경사형 내부연결 임플란트 시스템 (SS $III^{(R)}$)에서 지대주 형태에 따른 응력분포의 3차원 유한요소 분석

이혜승,김명래,박지만,김선종,Lee, Hye-Sung,Kim, Myung-Rae,Park, Ji-Man,Kim, Sun-Jong 대한치과보철학회 2010 대한치과보철학회지 Vol.48 No.3

연구 목적: 내부연결형 임플란트 고정체에 연결 방식이 다른 4종류의 지대주를 연결하여 교합력을 가하였을 때 각 구조에 발생하는 응력의 차이를 비교하고, 이들 연결방식이 임플란트 주위조직의 응력분포에 미치는 영향을 3차원 유한요소법을 통하여 알아보고, 지대주의 선택 기준을 마련하고자 하였다. 연구 재료 및 방법: 고정체로는 직경 4 mm, 길이 11.5 mm의 SS-$III^{(R)}$ (Osstem, Korea)를 사용하였으며, 사용된 지대주는 각각, 모델 1에서 Solid abutment, 모델 2에서 Com-Octa abutment, 모델 3에서 ComOcta Gold abutment, 모델 4에서 Octa abutment를 사용하였고, 네 가지 하중조건으로 치관중심와 (central fossa)에 fixture 장축에 평행하게 점하중으로100N의 수직하중, 협측교두에 대하여 fixture 장축에 평행하게 점하중으로 100N 수직하중, 치관중심와에서 설측으로 100N의 $30^{\circ}$ 경사하중, 협측교두 (buccal cusp)에 치아의 바깥쪽에서 내측으로 100N의 $30^{\circ}$ 경사하중을 주었고 3G.Author (Plasso Tech, USA)를 이용하여 분석하였다. 결과: 1. 골조직에서는 모든 모델에서 하중조건에 관계없이 가장 큰 응력이 고정체 상부에 집중되었고, 고정체 하부에서는 근단 부위에서 응력 집중을 보였으며, 그 외의 부위에서는 큰 응력 집중은 보이지 않았다. 2. 고정체에서의 응력은 모든 모델에서 하중조건에 관계없이 neck 부위에서 최대의 양상을 보였다. 3. 응력은 골에서보다 임플란트 내부에서 훨씬 높았다. 4. 중심와에 수직하중인 하중조건 1에서 가장 낮은 응력이 관찰되었으며, 이 때의 응력집중 현상도 가장 적게 나타났다. 서로 다른 지대주에서 응력분포 양상을 살펴본 결과, 같은 고정체를 사용한 경우에 지대주의 연결 형태에 따른 골조직에서의 응력 분포의 차이는 없었다. Purpose: The purpose of this study was to compare the stress distribution characteristics of four different abutment connections on SS-$III^{(R)}$ fixture under occlusal loading, using 3-dimensional finite element method. Materials and methods: The fixture of SS-$III^{(R)}$ (Osstem, Korea) with 4 mm diameter and 11.5 mm length and 4 types of abutments were analyzed; Solid, Com-Octa, ComOcta Gold, and Octa abutment. The models were placed in the area of first molar in the mandible. The 4 loading conditions were; (1) the vertical loading of 100 N on the central fossa, (2) the vertical loading of 100 N on the buccal cusp, (3) the $30^{\circ}$ inclined loading of 100 N to lingual side on the central fossa, and (4) the $30^{\circ}$ inclined loading of 100 N to the lingual side on the buccal cusp. The 3G.Author program was used, the von-Mises stress was calculated and the stress contours were plotted on each part of the implant systems and the surrounding bone structures. Results: Regardless of abutment types and loading conditions, higher stress concentration was observed at the cortical bone. In cancellous bone, the highest stress was observed at apical portion and the maximum stress occurred at the implant neck. The higher internal stress was observed in the fixtures than in the bone. The lowest stress was observed at loading condition 1 and the stress concentration was also lower than any other loading conditions. Conclusion: Within the limitation of the result of this study, it seems that the abutment connection type does not affect much on the stress distribution of bone structure.

신생아 담관 낭종의 수술 필요성에 대한 고찰

김현영,이혜승,이성철,정성은,박귀원,김우기,Kim, Hyun-Young,Lee, Hye-Seung,Lee, Seong-Cheol,Jung, Sung-Eun,Park, Kwi-Won,Kim, Woo-Ki 대한소아외과학회 2005 소아외과 Vol.11 No.1

Choledochal cysts have been associated with complications such as cholangitis, pancreatitis, and malignancy of the biliary tract. Recently, the incidence of choledochal cyst in neonate and young infant is increasing due to advances in diagnostic imaging. The aim of this study is to investigate the rationale of excision of choledochal cyst during the neonatal period. The clinical outcome and correlation between age at surgery and the degree of liver fibrosis were reviewed retrospectively. A total of 198 patients with choledochal cyst who were managed surgically between January 1985 and December 2000 at the Department of Surgery, Seoul National University Children's Hospital were included in this study. The overall outcome and the outcome of patients who were managed surgically during the neonatal period were compared. Correlation between age and the degree of liver fibrosis was evaluated by chi-square test and Pearson exact test. The mean age of the patients was 2 years 7 months (ranged from 5 days to 15 years). Mean postoperative follow-up period was 7 years 1 month (7 months to 20 years). The results are as follows. Twelve patients (6%) had postoperative complications, cholangitis (7), bleeding (4) and ileus (1). Eleven patients operated during the neonatal period had no postoperative complications. The positive correlation between age group and degree of liver fibrosis was statistically significant (chi-square: p=0.0165, Pearson exact test: p=0.019). The results support the rationale that excision of choledochal cyst can be performed safely without increasing morbidity in neonates.

식도 조직 검사상 우연히 발견된 호산구 식도염의 임상적 의의

정연무 ( Youn Mu Jung ),이혜승 ( Hye Seung Lee ),이동호 ( Dong Ho Lee ),정유정 ( You Jeong Jeong ),최태혁 ( Tae Hyuck Choi ),이상협 ( Sang Hyub Lee ),박영수 ( Young Soo Park ),황진혁 ( Jin Hyok Hwang ),김진욱 ( Jin Wook Kim ),정 대한소화기학회 2010 대한소화기학회지 Vol.55 No.3

목적: 호산구 식도염은 식도에 호산구가 심하게 침윤하여 삼킴 곤란이나 음식 막힘 등의 증상을 일으키는 만성적인 질환이다. 이에 저자들은 우리나라 식도 조직 검사상 호산구 식도염의 발견율과 임상 특징을 알아 보고자 하였다. 대상 및 방법: 분당서울대병원에서 2006년 1월부터 2008년 8월까지 식도 생검을 받은 환자들의 조직소견을 후향 분석하여 고배율에서 20개 이상의 호산구가 관찰될 때 호산구 식도염이라 정하였고 각 환자들의 임상 특징과 내시경 소견을 조사하였다. 결과: 2년 8개월간 내시경 식도 점막 이상으로 식도 생검을 받은 환자 1,609명 중 7명(0.4%)에서 고배율당 20개 이상의 호산구 침윤이 관찰되었으며 이들은 심와부 동통, 역류증세 및 소화장애 등의 비특이적인 소화기 증상과 백색 삼출과 백색 결절, 식도 용종 및 식도 비후증 등의 내시경 소견을 보였다. 결론: 생검을 시행한 환자들의 후향적인 식도 조직 재검토 결과 0.4%에서 호산구 식도염이 발견되었고, 임상 양상과 내시경 소견은 비특이적이었다. 전 세계적으로 호산구 식도염의 유병률이 빠르게 증가하는 것을 볼 때 만성적인 삼킴 곤란 증상이 있거나 특히 산 억제제 치료에 반응하지 않는 역류성 식도염 환자에서 호산구 식도염의 가능성을 고려하여 세심한 진단 접근 및 식도 생검이 요구되며 이에 대한 향후 대규모 전향 연구가 필요할 것으로 생각한다. Background/Aims: Eosinophilic esophagitis (EE) is a chronic inflammatory disorder characterized by abnormal dense eosinophilic infiltration of esophageal mucosa and results in dysphasia and food impaction. EE is being increasingly recognized in adults. The prevalence is largely unknown. This study was performed to evaluate the detection rate of EE diagnosed based on pathologic criteria and to define the clinical characteristics of EE in Korea. Methods: We reviewed biopsy specimen of the 1,609 patients who underwent esophageal biopsy from January 2006 till August 2008. The presence of more than 20 eosinophils per high power field in biopsy specimens was considered cases of EE. Clinical information and endoscopic findings were obtained. Results: 7 (0.4%) patients were diagnosed as EE based on pathologic criteria retrospectively. Clinical symptoms were epigastric pain (43%), regurgitation (29%), dyspepsia (14%), and no symptom (14%). Endoscopic findings were whitish exudates or granules (57%), esophageal polyp (29%), and hyperemic change (14%). Two patients received treatment. One patient with bronchial asthma improved after treatment with inhaled corticosteroid, and one patient improved after 8 week proton pump inhibitor therapy. Conclusions: Eosinophilic esophagitis was found in 0.4% of the total esophageal biopsied cases. Our results suggest that Korean patients with eosinophilic esophagitis showed symptoms mimicking gastroesophageal reflux disease and atypical endoscopic findings. Therefore, regardless of the gross appearance of the mucosa, meticulous diagnostic approaches are needed for patients with swallowing difficulty and lack of response to proton pump inhibitor. (Korean J Gastroenterol 2010;55:162-168)

소아에서 결절성 위염으로 발현한 위 점막연관림프조직 림프종 1예

이건송,양혜란,고재성,서정기,이혜승,Lee, Kun-Song,Yang, Hye-Ran,Ko, Jae-Sung,Seo, Jeong-Kee,Lee, Hye-Seung 대한소아소화기영양학회 2008 Pediatric gastroenterology, hepatology & nutrition Vol.11 No.2

만성 복통을 주소로 내원한 12세 여아에서 내시경 소견상 결절성 위염과 조직 검사상 H. pylori 감염을 확인 하였으며, 병리 소견 및 면역조직화학 검사상 위 MALT 림프종으로 진단되어, H. pylori 제균 치료 후 결절성 위염의 호전과 위 MALT 림프종의 완전한 관해를 경험하였기에 문헌 고찰과 함께 보고하는 바이다. Most cases of mucosa-associated lymphoid tissue (MALT) lymphoma occur in adults. MALT lymphoma is very rare in children. Helicobacter pylori (H. pylori) infection is known to be an important etiologic factor predisposing to the development of gastric MALT lymphoma. A 12-year-old girl was admitted because of intermittent abdominal pain occurring over the preceding 2 years. Nodular gastritis of the stomach was demonstrated on endoscopy. H. pylori infection was confirmed using the rapid urease test and histopathology. Histopathological examination of gastric biopsy specimens revealed lymphoepithelial lesions pathognomonic of MALT lymphoma, and immunohistochemical staining for CD20 was diffusely positive. Therefore, the patient was diagnosed with gastric MALT lymphoma. Clinical manifestations and histopathologic findings compatible with MALT lymphoma improved with the eradication of H. pylori infection. We report a case of primary gastric MALT lymphoma in a child, associated with H. pylori infection and presenting as nodular gastritis.

하부식도에 발생한 악성 위장관 간질종양 - 1례 보고 -

류경민,조석기,성숙환,이혜승,전상훈,Ryu, Kyoung-Min,Cho, Suk-Ki,Sung, Sook-Whan,Lee, Hye-Seung,Jheon, Sang-Hoon 대한기관식도과학회 2005 大韓氣管食道科學會誌 Vol.11 No.2

폐의 경흉 세침흡인 세포검사

김민석,박인애,박선후,박성신,김활웅,문경철,김영아,이혜승,박기화,서정욱,이현순,함의근,Kim, Min-Suk,Park, In-Ae,Park, Sun-Hoo,Park, Sung-Shin,Kim, Hwal-Wong,Moon, Kyung-Chul,Kim, Young-Ah,Lee, Hye-Seung,Park, Ki-Wha,Seo, Jeoug-Wook,Lee, Hy 대한세포병리학회 1999 대한세포병리학회지 Vol.10 No.1

The authors analysed 2,653 cases of transthoracic fine needle aspiration cytology of the lung to evaluate the diagnostic accuracy and its limitation. A comparison was made between the original cytologic and the final histologic diagnoses on 1,149 cases from 1,074 patients. A diagnosis of malignancy was established in 38.3% benign in 48.1%, atypical lesion in 2.3%, and inadequate one in 11.9% of the cases. Statistical data on cytologic diagnoses were as follows; specificity 98.9%: sensitivity of procedure, 76.8%: sensitivity of diagnosis, 95.5%: false positive 5 cases: false negative 18 cases: predictive value for malignancy, 98.8%: predictive value for benign lesion, 79.5%: overall diagnostic efficiency, 87.5%: typing accuracy in malignant tumor, 80%.

안검부종을 주소로 내원한 Melkersson-Rosenthal Syndrome

김태완 ( Tae Wan Kim ),권재우 ( Jae Woo Kwon ),양민석 ( Min Suk Yang ),이소희 ( So Hee Lee ),이상민 ( Sang Min Lee ),김세훈 ( Se Hoon Kim ),권혁수 ( Hyouk Soo Kwon ),이혜승 ( Hye Sung Lee ),박창한 ( Chang Han Park ),박흥우 ( Heung 대한천식알레르기학회 2007 천식 및 알레르기 Vol.27 No.4

Melkersson-Rosenthal syndrome, Orofacial edema Melkersson-Rosenthal syndrome (MRS) is a rare non-caseating granulomatous disease of unknown cause that is characterized by a triad of facial edema, facial palsy and furrowed tongue. Although most reported cases of MRS involve swelling of the perioral area, it rarely involves the periocular area. We report a case of MRS involving the periocular area for the first time in Korea. A 60-year-old man presented with recurrent orofacial swelling and facial palsy. Left facial palsy was developed one year ago. Recurrent swelling around the right orbital area and eyelid developed 6 months ago. Physical examination revealed a diffuse and firm edema of the face including the eyelids, periorbital region, and cheeks without erythema, tenderness or pitting. Upon neurologic examination, the left-sided facial palsy of peripheral nerve type was noted without abnormalities in taste sense or lacrimation. Biopsy performed from edematous cutaneous lesion revealed marked dermal edema with perivascular lymphocytic infiltration, telangiectasis and a few granulomatoid histiocytic collection, which was consistent with MRS. The patient was treated with oral antihistamines and corticosteroids without clinical improvement. Physicians should consider the possibility of MRS in the presence of any chronic facial swelling and recurrent peripheral facial palsy. (Korean J Asthma Allergy Clin Immunol 2007;27:268-272)

韓國人에서 HumFIBRA/FGA와 D21S11 遺傳座의 對立遺傳子 頻度와 遺傳的 變異의 分析

김윤신,황적준,이혜린,구태완,한길로,김성민,이혜승 大韓法醫學會 1998 대한법의학회지 Vol.22 No.1

Allele-and genotype frequencies of the two short tandem repeat (STR) loci, HumFGA and D21S11, were determined in Korean population(n=196). DNA typing was accomplished by applying fluorescence-labeled PCR products and a differently labeled sequenced allelic ladders, followed by automated analysis using ABI 377 automatic sequencer and GeneScan 2.02 software. Prior to typing, allelic ladder of each locus was constructed with a combination of all alleles occuring from the population sample. A total of 15 alleles and 48 genotypes with the heterozygosity of 0.854 for HumFGA, and 12 alleles and 33 genotypes with the heterozygosity of 0.787 for D21S11 are observed in a population of 196 genetically unrelated individuals. No deviations from Hardy-Weinberg equilibrium were observed(p=0.753 for HumFGA, p=0.262 for D21S11). The data presented here (power of discrimination and average power of exclusion) show that both STR Loci, HumFGA and D21S11, are very informative for individualization from criminal evidences, and are also useful for parentage testing.

뇌교 경색에서 T2 시상단층 영상과 기저동맥 신호소실의 임상적 의의

이혜승,이병철,황성희,백기훈,김대훈,김형철,송홍기 대한신경과학회 1999 대한신경과학회지 Vol.17 No.2

일과성 전기억상실과 중뇌주위 지주막하출혈을 보인 베체트씨 병 1예

안재영,이혜승,오경미,정진상 대한신경과학회 2001 대한신경과학회지 Vol.19 No.4