상악 영구 중철지의 외상성 치근파절 : 증례보고 A CASE REPORT

최형준,곽지윤,이종갑,최병재 大韓小兒齒科學會 2003 大韓小兒齒科學會誌 Vol.30 No.3

청소년기에는 두개악안면부위의 외상성 손상이 흔하다. 그러나 상아질, 백아질, 치수를 포함하는 치아파절로 정의되는 치근파절은 비교적 드물다. 치근파절에 대하여 취할 수 있는 적절한 조치는 파절편의 치관부위를 재위치시키고, 2∼3달간 레진강선 고정술을 시행하는 것이다. 치수과사나 치근흡수의 징후가 나타날때까지 근관치료를 보류해야 하는데 대부분의 증례에서 파절편의 치근부위는 그 생활력을 유지하기 때문이다. 본 증례의 10세 4개월된 남아는 상악영구중절치의 치근파절을 주소로 연세대학교 치과병원에 내원하엿으며, 그후 7년동안 동일부위에 2번의 반복적인 외상이 있었으나 파절편 치관부의 재위치, 레진 강선 고정술, 근관치료 시행 후 임상적으로 방사선학적으로 비교적 양호한 치료결과를 얻었기에 보고하는 바이다. Traumatic injuries in the young permanent dentition are common, but root fractures, defined as fractures in volving dentin, cementum and pulp, are relatively uncommon. Appropriate management of root fracture involves repositioning the coronal portion of the tooth fragment and firm immobilization with a splint for 2 to 3 month. Root canal treatment should not be initiated until the sign of necrosis or resorption are apparent because in most cases, the apical fragments maintain their vitality. The following case report describes a patient with root fractures injured three times over the period of 7 years. The results, clinically and radiographically, were acceptable, but term periodic evaluation is required.

Friedrich Durrenmatt의 演劇技法 : "老부인의 訪問"을 중심으로

최병준 西原大學校 1985 西原大學 論文集 Vol.15 No.-

Der Ausgangspunkt der Durrenmattischen Dramaturgie ist die Frage:Wie laβt sich unsere heutige Welt noch auf der Theaterbuhne darstellen? Durrenmatt behauptet, die klassische Form der Tragodie von Aristotelischer Tradition ist keine zeitangemessene Theaterform, um die heutige Welt auf der Buhne darzustellen. eines der wichtigsten Grunde dafur ist, daβ heute die tragische Helden fehlt, die die Welt reprasentieren konnen. Als eine mogliche Theater form bleibt bei uns nur die Komodie, die Durrenmatt "Welttheater" bzw. "Zeitstuck" nennt. Durrenmatt verwendet fur seine Komodie einerseits bekannte Stoffe, die er aus der Geschichte oder aus literarisch bereit geformten Vorlagen bezieht, Andererseits erfindet er seine Stoffe frei, einem Einfall folgend. Bei der Konzeption der Stoffe von seiner Komodien ist fur durrenmatt "Einfall" die Zentralbegriff. Unter dem "Einfall" versteht durrenmatt eine erfundence, nicht ge fundene, Handlung, die sich nicht in der Vergangenheit abspielt und nicht auf Mythen oder andere uberlieferungen zuruckgeht. Fur Durrenmatt ist der Ort der Handlung von groβer Bedeutung. Bei der Auswahl eines bestimmten Schauplatzes werden reale, historisch festgelegte Orte vernachlassigt, also "entstofflicht". Aber bei Durrenmatt bedeutet die Buhne in besonderer Weise die Welt. Diese Welt, die Durrenmatt als Ort der Handlung auswahlt, ist insgesamt verfallen, schmutzig, abstoβend. durrenmatts Komodien haufig durch das "Groteske" oder das "Paradoxe" charakterisiert. das Groteske und das Paradoxe in der Entwicklung der Handlung sind bei durrenmatt nicht nur Darstellungsmittel, das den "DistanzEffekt" erwirkt, sondern auch eine Ausdruk seiner Weltauffassung.

Lesch-Nyhan syndrome 환아의 oral self-mutilation 에 대한 증례보고

최병재,최형준,이제호,전진용 大韓小兒齒科學會 1999 大韓小兒齒科學會誌 Vol.26 No.1

1. 하순에 심한 self-mutilation wound를 야기한 Lesch-Nyhan Syndrome 환아에서 상하악 유전치에 치관부 절단 및 치수 절세술을 시행하여 치아에 의한 자해를 방지하였다. 2. 장치를 이용한 치료가 어려운 경우 발치가 고려되기도 하나 본 증례에서는 발치보다 보존적인 술식으로 만족할 만한 결과를 얻었다. Self-injurous behavior is defined as deliberate harm to one's own body without suicidal intent. It usually occurs as head banging or hitting, skin cutting, or finger biting and includes ocular, genital and oral self-mutilation. Lesch-Nyhan syndrome is a rate X-linked recessively inherited disorder, caused by complete absence of hypoxanthin-guanine phosphoribosyl transferase(HPRT) activity. Clinical presentation is characterized by mental retardation, chorea, athetosis, hyperuricemia, uricosuria and self-mutilating behavior. In these patients, the most typical feature is loss of tissue from biting themselves, even though they are not insensitive to pain. The dental management of self-mutilation includes treatment with appliances such as soft mouthgrard or lip bumper, extraction of all the teeth, and orthognathic surgery. We report a 25-month-old boy who was a known case of Lesch-Nyhan syndrome and presented with severe self-mutilation wound on his lower lip. Vital pulpectomy and coronal resection was done as a more conservative approach than extracting all primary anterior teeth. Due to maintaining the root portion of the teeth in the bone, it is expected that the normal growth of the alveolar bone will be achieved.

미성숙 영구치의 치근파절에 관한 증례보고

최병재,손흥규,김수연,최형준 大韓小兒齒科學會 1997 大韓小兒齒科學會誌 Vol.24 No.3

During the eruption of permanent teeth, Traumatic root fractures in young permanent incisors are rare. They occur most commonly in the maxillary central incisors of male patient and are frequently seen in the coronal third of the root. Permanent incisors are very important in terms of esthetics as well as of function, and so conservative treatment is advisable. It is important to maintain vitality of pulp to achieve better result. Location of the fracture line determines the Prognosis. No clinical change were seen in this three case. A case of central incisor with apparent healing of a root fracture without any tratment is presented in this paper. Long term clinical observation is required periodically.

구순 구개열 환아의 수유 보조 장치에 대한 증례보고

최형준,손흥규,최병재,박동석 大韓小兒齒科學會 1995 大韓小兒齒科學會誌 Vol.22 No.2

Cleft lip, cleft palate, cleft lip and palate are the most common congenital anomalies in cranio-orofacial region. These anomalies lead to esthetic problem as well as to difficulties in feeding and speech and also to chronic infection of upper airway and to disturbance of jaw growth during growing up. Especially, some difficulties during feeding make parents to be confused and puts infants in dangerous position. But these difficulties can be controlled by proper feeding methods according to pattern of cleft lip and palate. Among these feeding methods, feeding appliance is the most safe and relatively easy to manufacture. Early wearing of this appliance makes cleft lip and palate infants to a normal feeding and weight gain. As a member of team approach for the treatment of cleft lip and palate, a pediatric dentist should solve the feeding problems which cleft lip and palate infants and its parents are confronted and help in receiving further treatment.

Open-face Stainless Steel Crown을 이용한 유전치의 치료에 대한 증례보고

최형준,이제호,최병재,김종민 大韓小兒齒科學會 1997 大韓小兒齒科學會誌 Vol.24 No.4

In spite of the improvements of the techniques in the field of preventive dentistry, many children still present with extensive destruction of primary anterior teeth. Not only the practioner must consider the pulp state of the primary incisor, but also restore the form, function and esthetics of the tooth. Restorative treatment of primary incisor tooth requires durability, retention and esthetics. Stainless steel crowns used in restoring primary anterior teeth is retentive and durable in comparison with the composite resin, celluloid crown. But they are not esthetic. To enhance the esthetics of the anterior stainless steel crown without reducing its superior retention, an open-face stainless steel crown has been suggested. Several authors have suggested cutting away the labial portion of the stainless steel crown and placing the composite resin in that area. By following this technique, the practioner can prepare a retentive, durable, and esthetic restoration for primary teeth which have suffered from extensive loss of teeth structure. In addition, the single missing primary anterior teeth can be successfully restored by soldering the stainless steel crown together. Open-face stainless steel crown is indicated in the areas of large interproximal lesions involving incisal edge, crown fracture with pulp exposure and congenital malformation of the teeth. By this technique, the practioner can restore primary anterior teeth successfully regardless of the amount of remaining tooth structure, bruxism habit and presence of attrition. In this case, rampant caries with extensive loss of tooth structure and single missing of primary anterior tooth hart been successfully treated with open-face stainless steel crown.

상처치유시 Antisense TGF-β1 Oligodeoxynucleotides가 Inducible Nitric Oxide Synthase발현 조절에 미치는 영향

최병민,곽현정,전창덕,임정식,박석돈,정헌택 大韓免疫學會 1996 大韓免疫學會誌 Vol.18 No.4

Wound healing in the skin may be complicated by both microbial invasion and inflammation. Following injury, platelet degranulation releases a number of chemotactic factors including transforming growth factor (TGF-fl) and platelet derived growth factor (PDGF). TGF-19 is a cytokines that modulates many cellular function and gene expression. However, it is not known whether TGF-P could regulate inducible nitric oxide synthase (iNOS) gene expression during wound healing. Here we report that down regulation of TGF-Q gene expression by antisense oligodeoxynucleotides increase iNOS during wound healing. Our reverse transcription- polymerase chain reaction (RT-PCR) result has shown that antisense TGF-fil oligodeoxynucleotides (ODN) targeting the TGF-J11 translation initiation region markedly reduced TGF-(il mRNA levels in wounded skin. Also, marked reduction in TGF-fl1 mRNA after antisense treatment invited that the increment of iNOS mRNA in wounded skin. Therefore, our irnmunohistochemical studies revealed a "pattern of iNOS product in wounded skin treated antisense TGF-fl1 ODN that was similar to the pattern of RNA synthesis detected by RT-PCR. In conclusion, our results indicated that the regulatory actions of TGF fl1 on iNOS. might be involved in the initiation and faciliates the resolution of inflammation following wounding.

역위매복된 상악 중절치의 외과적 노출과 교정력을 이용한 증례보고

최형준,최병재,김재윤,이제호 大韓小兒齒科學會 1997 大韓小兒齒科學會誌 Vol.24 No.3

Inverted maxillary incisor is a state in which the maxillary incisor rotates to the upward position. The present report provides two examples of correction of inverted maxillary incisors with surgical intervention & orthodontic appliance. Through surgical exposure & direct bonding of lingual button, the central incisor were brought into proper eruption path with elastic traction. The case 1 & 2 were both treated successfully. The results showed the good position of treated teeth and satisfactory esthetics and adequate width of keratinized gingiva were achieved. Careful differential diagnosis procedure is needed in order to avoid dissatisfactory rusults and the treatment approaches taken in this case report provided an esthetic and functional results.

Methotrexate 치료를 받고 있는 활동성 류마티스 관절염 환자에서 etanercept의 유효성과 안전성에 관한 연구

최병렬,강태영,정청일,이혜순,엄완식,김태환,전재범,유대현,배상철 대한내과학회 2004 대한내과학회지 Vol.66 No.5

목적 : 류마티스 관절염을 앓고 있는 한국인 중에 기존 DMARDs로 치료 실패하였고, 고정용량의 MTX를 복용하고 있는 환자들에 있어서 etanercept의 유효성과 안전성을 평가하고자 하였다. 방법 : 기존 DMARDs로 치료 실패한 활동성 류마티스 관절염 환자 76명을 대상으로 하여 단일군, 공개시험을 하였다. 대상 환자들은 고정용량의 MTX를 복용하면서 etanercept 25 mg을 1주일에 두 번 피하 주사하였으며 12주간 투여하였다. 유효성은 ACR 20, ACR 50,조조강직 시간으로 평가하였고, 약제의 안전성은 이상반응 등으로 평가하였다. 결과 : 대상 환자는 총 76명으로 평균 연령은 45.2세, 남자 5명, 여자 71명이었다. 84.4%인 54명이 12주째에 ACR 20을 만족하였고, 53.1%인 34명이 12주째에 ACR 50을 만족하였다. 조조 강직 시간은 치료 전 203.3분에서 치료 12주째 42.6분을 평균 74.5% 호전되었다. 가장 흔한 이상반응은 주사부위 반응이었다. 이외에도 상기도 감염, 오심, 안면부종 등이 발생하였으나 심각한 부작용은 없었다. 결론 : etanercept는 효과적이고, 안전한 류마티스 관절염 치료 방법이며 특히 MTX치료에도 불구하고 활동성인 류마티스 관절염에 기대되는 치료라고 할 수 있다. Background : This study was performed to investigate the efficacy and safety of etanercept in active rheumatoid arthritis patients with stable dose of methotrexate in Korean. Methods : In a 12 week, single arm, open trial, we assigned 76 patients with active rheumatoid arthritis who had an inadequate response to disease-modifying antirheumatic drugs. Patients received twice-weekly subcutaneous injections of etanercept 25 ㎎ while containing to receive methotrexate at a stable dose of 7.5~25 ㎎ per week. The clinical response was defined as the percent improvement in disease activity according to the criteria of the American Collage of Rheumatology (ACR) at 12 weeks. Results : Etanrecept led to significant improvements in disease activity and was safe and well tolerated. At 12 week, 84.4% of the patients receiving 25 ㎎ of etanercept achieved a 20% ACR response, and 53.1% of those receiving etanercept achieved a 50% ACR response. The most common adverse event was injection-site reaction. Other advanse events were upper respiratory infection, nausea, and facial edema, but there were no serious adverse events associated with etanercept. Conclusion : In active rheumatoid arthritis patients, etanercept was safe, well tolerated, and provided rapid clinical improvements.

악교정 수술시 컴퓨터를 이용한 측면두부규격방사선사진 분석 및 예측의 유용성에 관한 연구

최병준,김여갑 大韓顎顔面成形再建外科學會 2003 Maxillofacial Plastic Reconstructive Surgery Vol.25 No.4

Analysis and prediction on lateral cephalometric must be necessary to know present states and it is important to decide method and magnitude of real orthognathic surgery. The purpose of this study is to evaluate accuracy that post-surgical lateral cephalometric analysis compared with simulated surgical lateral cephalometric analysis using orthognathic surgery prediction system (V-ceph™version 3.0). The result as follow Skeketal position change showed significantly difference between predicted and actual means.(12 of 19). Dental position change showed significantly difference between predicted and actual means.(5 of 9).The angles which were measured among three points showed significantly difference between predicted and actual means.(13 of 18). The distances which were measured between two points significantly difference between predicted and actual means.(4 of 8). None of 2 measurement for ratio showed significantly difference between predicted and actual means. Overall 17 of 28 measurements showed significant difference in means As the result of this study, it was inappropriate to apply prediction system in clincal situation. But the difference was not servere, prediction system could show out line of post-surgical reult approximately. So, it is possible to predict the post-surgical result simply, and to explain the surgery to patient.