발치와의 치유과정에서 교원질 및 비교원단백질의 분포에 관한 면역조직화학적 연구

오화탁,김현수,주성숙,신제원 慶熙大學校 齒科大學 1995 慶熙齒大論文集 Vol.17 No.2

During tooth socket healing, the coagulum in the socket is replaced by fibrous connective tissue which undergoes mineralization and eventually becomes bone. Using this model, the healing process of the tooth socket and the role of type I collagen(CI), fibronectin(FN), bone sialoprotein(BSP), and osteopontin(OP) in the process were studied. Thirty Sprague-Dawley rats weighing 130-150gm were fed fi -aminopropionitcille for 5days before extraction of the first maxillary molars, and sacrified by perfusion with 4% paraformaldehyde at 1, 3, 5, 7, and 10days after tooth extraction. The socket and surrounding tissues were cut, demineralized, dehydrated and embedded in paraffin. For morphological observation, the sections were stained by Azan. Immunostaining of the ECM components was achieved by the avidin-biotin complex method. The results as follows; 1. Morphology of the tooth socket 1day after tooth extraction. The socket was filled with blood coagulum which was composed of densly aggregated red blood cells, platelets and fibrin network. 2. Morphology of the tooth socket 3days after tooth exyraction. A large portion of the coagulum was replaced by fibrous connective tissue contains a large number of fibroblasts, come from periphery of the socket. 3. At 5days, the newly formed bone demonstrated the highest proliferation activity. At 7days, the soclet was occupied with new bone. 4. Type I collagen was observed in the newly formed connective tissue and around the new bone. fiber. 5. Intensive staining for fibronectin was observed in granulation tissue, especially around blood vessels as well as inflammatory cells. 6. Strong immunostaining for bone sialoprotein and osteopontin was found in osteoblasts and new bone, while weaker staining was observed on dense connective tissue. 7. These data suggest that collagen and noncollagen proteins (FN, BSP, OP) an important role daring socket healing.

산 완충용액의 pH 및 유산의 온도가 인공치근우식의 형성에 미치는 영향

오현석,노병덕,이찬영 대한치과보존학회 2007 Restorative Dentistry & Endodontics Vol.32 No.1

치근 우식증은 복합적인 요인에 의해 발생되는 질환으로 고령인구의 증가로 최근 증가추세 에 있으나 아직까지는 병소깊이, 상아질 탈회의 정도 및 양상, collagen의 파괴 정도 및 수산화인회석 결정 변화에 대한 탈회 완충액의 조직학적 연구는 미비한 실정이다. 본 연구는 우식 형성에 영향을 주는 산 완충용액 내의 pH와 유산의 농도변화에 따른 치근 상아질 우식 병소의 진행에 미치는 변화를 편광현미경을 이용하여 관찰하고 관찰된 우식 병소층의 수산화인회석의 결정 형태 변화를 주사전자현미경으로 관찰하여 탈회 과정을 살펴보고자 세 가지 pH (4.3, 5.0, 5.5)군과 각각의 pH군에 세 가지 유산의 농도 (25 mM, 50 mM, 100 mM)를 이용하여 인공치근 우식을 형성한 후 비교 분석하여 다음과 같은 결과를 얻었다. 1. 편광현미경 소견에서 우식 병소의 깊이는 pH 보다는 유산의 농도에 의해 더 영향을 많이 받았다. 2. 주사전자현미경 소견에서 유산의 농도가 높아질수록 그리고 pH가 낮아질수록 수산화인회석 결정의 소실이 더 많이 진행되었다. 3. 탈회는 수산화인회석 결정의 변연부가 소실되며 결정 cluster내 결정의 숫자 및 크기가 감소하였고 결정 cluster 사이의 간격이 넓어지는 양상으로 관찰되었다. 4. 표면층에서의 주사전자현미경 관찰 시 유산의 농도가 높아질수록 수산화인회석 결정 cluster의 형태는 소실되고 콜라겐 섬유 표면에 수산화인회석 결정의 용해, 재결합된 양상으로 관찰되었다. 5. 탈회 과정에 대한 주사전자현미경 관찰 시 상아질의 탈회는 단순히 탈회만 독립적으로 일어나는 과정이 아닌 탈회와 재광화가 동시에 일어나는 양상으로 관찰되었다. 이상의 결과 산 완충용액 내의 유산의 농도가 높아지고 pH가 낮아질수록 탈회의 속도가 증가하고 탈회의 과정은 수산 화인회석 결정 cluster의 표면으로부터 진행되며 시간이 경과함에 따라 수산화인회석 결정의 형태는 원형 또는 타원형에서 불규칙한 형태로 변화되었다. The purpose of this study is to compare and to evaluate the effect of pH and lactic acid concentration on the progression of artificial root caries lesion using polarizing microscope, and to evaluate the morphological changes of hydroxyapatite crystals of the demineralized area and to investigate the process of demineralization using scanning electron microscope. Artificial root caries lesion was created by dividing specimens into 3 pH groups (pH 4.3, 5.0, 5.5), and each pH group was divided into 3 lactic acid concentration groups (25 mM, 50 mM, 100 mM). Each group was immersed in acid buffer solution for 5 days and examined. The results were as follows: 1. Under polarized microscope, the depth of lesion was more effected by the lactic acid concentration rather than the pH. 2. Under scanning electron microscope, dissolution of hydroxyapatite crystals were increased as the lactic acid concentration increased and the pH decreased. 3. Demineralized hydroxyapatite crystals showed peripheral dissolution and decreased size and number within cluster of hydroxyapatite crystals and widening of intercluster and intercrystal spaces as the pH decreased and the lactic acid concentration increased. 4. Under scanning electron microscope evaluation of the surface zone, clusters of hydroxyapatite crystals were dissolved, and dissolution and reattachment of crystals on the surface of collagen fibrils were observed as the lactic acid concentration increased. 5. Under scanning electron microscope, demineralization of dentin occurred not only independently but also with remineralization simultaneously. In conclusion, the study showed that pH and lactic acid concentration influenced the rate of progression of the lesion in artificial root caries. Demineralization process was progressed from the surface of the cluster of hydroxyapatite crystals and the morphology of hydroxyapatite crystals changed from round or elliptical shape into irregular shape as time elapsed.

유방암의 위와 대장전이

유현아,김은영,서민지,정은,조민정,오현진,장지혜,박지찬,이정의,박석영 이화여자대학교 의과학연구소 2014 EMJ (Ewha medical journal) Vol.37 No.2

Gastric metastasis from breast cancer is rare and only six cases have been reported in Korea. Colon metastasis is more rare than gastric metastasis. We report a 63-year-old woman with gastric and colon metastases of invasive lobular carcinoma of breast. She was diagnosed as right breast cancer, received right modified radical mastectomy 10 years ago and has been treated with chemotherapy and hormone therapy. Investigating for melena and a small caliber of stool, we found gastric and colon metastases. The diagnosis of metastatic breast cancer was made through gross pathologic and immunohistochemistry staining. We report a case with gastric and colon metastases from breast cancer and a review of the associated six case reports in Korea.

공여자의 종류에 따른 간이식 후 감염성 합병증의 비교 : Comparison between Orthotopic and Living Donor Transplantation

기현균,손준성,오원섭,백경란,이남용,김성주,조재원,이석구,송재훈 대한감염학회 2004 감염과 화학요법 Vol.36 No.3

목적 : 최근 간이식 수요가 증가함에 따라 이에 대한 하나의 대안으로 생체 부분 간이식(LDLT) 시행례가 증가하고 있다. 이에 뇌사자 사체 간이식(OLT)과의 감염 양상을 비교하기 위하여 본 연구를 시행하였다. 방법 : 1996년 5월부터 2003년 8월까지 삼성서울병원에서 간이식을 시행 받은 284명의 환자들을 대상으로 후향적으로 분석하였다. 결과 : 188명은 LDLT를, 96명은 OLT를 시행 받았다. 간이식 후 감염증은 총 191명에서 발생하였고(67.0%) OLT 환자군과 LDLT 환자군 사이에 감염증의 발생 빈도와 원인 병원체의 빈도는 유의한 차이를 보이지 않았다. 병원체 별로는 Enterococcus 균정(16.2%) S. aureus(15.1%), coagulase negative staphylococci (13.4%)의 순서였다. 감염증의 종류는 복강 내 감염이 총 83례로 가장 많았는데, LDLT에서 OLT에 비하여 유의하게 높게 발생하였다(34.0% vs 19.8%, P=0.012). 요로 감염증(11.5% vs 4.3%, P=0.022)과 침습성 아스페르길루스증(7.3% vs 1.6%, P=0.034)은 OLT을 시행한 경우에 많았다. 기타 감염증은 통계적으로 유의한 차이가 없었다. 결론 : 간이식 환자에서 공여자의 종류에 따른 감염의 발생빈도는 차이가 없었으나 감염증 중 복강 내 감염은 LDLT에서 더 많이 발생하였다. 장구균 감염, 특히 반코마이신 내성 장구균이 간이식 후 발생하는 감염증의 중요한 원인 병원체임을 확인하였다. Background : Living donor liver transplantation (LDLT) has been performed more frequently to circumvent the shortage of donor organs. However, infectious complications after LDLT compared with orthotopic liver transplantation (OLT) have not been well investigated to date. Methods : We have retrospectively reviewed the medical records of all consecutive cases of liver transplantation, which had been performed at the Samsung Medical Center, Seoul, Korea, from May 1996 to August 2003. Results : Of the 284 patients enrolled, 188 (66.2%) underwent LDLT. Overall incidence of infectious complications after liver transplantation was 67.0% (191/284). Incidence of infections was not different between OLT group (67.7%) and LDLT group (67.0%) (P=0.9). Bacterial infections were the most common infectious complications (146 cases) followed by viral infections (32 cases), fungal infections (26 cases), and tuberculosis (4 cases). Enterococcus spp. (16.2%) were the leading pathogens followed by Staphylococcus aureus (15.1 %) and coagulase-negative staphylococci (13.4%). However, the distribution of etiologic agents was not different between OLT and LDLT group. Intra-abdominal infections (83 cases) were the most common type of infectious complications, which were more frequent in LDLT group (34.0%) than in OLT group (19.8%) (P=O.Ol). Conclusion : LDLT resulted in intra-abdominal infections more frequently than OLT. Enterococcus spp., especially vancomycin-resistant enterococci, are emerging pathogens in patients with liver transplantation.

대상 포진양 배열을 보인 다발성 에크린 나선종 1예

박현제,김문범,장봉석,오창근,장호선,권경술 대한피부과학회 2006 大韓皮膚科學會誌 Vol.44 No.4

최근 10년간 원광의대병원에서 시행한 소아 심장혈관 수술의 임상적 고찰

윤향석,정수미,최두영,오광수,오연균,김종덕,양현웅,이삼윤,김형곤,최종범,최순호,노병석 圓光大學校 醫科學硏究所 1995 圓光醫科學 Vol.11 No.2

We reviewed 10 years experiences of the clinical aspects and early postoperative results in 544 pediatric patients(age less than 16 years old). Among them. 529 cases had the congenital heart diseases, and 15 had the acquired diseases. Open heart surgery was performed in 413 patients. 115 cases were treated with non-open heart surgery. 16 with interventional catheterization. Annual increase of the cardiac patients was not significant in recent 10 years, except slight increase in 1994. The mean age of the study patients had been evidently changed to younger year by year. Total mortality rate of the open heart surgery was 6.4%. The cyanotic congenital heart diseases were high in early postoperative mortality by 25.7%, whereas 4% in acyanotic group. The age group less than one month was most highest in surgical mortality(66.7%). There were no deaths in patients with patent ductus arteriosus(103 cases), atrial septal defect(83 cases) or pulmonary stenosis(17 cases). Among 220 patients with ventricular septal defects(VSD). 10(4.5%) were died early postoperatively. In cyanotic group, the patients with pulmonary atresia with ventricular septal defects(PAVSD), transposition of the great arteries(TGA), interrupted aortic arch(IAA), complex cardiac anomalies with isomerism seemed to be most susceptible to an early death.

Flowable 및 microfill 복합레진으로 충전된 제 5급와동에서 load cycling 전,후의 미세변연누출 비교

강석호,김오영,오명환,조병훈,엄정문,권혁춘,손호현 大韓齒科保存學會 2002 Restorative Dentistry & Endodontics Vol.27 No.2

Low-viscosity composite resins may produce better sealed margins than stiffer compositions (KempScholte and Davidson, 1988; Crim, 1989). Flowable composites have been recommended for use in Class V cavities but it is also controversial because of its high rates of shrinkage. On the other hand, in the study comparing elastic moduli and leakage, the microfil had the least leakage (Rundle et al. 1997). Furthermore, in the 1996 survey of the Reality Editorial Team, microfills were the clear choice for abfraction lesions. The purpose of this study was to evaluate the microleakage of 6 composite resins (2 hybrids, 2 microfills, and 2 flowable composites) with and without load cycling. Notch-shaped Class V cavities were prepared on buccal surface of 180 extracted human upper premolars on cementum margin. The teeth were randomly divided into non-load cycling group (group 1) and load cycling group(group 2) of 90 teeth each. The experimental teeth of each group were randomly divided into 6 subgroups of 15 samples. All preparations were etched, and Single bond was applied. Preparations were restored with the following materials (n=15) : hybrid composite resin [Z250(3M Dental Products Inc. St.Paul, USA), Denfil(Vericom, Ahnyang, Korea)], microfil [Heliomolar RO(Vivadent, Schaan, Liechtenstein), Micronew(Bisco Inc. Schaumburg, IL, USA)], and flowable composite[AeliteFlo(Bisco Inc. Schaumburg, IL, USA), Revolution(Kerr Corp. Orange, CA, USA)]. Teeth of group 2 were subjected to occlusal load (100N for 50,000 cycles) using chewing simulator(MTS 858 Mini Bionix Ⅱ system, MTS Systems Corp., Minn, USA). All samples were coated with nail polish 1mm short of the restoration, placed in 2% methylene blue for 24 hours, and sectioned with a diamond wheel. Enamel and dentin/cementum margins were analyzed for microleakage on a sclale of 0 (no leakage) to 3 (3/3 of wall). Results were statistically analyzed by Kruskal-Wallis One way analysis, Mann-Whitney U-test, and Student-Newmann-Keuls method. (p=0.05) Results: 1. There was significantly less microleage in enamel margins than dentinal margins of all groups. (p<0.05) 2. There was no significant difference between six composite resin in enamel margin of group 1. 3. In dentin margin of group 1, flowable composite had more microleakage than others but not of significant differences. 4. There was no significant difference between six composite resin in enamel margin of group 2. 5. In dentin margin of group 2, the microleakage were R>A=H=M>D>Z. But there was no significant differences. 6. In enamel margins, load cycling did not affect the marginal microleakage in significant degree. 7. In dentin margins, load cycling did affect the marginal microleakage only in Revolution. (p<0.05)

영구형 항서맥 심박조율기 환자의 장기추적관찰

최현석,이무용,최영진,최성준,김효수,손대원,오병희,이명묵,박영배,최윤식,이영우,이명용 대한순환기학회 1998 Korean Circulation Journal Vol.28 No.5

Profile^(Ⓡ), ProTaper™ 및 K^(3TM) Ni-Ti파일의 과기구 조작이 치근단공 변위에 미치는 영향

양현,양인석,황윤찬,황인남,윤숙자,김원재,오원만 대한치과보존학회 2007 Restorative Dentistry & Endodontics Vol.32 No.2

본 연구는 ProFile, ProTaper 및 K^(3)를 이용하여 과잉 기구 조작에 의해 근관 성형 시 근관의 만곡형태와 Ni-Ti 파일의 종류에 따라 치근단공이 어떻게 변위 되는지를 비교 분석하고자 시행되었다. 본 실험에서는 레진모형근관으로 J자와 S자의 근관 형태가 재현된 ENDO-TRAINING BLOC을 사용하였다. 근관 성형 기구로는 ProFile^(®), ProTaper™, K^(3TM)를 사용하였다. 총 60개의 레진모형근관을 사용하였으며, 사용된 레진모형근관 및 Ni-Ti 파일의 종류에 따라 10개씩 6개의 군으로 나누어 근관성형을 시행하였다. 근관 성형 전·후 이미지를 Image-analyzing microscope 100X를 이용하여 얻고 Photoshop 7.0 프로그램을 이용하여 중첩하였다. 이미지 분석 프로그램을 이용하여 근관 성형 전·후 치근단공의 중심으로부터의 직경 변화량과 면적을 측정한 결과 만곡된 근관의 성형시 치근단공이 주로 만곡의 외측으로 변위됨을 나타내며 ProFile이 ProTaper나 K^(3) 보다 통계적으로 유의성이 있게 작은 변화량을 나타내어 근관성형시 바람직한 기구임을 시사한다. This study was done to evaluate transportation of the apical foramen after 0.5 mm overinstrumentation by ProFile, ProTaper and K^(3) in simulated resin root canal. Sixty simulated resin root canal with a curvature of J and S-shape were divided into two groups. Each group consisted of three subgroups with 10 blocks according to the instruments used: ProFile^(®), ProTaper™, and K^(3TM). Simulated resin root canal was prepared by ProFile, ProTaper and K^(3) with 300 rpm by the crown-down preparation technique. Pre- and post-instrumentation apical foramen images were overlapped and recorded with Image-analyzing microscope 100X (Camcope, Sometech Inc, Korea). The amounts of difference in width and dimension on overlapped images were measured after reference points were determined by Image Analysis program (Image-Pro^(®) Express, Media Cybernetic, USA). Data were analyzed using Kruskal-Wallis and Mann-Whitney U-test. The results suggest that ProFile showed significantly less canal transportation and maintained original apical foramen shape better than K^(3) and ProTaper.

치태형성 억제세균과 구강내 세균수와의 관계

양규호,오종석,정현주 大韓小兒齒科學會 1999 大韓小兒齒科學會誌 Vol.26 No.3

소아의 구강으로부터 분리한 비수용성 글루캔 형성 억제세균의 Streptococcus mutans 치태 형성에 대한 억제 정도와 분리 세균속의 타액내 농도가 전체 세균의 농도에 미치는 영향을 본 결과 다음과 같은 결과를 얻었다. 구강으로부터 분리한 비수용성 글루캔 형성 억제세균의 효과를 비커 와이어 검사로 본 결과,교정용 와이어상에 형성된 치태의 무게가 Streptococcus mutans 단독배양시 152mg에서 Enterococcus durans,Lactobacillus acidophilus,Streptococcus oralis와의 혼합배양시 각각 4mg,78mg,72mg으로 감소되였다.Streptococcus mutans의 생균수는 단독배양시 ml당3.6×10×10 개에서 Enterococcus durans,Lactobacillus acidophilus,Streptococcus oralis와의 혼합배양시 각각 ml당 1.4×10 ,5.6×10 ,3.8×10 으로 감소하였다.소아로부터 얻은 타액을 BHI agar에 접종하였을 때의 생균수는 4.8×10 에서 1.3×10 이었으나,이러한 전체 세균의 농도는 타액내 Enterococcus, Lactobacillus, Streptococcus mutans를 억제하는 Streptococcus의 농도와 관련이 없었다. 이상의 결과를 종합하면 소아의 구강으로부터 분리한 비수용성 글루캔 형성 억제 세균의 Streptococcus mutans 치태 형성에 대한 억제는 Streptococcus mutans의 증식을 억제하여 일어났으며, Enterococcus,Lactobacillus,Streptococcus mutans를 억제하는 Streptococcus의 구강내 농도는 구강 즉 타액내 전체 세균의 농도에 영향을 미치지 않았다. The inhibitation degree of the isolated on plaque formation of Streptococcus mutans,and the effect of these bacterial genus on the concentration of total bacteria in saliva were assessed with the following. The effectiveness of the isolated on the inhibitation of plaque formation was assessed culturing Streptococcus mutans in the beaker with orthodotic wires.The mean weight of plaque produced on a wire was 152mg in the culture of Streptococcus mutans only,whereas being reduced to 4mg,78mg,or 72mg in the combined culture of Streptococcus mutans and Enterococcus durans,Lactobacillus acidophilus,or Streptococcus oralis.The colony forming units(CFU) of Streptococcus mutans were 3.6×10 per ml in the culture of Streptococcus mutans,only,wheras 1.4×10 , 5.6×10 ,or 3.8×10 per ml in the culture of Streptococcus mutans and Streptococcus mutans and Enterococcus durans,Lactobacillus acidophilus,or Streptococcus oralis.When saliva from children was 4.8×10 to 1.3×10 per ml of saliva.The concentration of Enterococcus durans,Lactobacillus or Streptococcus inhibiting Streptococcus mutans in saliva was not proportioned to that oh total bacteria replicated on brain heart infusion agar. These results indicate that the isolated bacteria inhibited the replication of Streptococcus mutans,resulting into inhibiting the formation of plaque,but the concentration of Enterococcus,Lactobacillus,or Streptococcus inhibiting Streptococcus mutans,in saliva might not affect the total bacterial concentration of saliva.