출생 시 발생한 특발성 치은섬유종증

이효설,최형준,최병재,손홍규,이제호 大韓小兒齒科學會 2008 大韓小兒齒科學會誌 Vol.35 No.4

치은섬유종증(Gingival fibromaotsis)은 치은조직의 섬유성 증식을 나타내는 드문 구강질환이다. 원인은 명확히 규명되지 않았으나 상염색체 우성 또는 열성의 유전성이거나 특발성일수 있다. 주로 영구치 맹출 시기에 나타나기 시작하나, 드물게 유치열기나 출생시부터 이환되는 경우도 있다. 치은은 서서히 증식하여 치아의 해부학적 치관부위를 덮거나 구개 변이를 일으켜 혀 운동장애를 야기하거나 입술 폐쇄를 방해하기도 한다. 이 증례의 환아는 14개월 된 여아로 출생 시부터 계속딘 치은증식을 주소로 내원하였다. 특별한 가족력이나 의학적 병력은 없었고, 임상 유전검사 결과 알려진 어떤 증후군으로 진단되지 않았으나, 신체발달이 지연되어 있었다. 펀치 생검을 하였으며, 조직검사명은 치은섬유유종증이었다. 가족력이 없어 특발성 치은섬유종증으로 진단하였다. 환아의 연령 및 전신 상태를 고려해 치은 절제술 등의 외과적 치료는 연기하기로 하였다. Gingival fibromatosis is a rare condition characterized by varying degrees of gingival hyperplasia. Gingival fibromatosis usually occurs as an isolated disorder or can be associated with a variety of other syndromes. It usually appears at the time of eruption of permanent dentition but, can develop at the time of eruption of the primary dentition and rarely at birth. It may deform palatal contour and subsequently restrict the tongue movement, resulting in interference during speech and mastication. In addition, it incapacitates maintenance of normal lip closure. A 14-month-old girl visited the department of pediatric dentistry, Yonsei University Dental Hospital, for the congenital gingival overgrowth. There was no one in the family, who showed similar pattern of gingival growth. The intraoral clinical examination revealed generalized severe enlargement throughout the maxillary and the mandibular arches. Enlarged gingival tissue was pink and had firm consistency. She was referred for chromosomal analysis, which confirmed absence of any known syndrome. Under local anesthesia, "Punch-biopsy" was performed on the labial area, and the specimen was histologically diagnosed as gingival fibromatosis. For she did not have any medical problem nor familiar history, she was diagnosed as having idiopathic gingival fibromatosis. Regarding her age and behavior, close follow-up was decided.

치아종을 동반한 선천적 결손된 유견치의 공간

이정은,이제호,최형준,김성오,송제선,손흥규,최병재 大韓小兒齒科學會 2010 大韓小兒齒科學會誌 Vol.37 No.2

치열궁에서 공간이 상실되는 것은 악궁내 치아의 고유한 위치에 변화가 생겼을 때 인접 근육들간의 힘의 균형이 변함으로써 치아의 위치이동이 나타나게 되어 발생한다. 공간의 상실을 일으키는 원인으로는 인접면 우식증이나 조기 발거, 치아의 선천적 결손, 왜소치 등이 있는데, 그 중에서 치아의 선천적 결손은 유치열기에서는 영구치열기에 비하여 매우 낮은 빈도를 보이며 계승 영구치의 결손과 높은 관련성이 있다. 선전적 결손은 유측절치에서 호발하며 하악보다 상악에서 자주 발생하는 것으로 보고되었지만, 유견치에서는 드물게 나타난다. 유치의 선천적 결손은 악궁 내에서 인접치아의 경사 및 계승치를 위한 공간의 상설, 악궁 장경의 감소로 인한 치열궁 협착 등과 같은 공간문제를 야기시킬 수 있다. 이 증례는 연세대학교 치과대학병원 소아치과에 내원한 유치열기 어린이에서 상악 우측 유견치의 선천적 결손과 그 부위의 치아종이 있는 악궁의 공간에 대하여 관찰한 것이다 2년 10개월 동안의 정기검사에서 상악 우측 유견치 부위의 콩간 상실은 없었으며 정중선변위나인접치의 근심 경사, 치아종으로인한 임상및 방사선학적 증상등을보이지 않았다 주기적인 관찰을 통해 치아종이 측절치나 견치의 맹출을 방해하거나 주변으로 낭성변화 등의 합병증이 발생하지 않는다면 측절치나 견치의 맹출시기에 치아종을 외과적으로 제거할 예정이며, 상태에 따라 공간유지장치 또는 교정치료가 필요할 수 있을 것으로 생각한다. Space loss of dental arch can appear when the proper position of teeth within the dental arch changes by a certain cause, because the balance of force makes changes about tooth position as well as alignment, The causes of space loss include proximal caries, early extraction, congenital missing of a tooth and hypodontia, etc. Among those causes of space loss, congenital missing of a tooth is more rarely observed in the primary dentition than in the permanent dentition. Congenital missing in the primary dentition is associated with that in the permanent dentition. Furthermore, it can cause space problem, such as mesial tilting or drift of adjacent teeth, space loss for permanent successors and dental arch constriction, etc. Primary lateral incisors is the most commonly involved, in the maxilla rather than in the mandible, but primary canine is rarely reported. In this patient, who visited the department of pediatric dentistry at Yonsei university dental hospital. it was observed that the maxillary right primary canine was congenitally missing and an odontoma was found insteadly. However, neither the space loss for the congenitally missing primary canine nor midline deviation is remarkable during the 2-year-10-month observation period. In addition, any clinical or radiographical symptom did not occur in spite of odontoma. Therefore, surgical enucleation of odontoma is planned according to the eruption of permanent lateral incisor or canine, unless eruption failure of permanent lateral incisor or canine nor cystic change around the odontoma is occurred. Through further evaluation, space maintainer or orthodontic treatment may be necessary.

지각된 정구 수행 결과에 의한 귀인과 정서적 반응

이동재,김형준 群山大學校 1996 論文集 Vol.23 No.-

The purpose of this study were to find out causal relationship in the influence of perceived success and failure outcomes on sequencing achievement according to achievement motivation, attribution elements, attribution dimensions, emotion in soft tennis players. For this purpose this study took a regression by testing respectively above attribution patterns. To measure multi-dimension the attribution patterns according to achievement motivation in prior study, this study tried to explain rather comprehensive attribution course by measuring the casualty, stability, internal/external control as well as effort, ability, task difficulty and incident which is attribution elements. This study separated the players into groups according to their perception of success and failure, focusing on the individual interactions to clarify causal attribution. The finding were as follows: In case of success-perceived highschool players, task difficulty affects satisfaction, External control affects pried. In case of failure-perceived high school players, attribution dimension affects stability, internal control, external control except for causality. Futhermore, ability-attributed players affect shame, causality-attributed players affects mostly inferiority.

진행성 위암에 동반된 위 칸디다증 1예

이두영,김성호,선제형,박진석,손존광,선홍주,이승,박찬국 朝鮮大學校 附設 醫學硏究所 2004 The Medical Journal of Chosun University Vol.29 No.2

Gastric candidiasis is an uncommon disorder. It is an opportunistic pathogen in immune compromised individuals, alcoholics, persons treated with broad-spectrum antibiotics, immunosuppressive and chemotherapeutic agents. Besides, the use of drugs that reduce the gastric acid production may be a cause of gastric candidiasis. We experienced a case of gastric candidiasis following advanced gastric adenocarcinoma. A 85-year-old woman was admitted to our hospital because of epigastric soreness. Endoscopic findings revealed a large ulcero-infiltrating mass with yellow exudate at cardia of the stomach, which suggested an advanced gastric cancer. Endoscopic biopsy revealed spores and pseudohyphae infiltrating through the ulcerated stomach wall, diffuse infiltration of tumor cells and abortive tumor glands. After treatment with fluconazole 100 mg daily for 21 days, no evidence of the gastric candidiasis was seen on endoscopic biopsy and pathologic findings. The case is herein reported of gastric candidiasis following advanced gastric adenocarcinoma along with a review of corresponding literature.

패턴 Top Rounding 효과를 고려한 패턴 붕괴 전산모사

이형주,박준택,오혜근 한양대학교 이학기술연구소 2002 이학기술연구지 Vol.5 No.-

패턴의 선폭이 100 nm 이하로 작아짐에 따라 발생하는 패턴의 붕괴 현상은 반도체생산과 수율에 많은 영향을 미친다. 패턴 붕괴 현상은 리소그래피 과정 중 현상 후 세척액을 건조하는 과정에서 주로 발생하며 세척액의 표면장력에 의한 모세관 현상이 주된 원인으로 알려져 있다. 패턴 붕괴 현상을 시뮬레이션하기 위하여 패턴이 세척액에 외해서 균일한 압력을 받을 때와 집중 압력을 받을 때의 역학적 모델을 세우고 각각의 모델을 통하여 선폭과 패턴간의 거리에 따른 임계 높이/선폭비 (aspect ratio)를 계산하여 실제 실험 결과와 일치하는 모델을 선정하였다. 시뮬레이션 결과 패턴의 top 부분이 둥근 (rounded top) 패턴이 각진 (flat p) 패턴에 비해 변형이 줄어들 수 있다는 것을 확인할 수 있었다. The pattern size is reduced as the device is more integrated. The resist deformation phenomenon has been a serious problem under 100 nm line width pattems. The most applicable model for an existing empirical result is chosen to create a simulation tool by comparing the two mechanical models when a pattern receives a distributed pressure or a concentrated pressure from the rinse liquid. Based on the chosen model, the critical aspect ratio with respect to line width and space can be calculated. The simulated results show that the pattern collapse phenomenon is reduced for a rounded top resist profile rather than for aflat top profile

잔존 봉합사에 의해 발생한 점액종

이제호,최병재,서원건,최형준 大韓小兒齒科學會 1999 大韓小兒齒科學會誌 Vol.26 No.4

점액종이란 소타액선 분비관의 폐쇄 또는 파열로 인한 타액의 저류로 나타나는 종창에 대한 임상적인 용어이다. 점액종은 조직학적으로 삼출형과 잔류낭종형으로 분류되어, 삼출형은 외상등으로 소타액선 분비관이 파열된 후 점액이 조직내로 유출되어 조직간격에 고여있는 상태이기 때문에 상피 피복을 볼 수 없고 낭종벽은 육아조직으로 둘러싸여있다. 그리고 잔류낭종형은 소타액선 분비관이 작은 타석에의해 폐쇄되거나 분비관 주위 반흔조직의 협착으로 발생하며 낭종강은 원주상피 또는 위중층 편평상피로 피개되어있다. 본 증례는 3년전 하순의 열창 치료를 위해 봉합된 후 발사되지 않은 silk 봉합사에 의해 발생한 점액종의 치험례로, 발사되지 않은 봉합사가 하순 소타액선의 분비관을 관통하여 파열시켜서 점액이 결체조직으로 유출되어 점액종이 발생하였다. Mucocele is clinical term used to describe swelling caused by the pooling of saliva at the site of a severed or obstructed minor salivary gland duct. Mucoceles are categorized into two subgroups, extravasation type and retention cyst type. The etiology of extravasation type mucocele is related to mechanical trauma to the minor salivary gland excretory duct, resulting in extravasation of mucus into the fibrous connective tissue so that a cystlike cavity is produced, but the epithelial lining is absent. Retention cyst type mucocele results from obstruction of minor salivary gland excretory duct, and cystic cavity is lined by epithelial cells. This case report presents a mucocele occurred on the lower lip, and caused by suture silk unremoved for 3 years. Suture silk penetrated and tore the minor salivary gland duct on the lower lip with subsequent extravasation of mucus into the fibrous connective tissue.

치아 이상의 발생 빈도와 양상에 관한 연구

이제호,손홍규,전승준,최형준 大韓小兒齒科學會 1996 大韓小兒齒科學會誌 Vol.23 No.2

An object definition of the anomaly is not avaliable and most investigators define the term differently or fail to describe their criterion.Because dental anomaly may lead to many complications,early detection and diagnosis of dental anomalies are essential steps in the evaluation of the child patient and in treatment planning.These procedures require detailed medical and dental histories,through clinical examination and the use of radiographs.So,this study was designed to find out the prevalece of dental anomalies.The clinical and roentgenographic examination was undertaken for 8,054 children at age from 0 to 15 years and statistical analysis was done.The results were as follows: 1.Among the examined subjects 2,134 subjects(26.5%) showed dental anomalies.The prevalance of individure dental anomalies were as as follows:Supernumerary teeth 15.6% congenitally missing teeth 6.6%,fusion 2.2%,odontoma 0.35%,microdontia 1.2%,macrodotia 0.05%,gemination 0.22%,talon cusp 0.36%,dens evaginatus 0.24%,dens invaginatus 0.15%,dilaceration 0.27%,taurodontism 0.09%,abnormal tooth position 1.7%,natal $ neonatal teeth 0.92%,amelogenesis imperfecta 0.01%. 2.Significant correlations between the groups with individual dental anomalies were as follows:between groupⅠand other groups,there was nagative correlation,especially groupⅠ and groupⅡ.And the correlation coefficient between male and female showed differences. 3.For the supernumerary teeth group,the prevalence of male was higher than female(p<0.001).While for the congenitally missing teeth,macrodontia,microdontia,abnormal tooth position group,the prevalence of female was greater than male(p<0.001). 4.For the congenitally missing teeth group,the mandibular primary lateral incisor showed the highet incidence in primary dentition,while mandibular lateral incisor in permanent dentition.In the mandible(72.5%),this site showed higher prevelence than in maxilla.In this case with deciduous congenitally missing teeth,the prevelence of successive permanent congenitally missing teeth was about 33.9%,the incidence was highet in mandibular lateral incisors. 5.Most supernumerary teeth existed on middle area and showed inverted position and unerupted state.In addition,supernumerary teeth showed higher incidence on maxilla(99.3%). 6.In the case with deciduous fused teeth,the prevelence of successive permanent congenitally missing teeth was 39.9%,while that of successive permanent fused teeth was 2.7%.And the highet rate of the prevalence(40.3%) appeared in fusion of mandibular deciduous lateral incisor and canine. 7.In the case of odontoma,the prevelence was higher in maxilla(78.6%) and anterior region(82.7%) the mandible and posterior region.

공기 정압 저어널 베이링에서 동강성 측정에 관한 실험적 연구

이종렬,이준석,이득우,김태형,박보선 한국공작기계학회 2001 한국공작기계학회 춘계학술대회논문집 Vol.2001 No.-

This paper has been presented the dynamic effect by the journal speed, eccentricity and source positions in order to overcome the defects of air bearing such as low stiffness and damping coefficient. Choosing two row sources position of air bearing is different from previous investigations in the side of pressure distribution of air film by the wedge effects. An experimental study was performed to compare theoretical analysis. The dynamic stiffness was measured in actual cutting. It helps predicting of air spindle's characteristic in machining of die more precisely. The results of investigated characteristics was applied to air spindle for high speed milling.

수종 치과재료의 제I급 와동에서의 변연 누출에 관한 실험적 연구

이선희,손흥규,최형준 大韓小兒齒科學會 1996 大韓小兒齒科學會誌 Vol.23 No.1

Microleakage is a problem of all filling materials of losted teeth structure and is clinically undetectable. Because marginal leakage may be responsible for pulp irritation, pulp inflammation, necrosis and recurrent caries, it is essential to prevent and control it. For the evaluations of microleakage of various class I filling materials, 175 extracted teeth were filled with amalgam, light curing composite resin, glass inomer cement, IRM and Fermit-N. After thermocycling, speciemens were placed in 1% methylene blue dye solution for 24 hours in an incubator set 37℃. The teeth were sectioned at filling body center and margin and degree of dye penetration was observed with a stereomicroscope. The following results were obtained. 1. Light cured composite resin has the excellent results and microleakage is increased in the order of amalgam, IRM, Fermit-N, glass ionomer cement.(SAS-6.0 system) and there was a statistically significancy in marginal leakage for each filling materials.(Kruskal-Wallis analysis, P<0.05) 2. Microleakage of the center and margin was statistically insignificant (Mann-Whitney analysis P<0.05) 3. There was less microleakage for amalgam than light cured composite resin but was statistically insignificant (Mann-Whitney analysis, P<0.05) and also showed less marginal leakage for Fermit-N compared to glass ionomer cement but also was statistically insignificant. (Mann-Whitney analysis, P<0.05).

상악 정중부에 역위 매복된 과잉치의 악골 내 이동

이석우,이제호,김성오,최형준,손홍규,최병재 大韓小兒齒科學會 2008 大韓小兒齒科學會誌 Vol.35 No.4

과잉치는 상악 정중부에서 주로 발견되며,과잉치의 발생 기전은 유전적 또는 환경적 원인에 의하여 치배 형성기 동안에 정상 치판의 비정상적 증식에 의한 것으로 보고되었다. 과잉치로 인한 합병증으로는 인접 영구치의 맹출 장애와 전위,회전,정중이개,비강으로의 맹출,낭종 형성 등 이 있다. 과잉치를 외과적으로 발거하기 위한 시기에 대해서는 논란이 되고 있다. 인접치의 배열과 맹출 장애,전위를 야기할 수 있기 때문에 조기에 발거하자는 견해와 어린이의 행동 조절 및 인접 영구치의 치근 형성 정도를 고려하여 8~l0세 이후에 발거 하자는 견해가 있다. 후자와 같이 외과적 발거 시기를 연기할 경우,역위 및 수평 매복된 과잉치는 악골 내에서 비강 또는 경구개,소구치 부위 등으로 이동할 수 있으며,과잉치의 이동과 전상악골의 수직고경 증가로 인하여 외과적 발거 시 난이도가 높아질 수 있다. 따라서,역위 및 수평 매복된 과잉치의 외과적 발거 시기를 결정하기 위하여 연기하는 경우에 과잉치의 악골 내 이동을고려해야한다. 이 증례는 상악 정중부에 역위 매복된 과잉치가 있어서 내원한 6~7세의 어린이에서 과잉치의 외과적 발거 시기를 결정하기 위하여 주기적인 방사선 학적 검사로 관찰하던 중에 2~3년 후 과잉치 위치가 악골 내에서 초진 시 위치로부터 이동된 경우로 이를 보고하는 바이다. Supernumerary teeth are frequently found in the anterior portion of the maxilla and develop as a result of abnormal proliferation of the dental lamina during tooth germ formation, caused by genetic or environmental factors. They may result in various complications, such as eruption interference, displacement, rotation of adjacent teeth, diastema, eruption into the nasal cavity, and development of dentigerous cyst. The optimal time for surgical extraction of supernumerary teeth has been a controversial issue. Someone prefer early surgical extraction because supernumerary teeth can cause eruption interference and displacement of adjacent teeth, eventually altering occlusion. Others prefer to delay surgical extraction until 8~10 years of age in consideration of root maturation of the adjacent teeth and also patient's behavior. When surgical extraction of supernumerary teeth is postponed, there is possibility that impacted supernumerary teeth in the inverted or horizontal position move toward the nasal cavity, hard palate, or premolar area. When such intraosseous tooth migration is combined with the vertical growth of the maxilla. surgical approach becomes even harder. Therefore, possibility of intraosseous tooth migration should be considered as an important factor when deciding appropriate time for surgical extraction. We are presenting cases of mesiodens which showed intraosseous migration during 2~3 years of follow-up period since the first diagnosis had been made at the 6~7 years of age.