 65 patients were transported. Male to female ratio was 1.95:1. The mean transport time was 64.1 min(10 - 160 min). Majority of the evacuated patients was surgical patients (General Surgery : 16, Orthopedic surgery : 10, Neurosurgery : 6, Internal medicine : 13, Pediatrics : 3, and others : 3). Twenty-one of the 65 patients transported were admitted to ICU and 31 did not require ICU care. During the air evacuation, one physician and one nurse trained for air evacuation attended the patients. No medical problems or deaths developed during the air evacuation period. Conclusion: The first EMS helicopter was introduced to Korea in 1996. From Dec. 1, 1996 to Dec. 31, 1997, Samsung Medical Center's EMS helicopter was used for air evacuation of critically ill patients. The patients data reported.

치아종에 대한 증례보고

백병주,김재곤,주훈,양정숙 大韓小兒齒科學會 1995 大韓小兒齒科學會誌 Vol.22 No.2

Odontomas are most common benign odontogenic tumors, and have been defined as "mixed odontogenic tumor composed of epithelial and mesenchymal cells". Many authors are considered to be malformations rather than neoplasm. The etiology of odontoma is uncertain but hypothesized to involve local trauma, infection, inheritance or mutant gene interference with genetic control of tooth development. The recent classification by WHO divides odontoma into 2 groups such as complex odontoma and compound odontoma. Odontomas are usually asymptomatic and are usually discovered on routin dental radiographs. The most frequently encountered symptoms are impacted tooth and swelling. Radiographically, it appears as an irregular mass of calcified material surrounded by a radiolucent band. The possibility of an ameloblastic odontoma must be kept in mind during the differential diagnosis. Surgical excision and histopathological examination of the lesions is recommended. Following removal of the odontoma closing the incision and allowing the tooth to erupt spontaneously was considered. Hitchin suggested that spontaneous eruption may not occur if the root of the impacted tooth is completed. Failure to erupt would require a 2nd surgical exposure to place an orthodontic attachment. This report presents the result in treating patients, whose chief complaint was delayed eruption of teeth due to odontoma.

불소함유여부에 따른 치면열구전색제의 전단결합강도에 관한 실험적 연구

백병주,김재곤,허선,권선자 大韓小兒齒科學會 1996 大韓小兒齒科學會誌 Vol.23 No.2

This study was to evaluate shear bond strength fluoride-relesing sealant and nonfluoride-relesing sealant to enamel surface of bovine tooth. 80 extracted bovine teeth were randomly assigned to four groups,and four kind of sealants including Teethmate-A(Kuraray Co.),Teethmate-F(Kuraray Co.),Helioseal(Vivadent Co.),Helioseal-F(Vivadent Co.) were bonded to exposed enamel surfaces using silicon plate. Shear bond strength was determined in an instron universal testing machine at a crosshead speed of 1mm/min.Then,the fracture surfaces of test specimens were investigated with scanning electron microscope. The obtained results were as follows; 1.The shear bond strength decreased in the following oder:Teethmate-A(18.31MPa),Teethmate-F(11.90MPa),Helioseal(11.74MPa),Helioseal-F(10.64MPa). 2.The shear bond strength of Teethmate-A showed significantly higher than that of Teethmate-F(P<0.05),but Helioseal and Helioseal-F didn't showed statistically different(P<0.05). 3.According to the SEM,Teethmate-A group showed cohesive failure,and Teethmate-A group & Helioseal group showed mixed pattern of cohesive failure and Helioseal-F group showed adhesive failure.