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        후방골절단술과 Skeletal anchorage system를 이용한 사악구치부압하 : 증례보고 CASES REPORT

        임광수,풍무걸,김기형,이희철,김우형,김동우 대한악안면성형재건외과학회 2002 Maxillofacial Plastic Reconstructive Surgery Vol.24 No.1

        The severe extrusion of the maxillary [post.teeth after the early loss of the mandibular post.teeth makes the fabrication of the mandibular prothesis difficult, and without proper planning.the treatment results are often unsatisfactoy. Several treatment modalitys have been introducted to correct the interarch space deficency.:Reduction the occlusal surfaces,Crown lengthening,Endodontics & restorative approach,Extraction, Orthodontic intrusion and segmental osteotomy. Because of many advantages,conservative method is widely used if it has no particular limits of treatment adjustment, but the cases of surgical correction indication are found in clinical experience. In our clinic,we corrected severe extruded maxillary post.teeth by performance of a unilateral posterior osteotomy with superior repositioning of the segment and orthodontic intrusion using Skeletal anchorage system,so here we reported the cases with a study of documents.

      • 배추 시스테인 단백질 분해 효소 억제 유전자 BCPI-1의 발현과 종자 발아 및 유묘 생장과의 연관성

        홍준기,이은영,김정률,양경애,최영주,정우식,김호일,윤대진,이상열,조무제,임체오 Plant molecular biology and biotechnology research 2003 Plant molecular biology and biotechnology research Vol.2003 No.-

        Phytocystatins are protein inhibitors of cysteine proteinases of the papain family that have been identified in both monocot and dicot plants. A cDNA encoding a phytocystatin, BCPI-1 (Brassica Cysteine Proteinase Inhibitor-1) has been isolated from Chinese cabbage (Brassica campestris L. ssp. pekinensis) flower buds. Here, we tested whether BCPI-1 transcription is regulated by hormones, and could be involved in regulating cysteine proteinases during and after germination. BCPI-1 was sensitive to exogenous GA_(3) and ABA, which are important factors controlling seed germination, suggesting that the expression of BCPI-1 is hormonally regulated. We introduced a recombinant plasmid containing the full-length BCPI-1 cDNA under the control of cauliflower mosaic virus 35S promoter into rice embryogenic calli using the particle delivery method, and regenerated a number of transgenic rice plants. Constitutively over-expressed BCPI-1 caused changes in overall plant growth and development, including reduced germination and seedling growth. These data support the role of the BCPI-1 in the regulation of endogenous proteinases during both seed germination and subsequent seedling development. Phylocystatins은 papain계열의 cysteine 단백질 분해 효소 활성을 특이적으로 억제하는 억제자로 다양한 식물 종으로부터 분리되었다. 본고에서는, 배추 화아 cDNA library로부터 분리된 phytocystatin인 BCPI-1(Brassica Cysteine Proteinase Inhibitor-1)의 생체 내 기능에 대해 연구하였다. 먼저, BCPI-1 전사체는 발아 조절에 중요한 영향을 미치는 GA₃와 ABA에 의해 예민하게 증가, 혹은 감소되는 반응을 보임으로써, BCPI-1이 식물 호르몬의 영향을 받으며, 특히 발아나 유묘의 생장 조절에 관련이 있음을 알 수 있었다. Particle bombardment 방법을 통하여 BCPI-1을 벼의 배 형성 세포 내에 도입, 재분화 시켜 형질 전환 벼를 생성하였다. CaMV 35S promoter의 조절에 의해 지속적인 BCPI-1 발현을 보이는 형질 전환 벼의 경우, 발아와 유묘 생장이 현저히 지연되었다. 위의 결과들을 바탕으로, BCPI-1이 식물체 내에서 생성되는 cysteine 계열의 단밸질 분해 효소 활성을 조절하여 종자의 발아와 유묘의 생장에 영향을 미치는 것으로 추측한다.

      • 당뇨병과 동반된 화농성 간농양의 임상상 및 예후인자

        오은숙,강무일,이원영,오기원,임동준,이소영,이정민,고승현,김성래,안유배,손현식,윤건호,차봉연,이광우,손호영,강성구 대한당뇨병학회 2000 임상당뇨병 Vol.1 No.1

        연구배경: 감염질환은 혈관질환과 함께 당뇨병의 중요한 사망원인의 하나이며, 혈당조절이 불량할수록 감염 빈도가 증가됨은 잘 알려져 있다. 간농양의 발생이 있어서도 당뇨병은 중요한 기저질환 중의 하나이다. 일반적으로 간농양의 가장 흔한 원인균은 Escherichi coli라고 알려져 있으나, 최근 당뇨병을 가진 간농양 환자에서 Klesiella pneumoniae의 검출이 증가되고 있다. 또 최근 연구에 의하면 K.pneumonie가 간농양의 가장 흔한 원인균이며, K. pneumoniae에 의한 간농양은 K.pneumoniae 이외의 균주에 의한 간농양보다 당뇨병과 밀접히 관련되어 있다고 보고된 바 있다. 이에 저자들은 간농양 환자를 대상으로 당뇨병환자의 빈도를 알아보고, 그 원인균 및 특징을 비당뇨병 환자들의 경우와 비교해 보고자 하였다. 방법: 1992년 1월부터 1999년 6월까지 방사선학적 검사 혹은 수술에 의해 간농양이 확인되거나, 경피적 천자나 수술을 통한 배농액 배양, 혹은 혈액 검사에서 원인균이 증명된 182명의 환자를 대상으로 후향적 임상고찰을 실시하였다. 결과: 화농성 농양을 가진 167명의 환자(남:94명, 여:73명)중 당뇨병을 가진 환자는 54명 (남:30명, 여:24명)으로 32.3%를 차지하였다. 환자의 평균나이는 당뇨군에서 62.1 ± 13.4세, 비당뇨군에서는 55.1 ±15.5세로 당뇨군에서 높았으며(p=0.0021), 남녀간의 평균나이 비교 시 두 군 모두 여성의 나이가 의미있게 높았다. 비당뇨군에 비하여 당뇨군의 경우 저알부민혈증의 빈도와 aspartate transaminase가 증가되어있었다. 원인균주는 K. pneumoniae (당뇨군54%, 비당뇨군 39.1%), E. coli(당뇨군 17.5%, 비당뇨군 18.8%), Pseudomonas aeruginosa, Streptococcus viridans, Enterococcus 순이었으며 두 군간의 의미는 차이는 없었으나 K. pneumoniae의 경우 다른 균종에 비해 단독감염의 빈도가 높았다(82.8%). 사망률은 당뇨군에서 16.7%, 비당뇨군에서 7.1%로 당뇨군에서 의미있게 높았으며(p=0.019), 당뇨군에서의 사망환자는 모두 패혈증이 동반되어 있었다. 당뇨환자의 사망군은 생존군에 비해 당뇨병 이환기간이 길고 혼합감염의 빈도가 높았다(p=0.046). 검사실 소견에서는 총 빌리루빈 및 알카리성 포스파타제의 증가가 관찰되어 있었다. 결론: E. coli가 간농양의 주된 원인균이라는 기존 보고와는 달리 당뇨군과 비당뇨군 모두 K. pneumoniae가 간농양의 주된 원인균이었다. 또한 당뇨 유병기간이 길고 당뇨조절이 불량한 환자에서 혼합감염이며 총 빌리루빈 및 알카리성 포스파타제의 증가등과 같은 위험인자가 존재할 경우 사망률이 증가될 수 있으므로 이들 군에서는 적극적인 치료가 필요할 것으로 사료된다. Background: Liver abscesses are commonly associated with underlying disease, particularly diabete mellitus. The number of the liver abscesses caused by Klebslella pneumoniae in diabetic patient has been increased in Korea nowadays. This study was conducted to clarify the clinical presentation and prognostic factors of pyogenic liver abscesses, especially in diabetic patients and to determine the proportion of K. pneunomiae as a pathogen in liver abscess in Korea. Methods: Medical records of 167 patients treated for pyogenic liver abscess from January, 1992 through June, 1999 were reviewed retrospectively in detail. Major Pathogenic organism, clinical manifestations, prognostic factors, the importance of diabetes mellilus as an underlying disease and its effect on clinical features and prognosis were analyzed. Results: Among 167 cases of pyogenic liver abscess, underlying diabetes mellitus was present in 32.3%. The mean age of patients was 62.7 13.4 years in diabetic liver abscess group and 55.1 15.5 years in non-diabetic liver abscess group. Most liver abscesses were cryptogenic in origin or secondary to the billary tree diseases. The clinical presentations among the two groups were not significantly different. When compared to patients without diabetes, patients with diabetes had significantly higher proportions of hypoalbuminemia and elevated aspartate transaminase level. The most common organism of the pyogenic abscess was K. pneumoniae in both groups. Percutaneous drainage of the abscess with appropriate antibiotics was the most commonly used therapeutic modality in liver abscess. The mortality rate of diabetic liver abscess is 16.1 % and 7.1% in nondiabetic liver abscess. Complications, especially septicemla, were found more frequently in patients with diabetes than in patients without diabetes (64.8% vs 28.3%, septicemia : 31.5% vs 9.7%). The factors influencing mortality in the diabetic liver abscess were disease duration, mixed infection, presence of septicemia, elevated bilirubin and alkaline phosphatase. Conclusions: In contrast to prior report that the E. coli was the most common pathogen in liver abscess, we found that K. pneumoniae was the most common organism cultured in liver abscess. Diabetic patients have more complications and higher mortality than patients without diabetes. Early detection and proper treatment are needed to improve the outcome for diabetic patient with liver abscess.

      • SCIESCOPUSKCI등재
      • Simulation Study on the Efficacy of Toxin Removal by Pulsatile Flow in Blood Purification Systems that use Semipermeable Membranes

        Ki Moo Lim,Eun Bo Shim 대한기계학회 2008 대한기계학회 춘추학술대회 Vol.2008 No.11

        Using numerical models, we investigated the efficiency of toxin removal using pulsatile flow in blood purification systems that use semipermeable membranes. The model consisted of a three-compartmental mass transfer model for the inside body and a solute kinetics model for the dialyzer. The model predicted the toxin concentration inside the body during blood purification therapy, and the toxin removal efficiencies at different flow configurations were compared quantitatively. According to the simulation results, the clearances of urea and β₂ microglobulin (B2M) using a pulsatile pump were improved by up to 30.9% for hemofiltration, with a 2.0% higher urea clearance and 4.6% higher B2M clearance for high flux dialysis, and a 3.9% higher urea clearance and 8.2% higher B2M clearance for hemodiafiltration. These results suggest that using a pulsatile blood pump in blood purification systems with a semipermeable membrane improves the efficacy of toxin removal, especially for large molecules and hemofiltration treatment.

      • KCI등재

        Theoretical Estimation of Cannulation Methods for Left Ventricular Assist Device Support as a Bridge to Recovery

        Lim, Ki Moo,Lee, Jeong Sang,Song, Jin-Ho,Youn, Chan-Hyun,Choi, Jae-Sung,Shim, Eun Bo The Korean Academy of Medical Sciences 2011 JOURNAL OF KOREAN MEDICAL SCIENCE Vol.26 No.12

        <P>Left ventricular assist device (LVAD) support under cannulation connected from the left atrium to the aorta (LA-AA) is used as a bridge to recovery in heart failure patients because it is non-invasive to ventricular muscle. However, it has serious problems, such as valve stenosis and blood thrombosis due to the low ejection fraction of the ventricle. We theoretically estimated the effect of the in-series cannulation, connected from ascending aorta to descending aorta (AA-DA), on ventricular unloading as an alternative to the LA-AA method. We developed a theoretical model of a LVAD-implanted cardiovascular system that included coronary circulation. Using this model, we compared hemodynamic responses according to various cannulation methods such as LA-AA, AA-DA, and a cannulation connected from the left ventricle to ascending aorta (LV-AA), under continuous and pulsatile LVAD supports. The AA-DA method provided 14% and 18% less left ventricular peak pressure than the LA-AA method under continuous and pulsatile LVAD conditions, respectively. The LA-AA method demonstrated higher coronary flow than AA-DA method. Therefore, the LA-AA method is more advantageous in increasing ventricular unloading whereas the AA-DA method is a better choice to increase coronary perfusion.</P>

      • KCI등재

        Computational Quantification of the Cardiac Energy Consumption during Intra-Aortic Balloon Pumping Using a Cardiac Electromechanics Model

        Lim, Ki Moo,Lee, Jeong Sang,Gyeong, Min-Soo,Choi, Jae-Sung,Choi, Seong Wook,Shim, Eun Bo The Korean Academy of Medical Sciences 2013 JOURNAL OF KOREAN MEDICAL SCIENCE Vol.28 No.1

        <P>To quantify the reduction in workload during intra-aortic balloon pump (IABP) therapy, indirect parameters are used, such as the mean arterial pressure during diastole, product of heart rate and peak systolic pressure, and pressure-volume area. Therefore, we investigated the cardiac energy consumption during IABP therapy using a cardiac electromechanics model. We incorporated an IABP function into a previously developed electromechanical model of the ventricle with a lumped model of the circulatory system and investigated the cardiac energy consumption at different IABP inflation volumes. When the IABP was used at inflation level 5, the cardiac output and stroke volume increased 11%, the ejection fraction increased 21%, the stroke work decreased 1%, the mean arterial pressure increased 10%, and the ATP consumption decreased 12%. These results show that although the ATP consumption is decreased significantly, stroke work is decreased only slightly, which indicates that the IABP helps the failed ventricle to pump blood efficiently.</P>

      • Patient-Specific Identification of Optimal Ubiquitous Electrocardiogram (U-ECG) Placement Using a Three-Dimensional Model of Cardiac Electrophysiology

        Lim, Ki Moo,Jeon, Jae Won,Gyeong, Min-Soo,Hong, Seung Bae,Ko, Byung-Hoon,Bae, Sang-Kon,Shin, Kun Soo,Shim, Eun Bo IEEE 2013 IEEE Transactions on Biomedical Engineering Vol.60 No.1

        <P>A bipolar mini-ECG for ubiquitous healthcare (U-ECG) has been introduced, and various studies using the U-ECG device are in progress. Because it uses two electrodes within a small torso surface area, the design of the U-ECG must be suitable for detecting ECG signals. Using a 3-D model of cardiac electrophysiology, we have developed a simulation method for identifying the optimal placement of U-ECG electrodes on the torso surface. We simulated the heart-torso model to obtain a body surface potential map and ECG waveforms, which were compared with the empirical data. Using this model, we determined the optimal placement of the two U-ECG electrodes, spaced 5 cm apart, for detecting the P, R, and T waves. The ECG data, obtained using the optimal U-ECG placement for a specific wave, showed a clear shape for the target wave, but equivocal shapes for the other waves. The present study provides an efficient simulation method to identify the optimal attachment position and direction of the U-ECG electrodes on the surface of the torso.</P>

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