치과 임플랜트 식립시 관주에 따른 골 천공 기구의 열 발생에 관한 연구

문은수,임헌송,조인호,Moon, Eun-Soo,Lim, Heun-Song,Cho, In-Ho 대한치과보철학회 1999 대한치과보철학회지 Vol.37 No.4

There are a lot of elements affecting the success of implant prosthesis. The quality of surgical procedure is considered as one of the key factors. To avoid the excess heat generation is an important element of successful osseointegration and it can be achieved by using a gentle surgical technique with a sharp instrument in bone drilling. This study was performed to measure and analyze comparatively the heat transmitted to sur-rounding bone at a distance of 0.5mm from the periphery of the drill hole in each drilling stage. The results were as follows. In standard system, the temperature of surrounding bone tissue ranged from $29.2^{\circ}C\;to\;48.3^{\circ}C$ with irrigation and from $34.6^{\circ}C\;to\;84.3^{\circ}C$ without irrigation. And in wide system, the temperature of surrounding bone tissue ranged from $29.5^{\circ}C\;to\;52.5^{\circ}C$ with irrigation and from $34.8^{\circ}C\;to\;87.8^{\circ}C$ without irrigation. And the temperature ranges exceeded the threshold without irrigation, while showing less than the threshold by the cooling effect of irrigation. In comparing standard system with wide system, although there was no significant difference, ${\phi}4.3mm$ pilot and ${\phi}4.3mm$ twist drill of wide system showed high value and wide system showed slightly high elevation of temperature in all depth in fixture installation. In the finite element analysis, the calculated value by the Fourier's cooling law were applied to the bone drilling surface. And through analysis using different irrigation temperatures at $28^{\circ}C,\;15^{\circ}C\;and\;5^{\circ}C$, and according to the time. The result was that the cooling water at least below $15^{\circ}C$ was required to maintain the temperature of surrounding bone less than threshold in bone drilling, the cooling water below $5^{\circ}C$ was required to gain more sufficient cooling effect, and cooling over 5 seconds was needed after bone drilling for sufficient effect.

上顆洞 擧上術式後 즉시 埋植한 齒根形 埋植體의 周圍組織 反應에 關한 研究

문은수(Eun-Soo Moon),김종여(Jong-Yuh Kim),조인호(In-Ho Cho) 대한치과이식임플란트학회 1991 The Korean Academy of Implant Dentistry Vol.11 No.1

The purpose of this study was to evaluate the tissue reaction around the implnts installed by maxillary sinus lifting technique. The edentulous area was provided by extracting left maxillary molars of mature female dog. After healing, the cylindrical screw and basket type titanium implants were installed by sinus lift technique and the sinus was filled with non-resorbable HA. The specimens were obtained after 6 months’ osseointegration period and radiological and histological studies were performed on the peri-implant tissues. The results were as follow ; 1. The two types of titanium implants which were installed into maxillary sinus were maintained healthy condition without mobility and inflammation. 2. The surrounding area of the implant and HA granules showed osseointegrated bone when observed by radiological and histological study. 3. In the view point of histology, mild infiltlation of inflammatiory cells was found beneath of soft tissue epithelium at the recipient site of the implant, and the prepared edentulous bony site was covered with bone tissue. The part of HA filled interface was covered with bone tissue and connective tissure partially 4. In the area filled with HA, HA granules which were close to sinus wall were mostly surrounded by bone, and those which were far from sinus wall were surrounded by connective tissue. 5. The membrane of maxillary sinus maintained healthy condition without any evidence of inflammation.

족근 관절 연부조직 충돌 증후군에서 MRI의 진단적 의의 및 관절경적 치료 결과

이진우,문은수,김성재,한수봉,강응식,Lee, Jin-Woo,Moon, Eun-Su,Kim, Sung-Jae,Hahn, Soo-Bong,Kang, Eung-Shick 대한족부족관절학회 2003 대한족부족관절학회지 Vol.7 No.2

Introduction: Soft-tissue impingement syndrome is now increasingly recognized as a significant cause of the chronic ankle pain. As a method to detect soft-tissue ankle impingement, a characteristic history and physical examination, routine MR imaging, and direct MR arthrography were used. The efficacy of routine MR imaging has been controversial for usefulness because of low sensitivity and specificity. Direct MR artrhography was recommaned for diagnosis because of the highest sensitivity, specificity and accuracy, but it requires an invasive procedure. The purpose of this study is to investigate the diagnostic accuracy of Fat suppressed, contrast enhanced, three-dimensional fast gradient recalled acquisition in the steady state with rediofrequency spoiling magnetic resonance imaging(CE 3D-FSPGR MRI) and to evaluate the clinical outcome of the arthroscopic treatment in assessing soft-tissue impingement associated with trauma of the ankle. Materials and Methods: We reviewed 38 patients who had arthroscopic evaluations and preoperative magnetic resonance imaging studies(3D-FSPGR MRI) for post-traumatic chronic ankle pain between January 2000 and August 2002. Among them, 24 patients had osteochondral lesion, lateral instability, loose body, malunion of lateral malleoli, and peroneal tendon dislocation. The patient group consisted of 23 men and 15 women with the average age of 34 years(16-81 years). The mean time interval from the initial trauma to the operation was 15.5 months(3 to 40 months), The mean follow-up duration of the assessment was 15.6months(12-48 months). MRI was simultaneously reviewed by two radiologists blinded to the clinical diagnosis. The sensitivity, specificity and accuracy of MRI was obtained from radiologic and arthroscopic finding. Arthroscopic debridement and additional operation for associated disease were performed. We used a standard protocol to evaluate patients before the operation and at follow-up which includes American Orthopedic Foot and Ankle Society Ankle-Hindfoot Score. Results: For the assessment of the synovitis and soft tissue impingement, fat suppressed CE 3D-FSPGR MR imaging had the sensitivity of 91.9%, the specificity of 84.4 and the accuracy of 87.5%. AOFAS Ankle-Hindfoot Score of preoperative state was 69.2, and the mean score of the last follow-up was 89.1. These were assessed as having 50% excellent(90-100) and 50% good(75-89). The presence of other associated disease didn't show the statistically significant difference(>0.05). Conclusion: Fat suppressed CE 3D-FSPGR MR imaging is useful method comparable to MR arthrography for diagnosis of synovitis or soft-tissue impingement, and arthroscopic debridement results in good clinical outcome.

치과 임플란트 환자의 통계 분석에 관한 후향적 연구

조춘일,조인호,문은수,Zhao, Chun-Ri,Cho, In-Ho,Moon, Eun-Soo 대한치과보철학회 2009 대한치과보철학회지 Vol.47 No.3

연구목적: 전 세계적인 고령화 추세에 따라 무치악 환자들이 증가하고 이들의 임플란트 보철 수복에 대한 수요와 관심이 증가하고 있다. 부분 무치악 또는 완전 무치악에서 임플란트를 이용한 보철 치료는 효과적이며 그 성공율 또한 높게 보고되고 있다. 하지만 임플란트 사용 범위가 다양해짐에 따라 여러 가지 실패가 보고되고 이러한 실패를 줄이기 위한 방법들이 연구, 개발되고 있다. 이에 본 연구에서는 임플란트 생존율을 조사하고, 이를 토대로 향후 임플란트의 생존율에 대해 예측하고자 한다. 연구 방법: 1998년 8월부터 2003년 8월까지, 2003년 9월부터 2007년 4월까지 두 차례로 나누어 진료기록부 조사를 통해 최근 10년 동안 단국대학교 치과병원에서 임플란트를 치료받은 환자들의 임플란트 생존율에 대해 조사하였다. 결과: 진료기록부 조사를 통해 식립된 임플란트의 수, 임플란트 위치 및 분포, 1차 수술 후부터 2차 수술까지의 기간, 생존율 등을 조사하여 다음과 같은 결과를 얻었다. 1. 1차 조사에서 612명 환자에게 1680개의 임플란트가 식립되고, 2차 조사에서는 933명 환자에게 2438개가 식립되어 총 1545명의 환자에게 4118개 임플란트가 식립되었다. 2. 총 1545명 환자의 성비는 남성이 57.2% (884명), 여성이 42.8% (661명)였고, 총 4118개 임플란트에서 상악에 1739개 (42.2%), 하악에 2379개 (57.8%)가 식립되었으며 하악 구치부에 2043개 (53.2%)가 식립되어 제일 높은 비율을 차지하였다. 3. 1차 조사에서는 총 1680개의 임플란트 중 57개가 실패하였고 2차 조사에서는 2438개의 임플란트 중 17개가 실패하여 총 4118개의 임플란트 중 74개가 실패 하여 98.2%의 생존율을 보였다. 4. 1차 수술 이후 2차 수술이 시행되기까지의 기간은 상악에서 평균 7.4개월에서 6.8개월로, 하악에서 평균 5.6개월에서 5.0개월로 2차 조사 기간에서 0.6개월 단축되었다. 결론: 이상의 결과로 볼 때 1차 조사에서보다 2차 조사시에 식립된 임플란트의 수 및 생존율이 증가하였고 1차수술 후부터 2차 수술 전까지 기간도 단축되고 있음을 알 수 있었다. 앞으로도 임플란트에 대한 관심과 수요가 계속 증가 할 것이고 그 성공율 또한 증가하리라 사료된다. Statement of problem: The number of edentulous patients is increasing due to an aging society, which leads to increased demands and interests on implant restorations. Implant restorations are an effective treatment method for both complete and partially edentulous patients, and the success rate has been reported to be high. But because of the increased use of implants in various situations have resulted in frequent reports of failures on implant restorations. Various efforts to overcome these failures have been made. Purpose: The aim of this study was to investigate the statistic survival rate of dental implants on patients who were treated at Dankook University Dental Hospital during the past 10 years based on their charts. Materials and methods :The research was made for two different periods of time; The first investigation was for patients from August, 1998 to August, 2003 and the second was for patients from September, 2003 to April, 2007. Information on the number of implants placed, the location and distribution of implants, the duration between the first and second surgery, and the survival rate of implants were investigated from the patients'charts. Results: 1. According to the first investigation, 1680 implants were placed on 612 patients and the second investigation showed 2438 implants placed on 933 patients. Thus a total of 4118 implants on 1545 patients. 2. Among the 1545 patients, 884 patients were male (57.2 %) and 661 patients were female (42.8%). Out of 4118 implants, 1739 implants (42.2%) were placed on the maxilla, and 2379 implants (57.8%) on the mandible. Implants were placed most frequently in the posterior region of the mandible. A total of 2043 implants (53.2%) were placed in this region. 3. According to the first investigation, 57 out of 1680, implants failed, while from the second investigation, 17 out of 2438 implants were reported as failure. In total, 74 implants failed, which results in a 98.2% survival rate. 4. The average duration between the first and the second surgeries in maxillas decreased from 7.4 months to 6.8 months. The duration also decreased from 5.6 months to 5.0 months in mandibles. Conclusion: As shown in the results, the number of placed implants and the survival rate of implants were higher in the second investigation than that of the first investigation. And the time spent after the first surgery to the second surgery was less in the second investigation. Consequently, it can be presumed that the demand and consumption of dental implants as well as the survival rate will increase in the future.

알츠하이머병에서 초조/공격성과 신경해부학적 영역의 연관성

정민수(Min Soo Jung),이영민(Young Min Lee),박제민(Je Min Park),이병대(Byung Dae Lee),문은수(Eun Soo Moon),정희정(Hee Jeong Jeong) 대한노인정신의학회 2014 노인정신의학 Vol.18 No.1

알츠하이머병에서 초조/공격성과 신경해부학적 영역의 연관성

정민수(Min Soo Jung),이영민(Young Min Lee),박제민(Je Min Park),이병대(Byung Dae Lee),문은수(Eun Soo Moon),정희정(Hee Jeong Jeong) 대한노인정신의학회 2013 노인정신의학 Vol.17 No.2

Objectives:The aim of this study is to identify the association between agitation/aggression and atrophy in specific brain areas in Alzheimer’s disease (AD). Methods:Fifty six patients with mild or moderate AD participated in this study. Cognitive function was measured using the Korean version of the Mini-Mental State Examination (K-MMSE), and Clinical Dementia Rating (CDR). Agitation/aggression symptoms were measured using the Korean version of the Neuropsychiatric Inventory (K-NPI). Atrophies of brain were analyzed using Voxel Based Morphometry (VBM). Results:Higher scores of agitation/aggression were correlated with the atrophy of left middle temporal, left fusiform, right middle temporal, left inferior temporal, right inferior temporal, left superior temporal, left middle occipital, right orbitofrontal, right superior frontal, left angular and right middle frontal gyrus (p<0.001, uncorrected for multiple comparisons, extent threshold=200 voxel). Conclusion:Agitation/aggression was correlated with specific neuroanatomical changes in mild or moderate AD.

주관절 탈구를 동반한 요골두 골절의 수술적 치료 후 예후 인자 분석

강호정(Ho-Jung Kang),문은수(Eun-Su Moon),박진오(Jin-Oh Park),한수봉(Soo-Bong Hahn),윤상필(Sang-Pil Yoon),최종혁(Chong-Hyuk Choi) 대한정형외과학회 2007 대한정형외과학회지 Vol.42 No.5

목적: 요골두 골절은 성인의 주관절 골절 중에 가장 흔하며, 종종 주관절 탈구와 동반하여 다양한 합병증이 병발된다. 본 연구에서는 이에 대한 수술적 치료 후의 결과를 파악하고 그 예후 인자에 대해 평가하고자 한다. 대상 및 방법: 1997년 1월부터 2004년 2월까지 본원에 내원한 주관절 탈구 혹은 골절을 동반한 요골두 골절환자 중 12개월 이상 추시 관찰한 25명을 대상으로 후향적 분석을 시행하였다. 결과 분석은 다양한 예후인자들 및 Mayo Elbow Performance Index에 의한 주관절의 기능 및 동통 기준에 따라 평가하였다. 결과: Mayo Elbow Performance Index상 최우수 11예, 우수 5예, 보통 5예, 불량 4예의 결과를 보였다. 수술 후 주관절 불안정성을 보인 경우 의미 있게 불량한 결과를 보였으며 동반 골절이 없는 경우, 개방성 골절을 동반하지 않은 경우, Mason 분류 III형보다 II형인 경우, 고정기간이 5주 이상에 비해 4주 이하의 경우에서 의미 있는 좋은 결과를 나타내었다. 인자들 간의 상관관계 분석에서는 나이가 어릴수록, 고정기간이 짧을수록 좋은 결과를 나타내었으며 고정기간이 Mayo Elbow Performance Index 값과 가장 의미 있는 상관관계를 나타내었다. 결론: 주관절 탈구를 동반한 요골두 골절 환자에 있어서 젊은 연령에서 초기 수상 시 수상 정도가 적은 군 및 고정기간이 짧을수록 수술적 치료 후 결과가 좋았다. Purpose: Radial head fractures are the most common elbow fractures in adults, and are often accompanied with elbow dislocation resulting in various complications. This study examined the outcome of surgical treatment of a radial head fracture and its prognostic factors. Materials and Methods: From January 1997 to February 2004, a retrospective analysis was performed on 25 radial head fracture patients with an elbow dislocation, also including elbow fracture, whose follow-up data could be obtained for more than 12 months. The surgical results were evaluated according to the prognostic factors and the Mayo Elbow Performance Index, which assessed the elbow joint function and pain. Results: According to the Mayo Elbow Performance Index, the results were excellent in 11 cases, good in 5 cases, fair in 5 cases, and poor in 4 cases. Cases with post-surgical elbow joint instability showed statistically meaningful poor outcomes. However, there were good in the groups without an accompanied fracture, with no open fracture, type Ⅱ and Ⅲ Mason classification, and fixation period 4 weeks or less. Correlation analysis revealed a younger age and shorter immobilization period to have better results, and the immobilization period showed the strongest correlations with the Mayo Elbow Performance index. Conclusion: In conclusion, younger age, less severe injury in the initial event and a shorter immobilization period are good prognostic factors in radial head fractures combined elbow dislocations.

단순 소파술로 치료한 지골의 내연골종

신규호(Kyoo-Ho Shin),문은수(Eun-Su Moon),한수봉(Soo-Bong Hahn),강응식(Eung-Shick Kang) 대한정형외과학회 2004 대한정형외과학회지 Vol.39 No.1

목적: 수지 및 족지에 발생한 내연골종에서 단순 소파술만으로 치료한 결과를 후향적으로 분석하고자 하였다. 대상 및 방법: 1997년 7월부터 2002년 2월까지 수부 및 족부의 내연골종(다발성 내연골종증 9명,Maffucci 증후군 2명 포함)에 대한 치료로서 단순 소파술만을 이용하였고 최소 1년 이상 추시 관찰이 가능하였던 30명(남자 11명, 여자 19명)의 환자의 59예를 대상으로 하였으며, 방사선학적으로 치유정도를 평가하였다. 평균 추시 기간은 28.6개월(12-65개월)이었고, 결과는 소파술 후 신생골 형성 정도에 따라 분류하는 Tordai 등이 제안한 방법을 이용하여 분석하였다. 결과: 제1 군에 해당하는 피질골이 정상이고 골결손이 3mm 미만인 완전 치유의 소견은79.7%에서 보였으며, 수술 후 전체 평균 골경화 기간은 12.4개월이었고 고립성 내연골종만의 완전치유는 89.5%, 평균 골경화 기간은 8.1개월이었다. 재발을 포함한 합병증은 모든 예에서 관찰되지 않았다. 결론: 수지 및 족지의 내연골종에 대한 치료에서 자가골 이식의 단점인 통증, 감염, 고정의 필요성 등을 고려할 때 단순 소파술만으로도 좋은 결과를 얻을 수 있을 것으로 사료된다. Purpose: Retrospectively, to evaluate the result of treatment by curettage only, enchondroma of the digits. Materials and Methods: Fifty-nine cases in 30 patients (male 11, female 19), from July 1997 to Febuary 2002, were reviewed with a minimum follow up of 1 year. Thirty patients were treated for enchondroma of the digits (including Oilier's disease 9, and Maffucci syndrome 2) by curettage only, and the degree of healing was evaluated radiologically. The average duration of follow up was 28.6 months (12-65 months). Results: The radiologic results were evaluated according to the degree of new bone formation by the criteria suggested by Tordai. Group I achieved 79.7% overall and 89.5% for solitary enchondroma, meaning complete healing with normal cortical thickness and a bone defect of less than 3 mm. The average duration of consolidation was 12.4 months, and 8.1months for solitary enchondorma. No recurrence or other complication occured. Conclusion: Curettage alone is a good treatment option for enchondroma of the digits as comparing with autogenous bone graft, which has the disadvantages of pain, infection, and immobilization.

알츠하이머병 환자에서 해마 위축과 정신병적 증상

정희정(Hee Jeong Jeong)이영민(Young Min Lee),박제민(Je Min Park),이병대(Byung Dae Lee),문은수(Eun Soo Moon),김수연(Soo Yeon Kim),이강윤(Kang Yoon Lee),김지훈(Ji-Hoon Kim),정영인(Young-In Chung) 대한신경정신의학회 2018 신경정신의학 Vol.57 No.3

Objectives This study examined the difference in the volume or thickness of the medial temporal lobe between Alzheimer’s disease patients with psychosis (AD+P) and those without psychosis (AD-P). Methods Overall, 31 AD+P patients and 29 AD-P patients were included from the Memory impairment clinics of Pusan National University Hospital in Korea. AD+P was diagnosed according to Jeste and Finkel’s proposed diagnostic criteria for psychosis of Alzheimer’s disease. AD-P included AD patients with no psychotic symptoms during a 5-year follow-up period. Medial temporal volume or thickness was measured by 3-tesla MRI and freesufer analysis. Analysis of variance was used to examine the difference in the volume or thickness of medial temporal lobe between AP+P and AD-P after controlling for age, gender, education years, Clinical Dementia Rating scale-Sum of Box, and total intracranial volume. Results The hippocampal volume in AD+P was smaller than that in AD-P. Conclusion These findings suggest that AD+P is associated with a reduced hippocampal volume.

알츠하이머병 환자에서 정신병과 측두엽 위축과의 연관성

손제현(Je Hyun Sohn),이영민(Young Min Lee),박제민(Je Min Park),이병대(Byung Dae Lee),문은수(Eun Soo Moon),정희정(Hee Jeong Jeong),김수연(Soo Yeon Kim),이강윤(Kang Yoon Lee),김지훈(Ji-Hoon Kim),정영인(Young-In Chung) 대한노인정신의학회 2017 노인정신의학 Vol.21 No.2

Objective:The purpose of this study is to investigate the difference on regional volume in temporal lobe between Alzheimer’s disease patients with psychosis (AD+P) and Alzheimer’s disease patients without psychosis (AD-P). Methods:Altogether, 24 AD+P and 25 AD-P matched age, gender, and clinical dementia rating sum of box (CDR-SOB) were include from a Memory impairment clinics of Pusan National University Hospital in Korea. AD+P were diagnosed according to Jeste and Finkel’s proposed diagnostic criteria for psychosis of Alzheimer’s disease. Grey matter volume of temporal lobe was measured with 3-tesla magnetic resonance imaging and freesufer analysis. Analysis of variance was used to investigate the association between temporal lobe and AD+P after controlling age, gender, education years, CDR-SOB and total intracranial volume. Results:We found an association between AD+P and reduced grey matter volume in total temporal lobe as well as in specific temporal regions such as left middle temporal lobe, left inferior temporal lobe, both hippocampus and both fusiform. Conclusion:Our findings suggest that AD+P are associated with reduced grey matter volume of temporal lobe.