Cone beam형 전산화단층영상에서 골의 형태와 밀도의 평가

홍상우,김규태,최용석,황의환 대한구강악안면방사선학회 2008 Imaging Science in Dentistry Vol.38 No.1

Purpose : Diagnostic estimation of destruction and formation of bone has the typical limit according to capacity of x-ray generator and image detector. So the aim of this study was to find out how much it can reproduce the shape and the density of bone in the case of using recently developed dental type of cone beam computed tomography, and which image is applied by new detector and mathematic calculation. Materials and Methods : Cone beam computed tomography (PSR 9000N, Asahi Roentgen Ind. Co., Ltd., Japan) and soft x-ray radiography were executed on dry mandible that was already decalcified during 5 hours, 10 hours, 15 hours, 20 hours, and 25 hours. Estimating and comparing of those came to the following results. Results : The change of inferior border of mandible and anterior border of ramus in the region of cortical bone was observed between first 5 and 10 hours of decalcification. The reproduction of shape and density in the region of cortical bone and cancellous bone can be hardly observed at cone beam computed tomography compared with soft x-ray radiography. The difference of decrease of bone density according to hours of decalcification increase wasn’t reproduced at cone beam computed tomography compared with soft x-ray radiography. Conclusion : CBCT images revealed higher spatial resolution. However, contrast resolution in region of low contrast sensitivity is the inferiority of images’ property.

장중첩증을 동반한 맹장 지방종 1예

홍의실,나병규,김민옥,유일영,채지영,채희복,윤세진,이상전,송형근,박길선,정현용 충남대학교 의과대학 의학연구소 2002 충남의대잡지 Vol.29 No.2

대장 지방종은 주로 우측 결장에 호발하고 특히 회맹판 부위와 맹장 부위에 호발한다. 또한 50~60대에 빈도가 높고 증상이 있는 환자에서 장중첩증이 높게는 40~50%에서 보고되고 있어 성인 장중첩증의 원인으로 중요한 비중을 차지한다. 특히 성인 장중첩증 및 장폐쇄의 중요 원인인 악성 종양과 임상 양상이 유사하여 감별진단이 중요하다. 저자들은 반복적인 복통을 주소로 내원한 환자에서 맹장의 4×5㎝의 점막하 지방종이 말단 회장부위와 반복적인 장중첩중이 발생했던 1례를 부분 절제술로 치료하여 양호한 임상 경과를 경험하였기에 문헌 고찰과 함께 보고하는 바이다. Lipomas are one of the most common benign nonepithelial tumors of the colon which are often detected incidentally by radiologic investigation or on operation. These tumors are usually without specific symptoms. Colonic lipomas occur most often in the right colon, particularly in the ileocecal valve and the cecum. Most patients are asymptomatic. but tumors larger than 2 cm tend to produce a change in bowel habit. abdominal pain. rectorrhagia and complications including luminal obstruction or intestinal intussusception. Diagnosis can be made by colonoscopy abdominal CT. MRI, or barium enema. We report a case of lipoma of the cecum that originated in the submucosa and presented as a intussusception in a 50-year-old woman with a brief review of the literature.

산재보상을 신청한 뇌심혈관질환의 특성 분석

유재홍,하은희,김수근,김정연,김용규,이의철,이철호,손준석 대한산업의학회 2007 대한직업환경의학회지 Vol.19 No.1

목적: 이 연구는 뇌 · 심혈관 질환으로 업무상재해를 신청한 사례 중에서 승인된 사례와 불승인된 사례의 특성을 비교하여 뇌 · 심혈관 질환의 업무상 재해여부를 판단하는데 필요한 기초 자료를 제공하고자 한다. 방법: 2000년부터 2004년까지 근로복지공단에 업무상 재해로 요양이 신청되어 승인여부가 결정된 뇌 · 심혈관 질환자 12,309명을 대상으로 하였다. 승인여부와 관련된 특성을 확인하기 위해 연도별, 업종별, 규모별, 직업별, 성별, 연령별, 질환별, 생존유무별 그리고 기존질환 유무에 대하여 카이제곱 검정과 다변량 로지스틱 회귀분석을 이용하였다. 결과: 다변량 로지스틱 분석에서 뇌 · 심혈관 질환의 불승인에 대한 승인의 비차비는 광업을 기준으로 하였을 때에 전기가스 상수도업이 4.18(95% CI=1.43~12.17), 건설업이 2.39 (95% CI=1.22~4.69), 제조업이 2.10 (95% CI=1.08~4.07)이었고, 장치기계조작원 및 조립원에 비하여 서비스 근로자 및 상점과 시장 판매근로자 군이 1.90(95% CI=1.47~2.47), 전문가 군이 1.83(95% CI=1.50~2.23), 기술공 및 준전문가 군이 1.63(95% CI=1.35~1.97), 입법 공무원과 고위 임직원 및 관리자 군이 1.62(95% CI=1.24~2.12)이었고, 여성이 남성에 비하여 1.31(95% CI=1.13~1.53), 심장질환에 비하여 뇌혈관질환이 2.75(95% CI=2.42~3.13), 사망한 경우가 생존한 경우에 비하여 6.01(95% CI=4.89~7.38)이었다. 결론: 우리나라에서 뇌심혈관질환으로 업무상 재해를 신청하는 건수는 증가하고 있고 승인율은 비교적 높았으며 승인에 영향을 미치는 요인으로는 업종, 규모, 직종, 성, 연령, 질환, 생존유무 등이 확인되었다. 특히 업종과 직종에 따라서 승인율의 차이가 큰 것이 어떠한 요인의 영향 때문인지에 대한 검토가 필요하고, 특히 뇌실질내 출혈의 경우에 다른 질환에 비하여 승인율이 매우 높았던 것은 업무수행성에 대한 인정기준의 잘못된 적용의 결과 이므로 시정이 필요하겠다. Objectives: This study was performed to provide fundamental data to judge whether or not cerebro and cardiovascular diseases are work-related, by comparing the characteristics between approved and non-approved cases among the worker's compensation claims. Methods: We collected 12,309 cerebro and cardiovascular disease claims based on the worker's compensation records of the Labor Welfare Corporation from 2000 to 2004. The approved and non-approved cases were analyzed according to factors such as the calendar year, industry, company size, occupation, gender, age group, classification of cerebro and cardiovascular diseases, fatality and underlying diseases. We used x²-test and multivariate logistic regression for the analysis. Results: According to multivariate logistic regression, electricity gas and water supply (OR=4.18, 95% CI=1.43~12.17), construction (OR=2.39, 95% CI=1.22~4.69) and manufacturing (OR=2.10, 95% CI=1.08~4.07) industries had a higher approval rate than mining and quarrying industries. Service workers and sales & marketing department workers (OR=1.90, 95% CI=1.47~2.47), professionals (OR=1.83, 95% CI=1.50~2.23), technicians and associate professionals (OR=1.63, 95% CI=1.35~1.97) and legislators and senior officials and managers (OR=l.62, 95% CI=1.24~2.12) had a higher approval rate than plant and machine operators and assemblers. Female workers had a higher approval rate (OR=1.31, 95% CI=1.13~1.53) than male workers. Cerebrovascular diseases had a higher approval rate (OR=2.75, 95% CI=2.42~3.13) than cardiovascular diseases. Fatal cases had a higher approval rate (OR=6.01, 95% CI=4.89~7.38) than surviving cases. Conclusion: For cerebro and cardiovascular diseases, workers' compensation claims are increasing, approval rates are relatively high and factors such as industry, company size, occupation, gender and fatality are related. A remarkable difference in the approval rate was found according to industry and occupation, suggesting the need for further study to identify which factors influence the approval rate. The approval rate for intracerebral hemorrhage arising in the course of employment (COE) was significantly higher than that arising out of employment (AOE), suggesting the need to correct the approval criteria.

인공 치아우식 발생 모델에서 디지털 방사선 공제술을 이용한 인접면 치아우식증의 진단

박정훈,최용석,황의환,이기자,최삼진,박영호,김경숙,진현석,홍경원,오범석,박헌국 대한구강악안면방사선학회 2009 Imaging Science in Dentistry Vol.39 No.1

Purpose : The purpose of the experiment was to evaluating the diagnostic ability of dental caries detection using digital subtraction in the artificial caries activity model. Materials and Methods : Digital radiographies of five teeth with 8 proximal surfaces were obtained by CCD sensor (Kodak RVG 6100 using a size #2). The digital radiographic images and subtraction images from artificial proximal caries were examined and interpreted. In this study, we proposed novel caries detection method which could diagnose the dental proximal caries from single digital radiographic image. Results : In artificial caries activity model, the range of lesional depth was 572-1,374 μm and the range of lesional area was 36.95-138.52mm². The lesional depth and the area were significantly increased with demineralization time (p<0.001). Furthermore, the proximal caries detection using digital subtraction radiography showed high detection rate compared to the proximal caries examination using simple digital radiograph. Conclusion : The results demonstrated that the digital subtraction radiography from single radiographic image of artificial caries was highly efficient in the detection of dental caries compared to the data from simple digital radiograph.

14세 여환에서 쇄골에 발생한 동맥류성 골 낭종 : 증례보고

김동수,김용민,최의성,손현철,박경진,조병기,홍경호 충북대학교 의과대학 충북대학교 의학연구소 2010 忠北醫大學術誌 Vol.20 No.1

동맥류성 골낭종(aneurysmal bone cyst)은 Jaffe와 Lichtenstein(1942)에 의해 처음 기술된 이래 많은 증례가 보고되었다. 동맥류성 골낭종은 주로 장관 골의 골간단과 척추에서 발생한다. 병인은 정확히 밝혀지지 않았으나, 반응성 현상으로 생각되며, 원발성 또는 다른 병변과 동반될 수 있다. 쇄골 등 기타 골에서 발생하는 경우는 매우 드물다. 저자들은 우측 쇄골에서 동맥류성 골낭종 1예를 경험하여 보고하는 바이다. 14세 여자환자가 우측 견갑부의 우연히 발견된 종괴를 주소로 내원하였다. 환자는 종괴에 대해 이학적 검사 및 혈액 검사상 측이한 소견을 보이지 않았다. 방사선 검사상, 쇄골 내측부에 골 용해성으로 팽윤된 병변이 관찰되었고, 동맥류성 골낭종, 단순 골낭종, 전이성 골종양 등의 의증 하에 절제술을 시행하였다. 절제된 종괴의 육안 소견상, 얇은피질 골로 쌓여 있으며, 노란색 액체로 차있는 4x5cm 종괴가 관찰되었고, 완전 절제술을 시행하였다. 광학현미경상, 혈액으로 차있는 다양한 크기의 낭성 구조가 보였고, 여러 개의 거대세포가 격막을 이루고 있었다. 조직학적 소견과 MRI소견, 임상 소견을 종합하였을 때, 쇄골에서 원발성으로 발생한 동맥류성 골낭종을 진단할 수 있었다. Many cases of aneurysmal bone cyst(ABC) have been reported since Jaffe and Lichtenstein(1942) first reported. Aneurysmal bone cyst mostly occurs in metaphysis of the long bones and vertebral column. The reason for this disease has not be clearly explained yet, but it is estimated as reactive change and can be accompanied with primary lesion or another lesion. It rarely occurs in clavicle or other bones. We report one case of ABC in right clavicle. 14-year-old female patient who accidentally found palpable mass on right shoulder visited hospital. We did not find any specifics regarding this patient's mass after physical exam and blood test. Radiologic exam showed a large expansile mass with osteolytic lesion, The differential diagnosis includes ABC, simple bone cyst, metastatic bone tumor, etc. Based on visual observation on excised 4×5 cm mass, it was covered by thin cortical bone and filled with yellow fluid, and complete excision was done. On histological examination, the mass consist of various size of cystic structures. and several giant cells comprised septae. Based on histological examination, MRI, clinical examination, we made a diagnosis that it was primary anuerysmal bone cyst in clavicle

출혈성 소화성 궤양의 장기 재발률

심기남,정훈용,양석균,홍원선,박의련,박무인,김해련,민영일 대한소화기내시경학회 1999 Clinical Endoscopy Vol.19 No.2

Background/Aims: Bleeding from a peptic ulcer is one of the common and serious complications associated with the rate of reported mortality, which ranges from 5% to 10%. Endoscopic therapy is effective in controlling active bleeding and reducing the emer-gency surgery, the immediate mortality rate and the incidence of early rebleeding. But few recent studies have documented the long-term recurrent bleeding rate after discharge in patients with bleeding peptic ulcers. The aim of this study was to determine the long-term recurrent bleeding rate and factors predisposing to recurrent bleeding. Methods: Eighty-eight patients with bleeding peptic ulcers discharged after medical treatment between Dec. 1990 and Jul. 1992 were included in this study and retrospectively followed up with medical records and telephone interviews. The end point of follow-up was recur-rent hemorrhage, surgery for treatment of ulcer complication, or death. Results: By July 1997, retrospective follow-up was available in 76 patients. Recurrent bleeding occurred in 23 patients (30.3%) with bleeding peptic ulcers and the median follow-up period was 69 months (range, 1 ∼79 months). The estimated cumulative recurrent bleeding rate after 1, 2, 3, 4, 5 and 6 years was 11.8%, 14.5%, 19.9%, 24.2%, 27.2% and 34.2%, respectively. There was no difference between the recurrent bleeding group and the non-recurrent bleed-ing group according to age, sex, prior NSAIDs use, previous history of bleeding or pepticulcer, site of ulcer, stigmata of recent hemorrhage at initial examination, method of treatment and amount of transfusion. Conclusion: Recurrent bleeding occurred in one-third of patients with bleeding peptic ulcers after 6 years of follow-up and one-third of recurrent bleeders rebled within 1 year. The factors predisposing to recurrent bleeding in the long-term follow-up could not be found. Therefore, further studies designed to identify factors predisposing to recurrent bleeding are needed and the evaluation of Helicobacter pylori status in bleeding pepic ulcer is needed because Helicobacter pylori is an important factor of peptic ulcer recurrence.

대장내시경 전처치제로서 Sodium Phosphate 와 Polyethylene Glycol 용액의 전향적 비교 분석

이헌경,김승용,홍원선,민영일,정훈용,김해련,정성애,김석균,심기남,양석균,박의련,조문경 대한소화기내시경학회 1999 Clinical Endoscopy Vol.19 No.3

Background/Aims: Although some authors have suggested that sodium phosphate (NaP) is more effective than polyethylene glycol (PEG) in bowel cleansing, there has been no crossover study proving the superiority of NaP over PEG in bowel cleansing and patients' compliance. The aim of this study was to compare the two solutions for colonoscopy, PEG and NaP, through crossover design with regard to patients' compliance, cleansing ability and side effects. Methods: Thirty patients underwent two separate colonoscopies for colonic polyp(s) with PEG and NaP, respectively. Before and after bowel preparation, blood pressure, body weight, and serum biochemical parameters were measured in all patients. In addition, a detailed questionnaire was used to assess side effects and the patients' preference. The presence of bubbles, types of residual stool, and overall quality of colon cleansing were assessed by one endoscopist blinded to the type of preparation used. In each colonoscopy, two biopsy specimens were taken at rectum. Results: In the NaP group, but not in the PEG group, there were significant changes in several biochemical parameters including sodium (+3.0±3.0 mEq/L), potassium (-0.3±0.3mEq/L), calcium (-0.5±0.5 mg/dL), phosphorus (+3.9±2.2 mg/dL) and osmolarity ( +10.1±9.3 mOsm/kg) after bowel preparation. In addition, the degree of body weight change was greater with NaP (-2.2±2.3 kg) than with PEG (-1.2±2.0 kg) (p=0.06) and the formation of bubbles that disturb luminal observation was more frequently found in the NaP group (p$lt;0.01). There was no difference, however, in the type of residual stool and the overall quality of bowel preparation between the two groups and no significant mucosal change was noted after bowel preparation in both groups. Moreover, PEG was found to be more difficult to take than NaP (p$lt;0.05) and among the 30 patients, 26 (87%) preferred NaP, while only two favored PEG (p$lt;0.01). Conclusions: We conclude that NaP can replace PEG at least in patients with good general condition. Further studies to decrease the incidence of bubbles and to establish subgroups suitable for NaP are needed.

흡연력을 고려한 궤양성 대장염 발생과 충수 절제술 사이의 상관 관계

남승우,양석균,정훈용,심기남,조병동,김승용,박의련,홍원선,민영일 大韓消化器病學會 1998 大韓消化器病學會誌 Vol.32 No.1

상완골 근위부 분쇄 골절에서의 상완골 두 치환술

서중배,원중희,김용민,최의성,이호승,홍윤철 대한견.주관절학회 2000 大韓肩.주關節學會誌 Vol.3 No.2

Effect of aluminium doping on the Photoelectric properties of prepared AZO thin films

Hong Eui Yong(홍의용),Balasubramaniam Saravanakumar(사라바나구마르),Sang-Jae Kim(김상재) 대한기계학회 2013 대한기계학회 춘추학술대회 Vol.2013 No.3