심한 하악골 전돌증 환자의 외과적 치험례

권대근,이상한,이근호,장도근 大韓顎顔面成形再建外科學會 1994 Maxillofacial Plastic Reconstructive Surgery Vol.16 No.1

Obwegeser Ⅱ method and Rigid fixation conserving the condylar position has been performed on 5 patients with severe mandibular prognathism, and we obtained the result after the follow up study follows. 1. Obwegeser Ⅱ method is considered to move the distal segment passively when surgical correction of severe open bite correction and large amount of set back above 15mm is needed. 2. In one case that has more change of condylar position after operation, documented immediate post- operative relapse have been occurred 3. In the others that have adequate control of condylar position, passive set back and firm skeletal fixation, more functional and esthetic improvement and more post-operative stability has been achieved

상악골과 비사골동에 이환된 백악질 골화성 섬유종(cemento-ssifying fibroma)의 치험례

권대현,김신유,남정순,구명숙,이봉서,권대근,김종배 大韓顎顔面成形再建外科學會 2001 Maxillofacial Plastic Reconstructive Surgery Vol.23 No.6

The cemento-ossifying fibroma is a benign fibro-osseous tumor that may behave in an aggressive pattern. Although found predominantly in the mandible, most of these unusual tumors may arise in the maxilla and paranasal sinuses. Especially these lesion in the maxilla and sinuses behave more aggressively and are more prone to recur compared to mandibular counterparts. Therefore, more radical approach may be recommended than expectant observation or curettage in the initial management of this neoplasm. This is a case report of cemento-ossifying fibroma extended to maxillary sinus and naso-ethmoidal area treated by wide surgical excision after repeated conservative treatments.

방사성폐기물처분연구를 위한 유성지역 화강암내 심부 시추공 단열충전광물의 광물학적 특성

김건영,고용권,배대석,김천수 한국광물학회 2004 광물과 암석 (J.Miner.Soc.Korea) Vol.17 No.1

방사성폐기물의 처분연구와 관련하여 대전 유성지역 화강암내 심부 시추공 시추코아의 단열 광물들에 대한 광물학적 특성을 연구하였다. 유성지역의 심부시추공들에는 다수의 단열대가 발달해 있으며 국지적인 열수변질작용이 중첩되어 있다. YS-01 시추코아에 대한 전암분석결과 -90 m ∼-130 m 구간과 -230 m∼-250 m 구간에서 급격한 SiO₂ 함량 감소와 Al₂O₃, CaO, L.O.I 값의 증가가 관찰되며 이는 단열충전광물의 생성과 관련이 있다. 이러한 단열충전광물에 대한 XRD분석결과 불석광물(로몬타 휼란다이트), 방해석, 일라이트(2M₁1M_(d) 다형), 녹니석, 녹염석, 카올리나이트 등이 확인되었으며, 산출되되는 양은 방해석 불석광물 > 일라이트 > 녹염석 >> 녹니석 > 카올리나이트의 순이다. SEM관찰 및 EPMA 분석결과, 단열충전광물들의 심도에 따른 조직 및 화학특성 변화는 관찰되지 않는다. 연구지역은 화강암반내에 발달된 단열재가 지하수의 유동로로 작용하여 오랜 기간에 걸친 물-암석 반응이 진행되었고, 또한 저온의 열수변질작용이 중첩되었기 때문에 이들에 의한 단열충전광물의 생성기원 연구가 필요하다. Mineralogical characteristics of fracture-filling minerals from deep borehole in the Yuseong area were studied for the radioactive waste disposal project. There are many fracture zones in the deep drill holes of the Yuseong granite, which was locally affected by the hydrothermal alteration. According to the results of hole rock analysis of drill core samples, SiO2 contents are distinctly decreased, whereas A12O3 and CaO contents and L.O.I. values are increased in the -90 m∼-130 m and -230 m∼-250 m zone, which is related to the formations of filling minerals. Fracture-filling minerals mainly consist of zeolite minerals (laumontite and heulandite), calcite, illite (2M₁ and 1M_(d) polytypes), chlorite, epidote and kaolinite. The relative frequency of occurrence among the hcture-filling minerals is calcite ≥ zeolite mineral > illite > epidote >> chlorite kaolinite. Judging from the SEM observation and EPMA analysis, there is no systematic change in the texture and chemical composition of the fracture-filling minerals with depth. In the study area, low temperature hydrothermal alteration was overlapped with water-rock interactions for a long geological time through the fracture zone developed in the granite body. Therefore the further study on the origin and paragenesis of the fracture-filling minerals are required.

충남지역 활석광상에서 산출되는 금운모의 광물특성 및 기원

김건영,김수진,고용권,배대석 한국광물학회 2004 광물과 암석 (J.Miner.Soc.Korea) Vol.17 No.3

충남지역 활석광상에서 산출되는 금운도의 광물학적 특성 및 활성화 작용과 연관된 금운모의 생성기원을 연구하였다. 연구지역의 활석광상에서 산출되는 운모류는 녹니석과 더불어 활석광석의 주요 불순광물이다 화학적으로 활석과 공존하는 운모류들은 전형적인 금운모 조성을 보여주고 활석과 직접적인 관련이 없이 산출되는 운모류들은 흑운모에서부터 금운모 조성까지 광범위한 분포를 보여준다. 금운모는 주로 활석광체의 외곽부의 검은 변질대에 분포하며, 특히 괴상 활석광석에 수반되어 산출된다. 편광현미경이나 후방산란전자상에서는 금운모와 녹니석이 혼정을 이루고 있는 양상을 흔히 관찰할 수 있으며, 드물게 활석과 함께 혼정을 이루는 양상을 관찰할 수 있다. 금운모의 투과전자현경관찰결과, 일반적으로 전형전인 10Å의 격자상 내에 14 Å의 녹니석층이 불규칙하게 혼합되어 있기 때문에 금운모의 생성과정이 녹니석과 밀접한 관계가 있음을 지시하고 있다. 이러한 금운모의 산출상태와 광물학적 특성 및 금운모생성에 필요한 K의 기원을 고려하였을 때, 연구지역의 금운모는 활석화 작용의 후기단계에서, 포기 성분과는 달리 K을 충분히 함유한 열수용액과 활석 광체와의 반응에 의해서 주고 생성된 것으로 판단된다. K은 이러한 K-변질작용이 일어나기 용이한 구조조건을 가진 활석광체와 주변 화강암질 편마암과의 접촉부에서 화강암질 편마암으로부터 유입되었다. Mineralogical characteristics and genesis of phlogopite in the talc deposits of the chungnam area were studied. Mica is one of the major impurity of talc ores in the study area. Talc-related micas show typical phlogopite composition, whereas talc-unrelated micas show wide compositional variations between biotite and phlogopite. Phlogopite mainly occurs in the black-wall type zone, especially in the nodular talc ores near the outer part of talc ore bodies. Interleaving textures of phlogopite and chlorite are easily observed under the optical microscope and back-scattered electron images. Interleaving textures of phlogopite and talc are observed also. Examination of the phlogopite by transmission electron microscope reveals that 14 Å layers of chlorite are randomly interlayered within the 10 Å layers of phlogopite, which suggests that the genesis of phlogopite is closely related to chlorite. Considering the occurrence and mineralogical characteristics of phlogopite, and the possible origin of K for the formation of phlogopite, phlogopite of the study area was formed by interaction between talc ore body and hydrothermal solution containing sufficient K at the late stage of talc formation. K might be introduced from the granitic gneiss at the contact zone between the talc ore body and the granitic gneiss under favorable structural condition for the potash metasomatism.

정신분열병 및 정신분열형 장애에 대한 올란자핀의 효과와 안전성

안용민,강대엽,권준수,김창윤,김철응,반건호,신영민,이기철,이동우,이중서,조현상,채정호,김용식 大韓神經精神醫學會 2001 신경정신의학 Vol.40 No.4

연구목적 : 본 다기관 공동임상연구는 국내 환자를 대상으로 새로운 항정신병약물인 올라자핀의 치료 효과와 안전성을 확인하고자 시행되었다. 방 법 : 1999년 7월부터 2000년 3월까지 국내 10개 병원에 방문한 정신분열병 및 정신분열형 장애 105명을 대상으로 비대조 개방 임상연구를 시행하였다. 중등도 이상의 정신병 증상을 지니거나, 부작용으로 약물교체가 필요한 경우 또는 기분장애 증상의 치료가 필요한 환자를 대상으로 하였다. 2∼7일간의 약물 배설기간 후에 1일 10mg의 올란자핀을 투여하였고, 이후로 3∼7일 간격으로 용량을 조절하여 총 8주간 투여하였다. 치료 효과는 PANSS(Positive and Negative Syndrome Scale), BPRS(Brief Psychiatric Rating Scale), CGI(Clinical Global Impression-Severity), MADRS(Montgomery-Asberg Depression Rating Scale), HAM-A(Hamilton Rating Scale for Anxiety)로 판정하였다. 안전성 평가는 자발적인 이상반응 보고, 활력징후와 혈액 검사 및 SAS(Simpson-Angus Scale), BARS(Barnes Akathisia Rating Scale), AIMS(Abnormal Involuntary Movement Scale)척도를 이용하였다. 결 과 : 105명중에서 85.7%인 90명이 8주간의 치료를 완료하였다. 평균 최빈 용량은 일일 16.1(±4.7)mg이었고, 종료시점에서의 BPRS전체 점수가 기저 상태에 비해 40%이상 감소된 반응군은 69.5%이었다. PANSS의 양성 증후군과 일반정신병리 뿐만 아니라 음성 증후군 소척도에서도 유의한 감소를 보였으며, 이 감소들은 치료 초기부터 나타나서 8주간 지속되었다. 43.8%의 피험자가 중등도 이상의 우울증상을 같이 지니고 있었으며, 올란자핀에 의해 MADRS와 HAM-A가 유의하게 감소하였다. 치료 기간 동안에 활력징후에는 뚜렷한 변화가 없었으나 체중은 8주간 지속적으로 증가하였다. SAS와 AIMS는 감소하였으며, 정좌불능증을 제외한 나머지 추체외로 증상의 발생비율도 낮았다. 임상적인 증상이나 징후를 동반하지 않는 ALT/SGPT의 상승을 보였지만 프로락틴을 포함하는 대부분의 혈액 검사상 뚜렷한 이상 변화는 없었다. 결 론 ; 비록 본 임상연구가 비대조 개방 임상연구로서 많은 제한점을 가지고 있지만, 올란자핀이 기존 약물에 내약성을 보이거나 기분증상을 동반하는 정신병에 치료 효과가 있었다. 그리고 기존 항정신병약물 치료시에 문제가 되었던 추체외로 증상과 고프르로락틴 혈증을 포함하는 대부분의 부작용면에서 안전성을 보여 주었다. Objective : This multicenter clinical trial was carried out to investigate the efficacy and the safety of olanzpine for the treatment of Korean patients. Mothod : 105 patients with schizophrenia and schizophreniform disorder, visited at 10 mental or university hospitals, had received an open and non-comparative treatment with olanzapine for 8 weeks. Patients had psychotic or depressive symptoms with the severity above moderate degree or intolerable side effects to previous antipsychotics. After a wash-out period of 2-7 days, 10mg olanzapine was prescribed initially to all the patients, and then the dosage could be adjusted within the range of 5-20mg/day of olanzapine by 3-7 days. Results : 90(85.7%) of 105 patients completed the 8-weeks trial and the mean modal dose of olanzapine was 16.1(±4.7%)mg/day. At the end of the trial, 73 patients(69.5%) were classified as responder, which was defined as 40% or more improvement in BPRS(Brief Psychiatric Rating Scale) score comparing to baseline. There was a significant reduction in the scores of PANSS(Positive and Negative Syndrome Scale)and subscales including negative symptom scores and CGI. Also weekly analysis showed that the reductions in scores were kept on for the whole period of the trial. 43.8% of all the patients had depressive symptoms at the baseline and total scores of MADRS(Montgomery-Asberg Depression Rating Scale) and HAM-A(Hamilton Rating Scale for Anxiety) were also reduced after the trials. Vital signs revealed no clinically significant changes but continuous weight gain was observed during the treatment with olanzapine. The scores of SAS(Simpson-Angus Scale) and AIMS(Abnormal Involuntary Movement Scale) for assessing the EPS(extrapyramidal symptoms)and tardive dyskinesia respectively were significantly decreased and only a few patients reported EPS as adverse events. Although mild and clinically non-significant of ALT/SGPT was observed, most laboratory parameters including plasma prolactin level showed to significant changes during the trial. Conclusions : Although this trial had many limitations because it was a non-comparative and open study, olanzapine showed high efficacy on the positive, negative and depressive symptoms in schizophrenia and schizophreniform disorder.In addition to that, olanzapine showed a substantially favorable safety profile, such as low incidence of EPS and hyperprolactinemia.

Cao-MgO-SiO₂-P₂O -CaF₂계 생체활성 결정화 유리의 기계적 성질에 미치는 ZrO₂및 Al₂O₃의 분산 강화 효과

박찬운,강건구,원대희,이민호,배태성 대한치과기재학회 1998 대한치과재료학회지 Vol.25 No.2

Bioactive glass-ceramics can form tight chemical bonds with bone, however, their poor mechanical properties may limit their clinical applications. Alumina ceramics show good biocompatibility and high strength but can't form chemical bonds with bone. Hydroxyapatite ceramics and bioglass form chemical bonds with bone but their strength and fracture are relatively low. Glass ceramics containing apatite and wollastonite crystals can form tight chemical bonds with bone and show relatively high strength and fracture toughness. Bioactive glass-ceramics toughened by alumina and tetragonal zirconia polycrystals show relatively high mechanical strength. Both bioactive and high strength ceramics will be widely applicable to many clinical applications. In this study, bioactive glass-ceramics toughened by alumina and zirconia polycrystals were fabricated, and crystallization behavior, biaxial flexure strength, fracture toughness, and bioactivity were measured. The results obtained were summarized as follows; 1. The major crystaline phase in the matrix glass were observed to be apatite, wollastonite, and β-TCP. 2. Biaxial flexure strength and fracture toughness values were more improved by the dispersion toughening of alumina and zirconia, and the improvement of mechanical strength was more higher in the dispersion toughening of zirconia than that of alumina. 3. The bioactivity, which was evaluted from apatite formation in the simulated body fluid, was higher in the dispersion toughening of Zr-O₂than that of Al₂O₃.

주폐자충 폐렴으로 발현된 Felty 증후군 1예

김성호,남대근,문재현,김지홍,김보석,안진광,문태건,안병재,김성일 全南大醫大 2001 전남의대학술지 Vol.37 No.3

Immunoturbidimetric assay를 이용한 철결핍 및 만성질환에 의한 빈형에서 가용성 트란스페린 수용체 측정의 진단적 유용성

박영진,박건,박상묵,최영화,장숙진,문대수 조선대학교 2001 The Medical Journal of Chosun University Vol.26 No.2

Background : Soluble transferrin receptor (sTfR) has been known to be a good marker for evaluating iron deficiency anemia (IDA) and anemia of chronic disease (ACD) without bone marrow aspiration. The sTfR has been measured with enzyme linked immunosorbent assay (ELISA). However, Immunoturbidimetric (IT) assay for measuring sTfR was recently introduced. Author try to use clinical application and measure sTfR using IT assay. Methods : IDA group (26 patients, ferritin < 12.0 μg/L), ACD group (20 patients, ferritin > 60.0 μg/L), Iron depletion and control group (30 normal persons) were classified. Hemoglobin, RBC indices, serum iron, serum transferrin, serum ferritin, total iron binding capacity were measured and calculated. Serum sTfR measured with IT assay using automated chemical analyzer. Those sTfR levels of each other group were compared. The correlations between iron parameters and sTfR were studied in other group. Results : The sTfR receptor levels were prominently higher in IDA group (5.2 ± 2.2 nmol/L) than in ACD group (1.1 ± 0.8 nmol/L), and normal control group (1.4 ± 0.3 nmol/L). The sTfR levels between ACD group and control group was not different. The correlations between sTfR and Hb levels in IDA group was in good inverse line. Other iron parameters and sTfR levels were not correlated in other groups. Conclusion : The results indicate that IDA can be differentiated efficiently from ACD with IT method to measure sTfR.

HCC : PE-042 ; Feasibility of α-fetoprotein as a screening and diagnostic tool for hepatocellular carcinoma (multicenter study)

( Dae Geon Ahn ),( Hyung Joon Kim ),( Hyun Woong Lee ),( Si Hyun Bae ),( Joon Hyeok Lee ),( Yong Han Paik ) 대한간학회 2012 춘·추계 학술대회 (KASL) Vol.2012 No.-

Background: Recent systematic reviews show that the quality of evidence supporting the use of AFP as a diagnostic and screening test for hepatocellular carcinoma (HCC) is limited. The Korean Liver Cancer Study Group recommended the cutoff value of 200ng/mL as a diagnostic tool. The aim of this study was to evaluate the feasibility of AFP as a screening and and to explore the optimal level of AFP for HCC diagnosis Methods: We retrospectively reviewed the medical records of HCC (all cases were biopsy proven) and cirrhosis patient have available data in 3 hospitals. A total of 1,560 patients were classified into three groups: 564 were cirrhosis controls, 766 were patient with early stage HCC (n = 123 very early, n = 643 early) and 230 were patient with late stage HCC. The performance of AFP in three groups was compared with each other. The AFP sensitivity, specificity, positive and negative predictive values were calculated. Results: The mean age was 54 years in cases, and 56 years in control. Male was dominant in both groups (case, 81.1% vs. control, 65.7%). The mean AFP was significantly higher in patients with overall HCC (early, late) than in those with liver cirrhosis. [early HCC, 2,769ng/ml (1-200,000) , late HCC, 9,818ng/ml (1-639,100), control, 20ng/ml (0.61-1,753)]. (p< 0.0001) Area under the receiver operating characteristic curve for those overall HCC with cirrhosis is 0.78. The sensitivity, specificity, and PPV of AFP was 52.6%, 87.7%, 88.3% at a cutoff of 20ng/ml; 36.9%, 95.9%, 94.1% at a cutoff of 100ng/ml and 29.5%, 98.0%, 96.3% at a cutoff of 200 ng/ml. As a screening tool for HCC , a cutoff of 100ng/ml is more sensitive than 200 ng/ml with equivalent specificity and PPV. The optimal AFP cutoff value was 8.2ng/ml leading to a sensitivity of 66.9% and a specificity of 75.7%. Conclusions: Our study cautiously suggested that the optimal value of AFP in the diagnosis of HCC might be switched 200 ng/ml to 100ng/ml.

HCC : PE-042 ; Feasibility of α-fetoprotein as a screening and diagnostic tool for hepatocellular carcinoma (multicenter study)

( Dae Geon Ahn ),( Hyung Joon Kim ),( Hyun Woong Lee ),( Si Hyun Bae ),( Joon Hyeok Lee ),( Yong Han Paik ) 대한간학회 2012 춘·추계 학술대회 (KASL) Vol.2012 No.1

Background: Recent systematic reviews show that the quality of evidence supporting the use of AFP as a diagnostic and screening test for hepatocellular carcinoma (HCC) is limited. The Korean Liver Cancer Study Group recommended the cutoff value of 200ng/mL as a diagnostic tool. The aim of this study was to evaluate the feasibility of AFP as a screening and and to explore the optimal level of AFP for HCC diagnosis Methods: We retrospectively reviewed the medical records of HCC (all cases were biopsy proven) and cirrhosis patient have available data in 3 hospitals. A total of 1,560 patients were classified into three groups: 564 were cirrhosis controls, 766 were patient with early stage HCC (n = 123 very early, n = 643 early) and 230 were patient with late stage HCC. The performance of AFP in three groups was compared with each other. The AFP sensitivity, specificity, positive and negative predictive values were calculated. Results: The mean age was 54 years in cases, and 56 years in control. Male was dominant in both groups (case, 81.1% vs. control, 65.7%). The mean AFP was significantly higher in patients with overall HCC (early, late) than in those with liver cirrhosis. [early HCC, 2,769ng/ml (1-200,000) , late HCC, 9,818ng/ml (1-639,100), control, 20ng/ml (0.61-1,753)]. (p< 0.0001) Area under the receiver operating characteristic curve for those overall HCC with cirrhosis is 0.78. The sensitivity, specificity, and PPV of AFP was 52.6%, 87.7%, 88.3% at a cutoff of 20ng/ml; 36.9%, 95.9%, 94.1% at a cutoff of 100ng/ml and 29.5%, 98.0%, 96.3% at a cutoff of 200 ng/ml. As a screening tool for HCC , a cutoff of 100ng/ml is more sensitive than 200 ng/ml with equivalent specificity and PPV. The optimal AFP cutoff value was 8.2ng/ml leading to a sensitivity of 66.9% and a specificity of 75.7%. Conclusions: Our study cautiously suggested that the optimal value of AFP in the diagnosis of HCC might be switched 200 ng/ml to 100ng/ml.