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      • 頰骨骨折에 關한 臨床的 考察

        張世洪,鄭雲夏 慶北大學校 齒科大學 1984 慶北齒大論文集 Vol.1 No.1

        This study was undertaken to survey 95 patients with zygomatic fractures who were admitted to Fatima Hospital and the department of dentistryof Kyungpook University Hospital during a eight and a half-year period, from April 1973 to September 1981 The majority of the patients in this series came from the city of Taegu and its vicinity. The results are as follows: The incidence of zygomatic fracture was most frequent in the second decade and males were predominant, representing 90.5% of the total, with the male to female ratio being 9.6:1. Road traffic accidents were by far the most frequent cause of the zygomatic fractures, accounting for 62.1% of the total. Motorcycle accidents were responsible for 24.2% of the total. Of the 95 patients, 54 (56.9%) were injured on the left side, whereas the right side was affected in 38 (40.1%) and 3 (3.2%) had bilateral fractures. There were relatively high incidence of associated laceration of the face, craniocerebral injury and fractures of the mandible and maxilla. Of the 46 patients treated surgically, 21(45.6%) were treated within 1 week after their injuries and 25 (54.4%) were treated during the second, third, and fourth week after injuries. The most commonly used method of surgical treatment was open reduction and interosseous wire fixation via lateral eyebrow approach.

      • KCI등재
      • 口腔內 Candida의 分布 및 抗眞菌劑에 對한 感受性

        張世洪,薛盛用,趙東澤,全燾基 대한화학요법학회 1985 대한화학요법학회지 Vol.3 No.1

        齒科 來院患者 473名을 對象으로 口腔內 Candida의 分布와 分離된 261株의 抗眞菌劑에 對한 感受性을 調査하여 다음과 같은 成績을 얻었다. 來院患者 473名中 163名(34.5%)의 口腔에서 Candida를 檢出할 수 있었으며, 分離率은 男性이 22.8%, 女性이 42.3%으로 女性이 男性에 比하여 越等히 높았고 年令別로는 10代에서 60代까지 14.6%에서 50%로 年令에 따라 增加하였으나 10歲미만의 小兒에서는 43.8%의 高率로 分離되었다. 採取部位別 分離率은 舌面에서 더 높았으며 舌面에서만 分離된 것이 32.5%, 齒??部에서만 分離되는 것이 10.4%였고 兩部位에서 모두 分離된 것이 57.1%였다. 分離된 Candida는 C. albicans 및 C. tropicalis 2種뿐이었으며 C. albicans가 全體의 94.6%, C. tropicalis가 5.4%였다. 檢出되는 菌數는 男性에 比하여 女性에서 얻은 材料에서 더 많은 集落을 形成하는 傾向이 있었으나 年領과는 相關關係가 없었다. 口腔內 疾患有無와의 關係는 齒牙??蝕症과 其他 口腔疾患이 同時에 存在하는 患者가 43.4%로 가장 높고 다음이 齒牙??蝕症患者 41.2% 其他 口腔疾患 患者 32.1% 順이었으며 다같이 特別한 口腔疾患이 觀察되지 않은 사람의 23.7%보다 높았으나 集落數와의 關聯性은 없었다. 義齒保有者에서는 53.6%로 가장 높은 檢出率을 나타내었으며 多數의 集落을 形成하는 頻度도 높았다. 分離된 Candida에 對한 amphotericin B, nystatin, miconazole nitrate(MCN) 및 ketoconazole(KCZ)의 90% 菌株의 發育沮止濃(MIC_(90))는 各各 C. albicans에서 0.1㎍/㎖, 1.6㎍/㎖, 12.5㎍/㎖ 및 25㎍/㎖인 反面 C. tropicalis에서 0.2㎍/㎖, 3.1㎍/㎖, 25㎍/㎖ 및 25㎍/㎖로서 KCZ는 兩 Candida 菌種에서 同一하였으나 그外는 C. tropicalis에서 C. albicans보다 2倍 더 높았다. Candida에 對한 KCZ의 (MIC_(90))은 pH6.0인 casein yeast extract-glucose agar(CYGA)에서보다 pH7.0인 buffered CYGA에서 2倍 더 낮았으나 MCN의 境遇는 兩培地에서 同一하였다. MCN의 (MIC_(90))은 C. albicans에 대해서는 CYGA, yeast morphology agar(YMA) 및 agar를 添加한 yeast nitrogen base medium(YNA)에서 보다 Sabouraud-glucose agar(SGA)에서, C. tropicalis에 대해서는 CYGA보다 SGA, YMA 및 YNA에서 2倍더 낮았다. KCZ의 (MIC_(90))은 C. tropicalis에 대해서는 YMA 및 YNA가 CYGA 및 SGA보다 더 낮았으며 C. albicans에 대해서는 4種의 培地에서 同一하였다. The distributin of Candida in oral cavity was studied in 473 patients with various oral disorders. A total of 251 strains of Candida were isolated and tested for the susceptibility to 4 antifungal drugs. Of 473 patients, 163(34.5%) carried Candida in oral cavity. Isolation frequency of Candida was higher in females(42.3%) than in males(22.3%) and increased with agss from 14.6% to 50%, but children under ten years of age carried with high frequency (43.8%). The distribution of Candida, in oral cavity was higher in specimens from tongue than from gingiva. The incidence by site was 32.2% from tongue. 12.4% from gingiva. and 55.4% from both sites. Of 261 Candida isolated. 94.6% were identified as C. albicans and 5.4% as C. tropicalis. The specimens from females produced greater numbers of colonies than those from males, but there was no correlation with ages. The incidence of Candida was 43. 4% in patients with oral disease and dental caries, 41.2% with dental caries, 32.1 % with oral disease and these incidence were higher than in normal group (23.7%). There was no correlation with various oral disorders in number of yeast colonies formed. In denture wearers, Candida were isolated with high frequency (53.6%) and with the tendency of producing greater numbers of colonies. Concentrations required to inhibit 90% of strains (MIC_(90)) of amphotericin B, nystatin, miconazole nitrate(MCN), and ketoconazole(KCZ) were 0.1㎍/㎖, 1.6,12.5, and 25 to C. albicans and 0.2㎍/㎖, 3.1, 25, and 25 to C. tropialis, respectively. MIC_(90) of durgs to C. tropicalis were twofold higher than to C. albicans, while MICso of KCZ were the same to both Candida species. MIC_(90) of KCZ to Candida was twofold lower in buffered casein-yeast extract-glucose agar (CYGA), pH 7.0. than in CYGA, pH 6,0, whereas there was no difference between both media with MCN. MIC_(90) of MCN to C. alticans was twofold lower in Sabouraud glucose agar(SGA) than in CYGA, yeast morpliology agar(YMA), and yeast nitrogen base mediam added agar(YNA), aad MIC_(90) to C. tropicalis was twofold lower in SGA, YMA, and YNA than in CYGA. MIC_(90) of KCZ to C. tropicalis was twofold lower in YMA, YNA than in CYGA and SGA, whereas there was no difference among 4 media ia those of C. albicans.

      • KCI등재

        후방접근법을 이용한 장골채취술

        안재진,소재정,장세홍 大韓顎顔面成形再建外科學會 1990 Maxillofacial Plastic Reconstructive Surgery Vol.12 No.2

        Because of it's accessibility and the quantity of bone available, the ilium is a common donor site for autogenous cancellous, cortical, and corticocancellous grafts to the facial skeleton. Especially, the anterior iliac crest has been the traditional source of pelvic bone for autogenous bone grafting in the maxillofacial skeleton. Recently the need for large amounts of bone in some reconstructive procedures of the facial skeleton has led to the evaluation of posterior ilium. The posterior approach to the ilium is superior to the anterior approach when large quantities of cancellous bone are required for facial reconstruction. The posterior approach has the advantages of more available bone, fewer complications, less postoperative pain, less disturbance in ambulation, and a possible reduction in the length of hospitalization. As the posterior approach affords an almost unlimited amount of bone for autogenous grafting in the maxillofacial region, we feel its use is indicated when very large amounts of bone are required.

      • KCI등재

        자가장골 및 늑연골의 복합이식을 통한 하악골 재건술

        장세홍(Se Hong Chang),안재진(Jye Jynn Ann),소재정(Jae Jung Soh),박지희(Chi Hee Park) 대한악안면성형재건외과학회 1991 Maxillofacial Plastic Reconstructive Surgery Vol.13 No.1

        외상이나 감염 또는 종양의 적출에 의해 발생한 하악골 결순부는 심미적, 기능적으로 많은 문제를 야기한다. Sykoff 가 1900 년에 자가골 이식으로 하악골 결손부를 수복한 이후 현재까지 많은 이식물과 이식방법이 이용되어져 왔으며 특히 늑연골은 1920 년에 Gillies 에 의해서 TMJ 수복에 처음 사용된 이후 성장기 아동의 과두결손부 수복에 많이 이용되고 있다. 또한 자가장골은 안면부의 수복에 보편적으로 이용되고 있는 공급부위이며 특히 많은 양의 망상골이 필요한 경우에는 후방 접근법을 이용함으로서 충분한 양의 골을 얻을 수 있다.수복의 시기는 환자마다 차이가 있어서 나이, 과거력, 초기질병의 상태, 성장발육정도 및 심미적, 정신적인 면을 고려하여야 하며 악성종양의 제거시에는 재발여부와 방사선 치료 등을 고려하여 적절한 시기를 선택하여야 하나, 일반적으로 술후 약 1 - 2 년 후에 시행할 수 있다.본원에서는 하악골 골육종으로 진단된 15 세 남자 환자에서 과두를 포함하는 좌측 하악골 절단술후 임시로 레진수복물을 장착한뒤 약 20 개월간의 주기적인 검진결과 재발의 기미가 없어 늑연골과 장골의 복합이식을 통하여 심미적, 기능적으로 양호한 결과를 얻었기에 그 증례를 보고하는 바이다. Loss of mandibular continuity due to neoplasm, trauma, or infection results in major esthetic and biologic compromise. The use of costochondral grafts for reconstruction of temporomandibular joint, described first by Gillies in 1920 has been accepted as a suitable method for replacing the mandibular condyle, especially in growing children. Autogenous iliac bone graft has been a satisfactory source of mandibular reconstrucion since Sykoffs report in 1900. Autogenous bone grafts the posterior aspects of the ilium provide large amount of PMCB with acceptable donor site morbidity. In timing of reconstruction, initial disease, age, medical history, growth and development esthetic and psychlogic factors. should be considered. We present a case of osteosarcoma in the mandible that was treated by a hemimandibulectomy and the defect was reconstructed 20 months later with composite method of costochondral and posterior iliac bone graft.

      • KCI등재

        늑연골 이식술을 이용한 하악관절 유착증 치험례

        장세홍(Se Hong Chang),안재진(Jye Jynn Ann),황경룡(Kyung Ryong Hwang) 대한구강악안면외과학회 1987 대한구강악안면외과학회지 Vol.13 No.1

        Trismus and disharmony of facial growth were the usual results of injury to the mandibular condyle in growing children. Early replacement of ankylosed condyle with a costochondral joint was recommended as best approach to management of such problems. A detailed review of the literature supports the principle that cartilagenous growth site was responsible for the growth and maturation of facial skeleton. A case of true bony ankylosis of the TMJ was treated by condylectomy and autogenous costochondral grafting. Results were encouraging functionally and esthetically, but continued observation of this patient is necessary to evaluate the growth of transplanted graft.

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