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교정용 브라켓의 종류와 각도, 호선의 코팅 여부에 따른 마찰력의 비교
장태호(Tae-Ho Jang),김상철(Sang-Cheol Kim),조진형(Jin-Hyoung Cho),채종문(Jong-Moon Chae),장나영(Na-Young Chang),강경화(Kyung Hwa Kang) 대한치과교정학회 2011 대한치과교정학회지 Vol.41 No.6
본 연구의 목적은 코팅된 호선, 다양한 브라켓, 그리고 브라켓-호선 각도가 교정용 호선이 브라켓을 활주 이동하는 동안 발생되는 마찰력에 어떠한 영향을 미치는지에 대하여 평가해보는 것이었다. 고정식 장치를 이용한 교정치료 시 발생할 수 있는 상황을 시뮬레이션하기 위하여 4종류의 브라켓(금속 브라켓인 Micro-arch, 단결정 세라믹 브라켓인 Perpect Clear2, active type의 자가결찰 브라켓인 Clippy-C, passive type의 자가결찰 브라켓인 Damon3)과 5종류의 교정용 호선(0.014", 0.016", 0.016" × 0.022" inch coated Ni-Ti 호선, 0.016", 0.016" × 0.022" inch Ni-Ti 호선)이 사용되었고 브라켓-호선 각도는 각각 0˚, 3˚, 6˚, 9˚로 조절되었다. 모든 실험군에서 자가결찰 브라켓군, Micro-arch군, Perpect Clear2이 순으로 정지, 운동 마찰력이 유의하게 높았다 (p < 0.001). 0˚와 3˚의 브라켓-호선 각도에서 같은 크기의 Ni-Ti 호선은 코팅 여부에 따른 정지, 운동 마찰력의 유의한 차이가 없었으나, 3˚에서 자가결찰 브라켓군의 0.016" × 0.022" inch Ni-Ti 호선에서만 코팅된 경우에 마찰력이 유의하게 높았으며 (p < 0.001), 6˚와 9˚의 브라켓-호선 각도에서 원형과 각형 호선은 모두 같은 크기의 코팅된 호선에서 정지, 운동 마찰력이 유의하게 높았다 (p < 0.001). 코팅된 호선은 크기가 커질수록 정지, 운동 마찰력이 유의하게 높아졌다 (p < 0.001). 각형 호선은 원형 호선 보다 정지, 운동 마찰력이 유의하게 높았으나, 9˚의 브라켓-호선 각도에서 0.016" inch coated Ni-Ti 호선만은 0.016" × 0.022" inch Ni-Ti 호선보다 마찰력이 높았다 (p < 0.001). 브라켓-호선 각도가 증가함에 따라 정지, 운동 마찰력도 유의하게 높아졌으나 (p < 0.001), Micro-arch군과 Perpect Clear2군에서 0.016 inch Ni-Ti 호선과 이루는 각도 0˚, 3˚에서는 마찰력의 유의한 차이가 없었다. (대치교정지 2011;41(6):399-410) Objective: The purpose of this study was to evaluate the difference in frictional resistance among metal, ceramic, self-ligation brackets and coated or non-coated Ni-Ti archwires at various bracket-archwire angulations during the sliding movement of an orthodontic archwire, using an orthodontic sliding simulation device. Methods: Four types of bracket (Micro-arch Perpect Clear2 Clippy-C and Damon3 and 5 types of orthodontic archwire (0.014", 0.016", and 0.016" × 0.022" inch coated Ni-Ti, and 0.016" and 0.016" × 0.022" inch Ni-Ti) were used. Further, the bracket-archwire angles were set at 4 different angulations: 0°, 3°, 6°, and 9°. Results: The frictions from all the experimental groups were found to be significantly increased in order of self-ligation brackets, Micro-arch and Perpect Clear2 (p < 0.001). The presence of a coat had no effect on the friction of the same sized archwires at 0° and 3° bracket-archwire angles (p < 0.001). Coated archwires had significantly higher frictions than the same sized non-coated archwires at 6° and 9° bracket-archwire angles (p < 0.001). The frictions increased significantly as the bracket-archwire angles were increased (p < 0.001). Conclusions: The use of self-ligation brackets will be beneficial in clinical situations where a low frictional force is required. Further, in cases where crowding is not severe, the use of coated archwires should not cause problems. However, more additional explanation is required considering the fact that the damage of coated archwire and exposure of the metal portion in case of binding and notching and the effects of saliva were not taken into account. (Korean J Orthod 2011; 41(6):399-410)
전정맥마취 시 기관 내 삽관에 의한 심혈관계 반응을 최소화하기 위한 Remifentanil과 Propofol TCI의 적정 용량
심민성 ( Min Seong Shim ),김주덕 ( Joo Duk Kim ),최형규 ( Hyung Kyu Choi ),유수봉 ( Soo Bong Yoo ),류시정 ( Sie Jeong Ryu ),김경한 ( Kyung Han Kim ),김세환 ( Se Hwan Kim ),장태호 ( Tae Ho Chang ) 대한마취과학회 2008 Korean Journal of Anesthesiology Vol.54 No.4
임상연구 : 마취유도 시 Rocuronium의 정주통 예방을 위한 8.4% Sodium Bicarbonate의 적정용량
최형규 ( Hyung Gyu Choi ),김두식 ( Doo Sik Kim ),장태호 ( Tae Ho Chang ),김세환 ( Se Hwan Kim ),김경한 ( Kyung Han Kim ),류시정 ( Sie Jeong Ryu ) 대한마취과학회 2006 Korean Journal of Anesthesiology Vol.51 No.2
Background: The administration of rocuronium is associated with severe burning pain on injection that lasts for approximately 10- 20 seconds. Injection pain is probably caused by the acidic pH of rocuronium. Mixing rocuronium with 8.4% sodium bicarbonate might neutralize the acidic pH thereby decrease the level of injection pain. This study investigated the appropriate sodium bicarbonate dose for preventing injection pain. Methods: The study examined 250 patients (aged 20 to 60 years) from ASA I and II groups who scheduled for elective surgery. The patients were divided randomly into five groups. The control group (SB0) received rocuronium 50 mg (5 ml) only and the experimental groups received rocuronium 50 mg mixed with 8.4% sodium bicarbonate 1 (SB1), 2.5 (SB2.5), 5 (SB5), 7 (SB7) ml, respectively. The level of pain was evaluated as the withdrawal response as follows: no movement, 0; hand and wrist movement, 1 point; ipsilateral arm movement, 2 points; and general movement 3 points. Results: The incidence of a withdrawal response was 68% in the control group (SB0). On the other hand, the incidence of a withdrawal response was 38%, 28%, 14% and 12% in the SB1, SB2.5, SB5 and SB7 groups, respectively. The withdrawal response was significantly lower in the experimental groups than in the control group (P < 0.01). In the experimental groups, a significant difference was observed between the SB1 and SB5, SB7 groups. However, there was no significant difference observed between the SB2.5, SB5 and SB7 groups. Conclusions: Mixing 5 ml of 8.4% sodium bicarbonate with rocuronium 50 mg (5 ml) is the most effective in preventing the injection pain associated with rocuronium during the induction of anesthesia. (Korean J Anesthesiol 2006; 51: 162~6)
임상연구 : 위아전절제술 후 정맥자가통증조절 시 Butorphanol의 용량별 진통효과
김성택 ( Sung Taek Kim ),김경한 ( Kyung Han Kim ),김세환 ( Se Hwan Kim ),장태호 ( Tae Ho Chang ),류시정 ( Sie Jeong Ryu ),김두식 ( Doo Sik Kim ) 대한마취과학회 2006 Korean Journal of Anesthesiology Vol.51 No.2
Background: Butorphanol, a synthetic partial agonist-antagonist narcotic, produces adequate analgesia for postoperative pain. This study was designed to determine the appropriate dosage of butorphanol when administered with ketorolac by intravenous patient controlled analgesia (IV -PCA) after subtotal gastrectomy. Methods: Ninety ASA physical status I or II patients undergoing subtotal gastrectomy were randomly allocated into one of three groups according to type of drug used (n = 30 for each group). The patients were divided into group B6 (butorphanol 6 mg), group Bl0 (butorphanol 10 mg) and group B14 (butorphanol 14 mg). Drugs for each group were mixed with 300 mg of ketorolac and normal saline (total amount: 100 ml) for infusion. Bolus dose, maintenance dose and lockout interval were 0.5 ml per each press, 1 ml/hr and 15 minutes, respectively. In each group, numerical rating scale (NRS) score, sedation score and incidence of side effect were checked. Results: There were no significant differences in analgesic effects and sedation score among three groups but the NRS score of group B14 is lower than that of group B6 (P < 0.05) 3 hrs after the recovery room. Conclusions: We recommend 6 mg butorphanol, mixed with 300 mg of ketorolac, and normal saline for postoperative pain relief using IV-PCA. (Korean J Anesthesiol 2006; 51: 190~4)
Remifentanil과 Lidocaine이 고혈압 환자에서 기관내삽관 시 심혈관계 반응에 미치는 효과
강효석 ( Hyo Suk Kang ),유수봉 ( Soo Bong Yu ),김두식 ( Doo Sik Kim ),류시정 ( Sie Jeong Ryu ),장태호 ( Tae Ho Chang ),김세환 ( Se Hwan Kim ),김경한 ( Kyung Han Kim ) 대한마취과학회 2009 Korean Journal of Anesthesiology Vol.57 No.1
Background: Hypertensive patients are more prone to exhibit an exaggerated hemodynamic responses to laryngoscopy and tracheal intubation. We compared the effects of remifentanil and lidocaine on the cardiovascular responses during intubation in hypertensive patients. Methods: Fifty adult hypertensive patients (>140/90 mmHg) were divided into 2 groups (remifentanil group; 1.0 μg/kg, n=25, lidocaine group; 1.5 mg/kg, n=25). After 3 minutes`oxygenation, anesthesia was induced using 0.2 mg glycopyrrolate, 1.5 mg/kg propofol, and 1 of experimental drugs (30 seconds) bolus administration. Tracheal intubation was facilitated 90 seconds after administration of rocuronium; anesthesia was maintained with 2% sevoflurane and air in oxygen. Arterial blood pressure and heart rate were measured at the following times: resting state (baseline), after oxygenation; before intubation; just after intubation; and at 1, 3, and 5 minutes after intubation. Results: There was significant attenuation of mean systolic and diastolic arterial blood pressures, after intubation of the remifentanil group compared to the lidocaine group at just after intubation and at 1 minute after intubation (P<.05). The difference in heart rate was not significant between both groups. Conclusions: Bolus administration of remifentanil was found to be superior to lidocaine in the attenuation of the blood pressure during intubation in hypertensive patients. (Korean J Anesthesiol 2009; 57: 20~5)
임상연구 : 정맥내 자가조절진통이 근이완제를 사용한 환자에서 근력과 호흡능력의 회복에 미치는 영향
김세환 ( Se Hwan Kim ),한옥식 ( Ok Sik Han ),정희숭 ( Hee Soong Jung ),김두식 ( Doo Sik Kim ),류시정 ( Sie Jeong Ryu ),장태호 ( Tae Ho Chang ),김경한 ( Kyung Han Kim ) 대한마취과학회 2006 Korean Journal of Anesthesiology Vol.51 No.2
Background: Residual muscle paralysis after anesthesia is reduced with the advent of intermediate-acting neuromuscular blocking drugs, yet the incidence is as high as about 10 percent. Opioids in patient-controlled analgesia (PCA) may cause respiratory depression and other problems after anesthesia. The purpose of this study is to evaluate the influence of PCA on the SPO2, TOF ratio, head-lift and tongue protrusion during recovery room stay following intraoperative muscle relaxants. Methods: 120 patients aged from 20 to 65 in ASA class I and II were divided into control or PCA groups. All patients received rocuronium (0.9 mg/kg) or atracurium (0.5 mg/kg) for tracheal intubation, and maintenance of relaxation was done with atracurium 0.2 mg/kg/hr during inhalation anesthesia. Reversal of block was done with pyridostigmine 0.15 mg/kg and glycopyrrolate 0.2 mg. SpO2. TOF ratio, 5 see-head lift, tongue protrusion tests were evaluated in the recovery room. Results: IV-PCA did not influence the incidence of residual block, SPO2, TOF ratio during recovery room stay for 20 minutes, but influenced negatively 5 see-head lift test, tongue protrusion test only immediately after arrival at the recovery room. Conclusions: Since IV-PCA decreased the ability to perform head-lift and tongue protrusion early postoperatively, it is recommended that patients with IV-PCA should be carefully managed against the risk of aspiration or upper respiratory obstruction during their early recovery room stay. (Korean J Anesthesiol 2006; 51: 167~73)