Callus distraction method를 이용한 하악골 신장술 : 계단골절단술식의 적용

김명진,윤필영,신동준,김수경,김종원,김규식 대한악안면성형재건외과학회 2000 Maxillofacial Plastic Reconstructive Surgery Vol.22 No.2

Since callus distraction technique was applied clinically for the correction of dentofacial deformity to the patients with hemifacial dysplasia by McCarthy in 1992, many surgeons have tried to apply this method to the maxillofacial region. But this technique has some drawbacks. One of the disadvantages of this technique is extensive scar formation in the facial area, which is a sequelae of extraoral approach for supraperiosteal dissection of the periosteum overlying the mandible. Recently, we have made an effort to perform this technique through intraoral approaches to prevent scar formation on the submandibular area and modified the design of the osteotomy, that is step osteotomy technique, to increase the raw bone surface on both osteotomized segments. The rationale for the application of this step osteotomy technique is to increase the amount of regeneracted bone and the length of distraction, to avoid damage of inferior alveolar neurovascular bundle, and to increase initial stability of the splitted segments. Step osteotomy procedure can be done with fine micro-osteotomy saw through subperiosteal tunneling. Extraoral pins should be inserted before making the osteotomy. Since 1974 we have applied this technique at 8 sites In 5 patients with mandibular deficiencies: 2 cases of hemifacial microsomia, 1 case of developmental facial asymmetry and 2 cases of mandibular bony defect. Mandibular elongation have been achieved from 12 to 20mm in length. 1 out of 8 site, we experienced non-union in the case of mandibular body defect. Some skeletal relapse and growth retardation phenomenon have been observed in some cases with the longest follow-up of 48 months.

서울의 Penicillinase Producing Neisseria gonorrhoeae 발생빈도(1998)

김재홍,김준호,반재용,이정우,황성주,정준규,정성태,강진문,조흔정,홍창의,정혜신,이한승,김이선,이봉길,이종호,선영우,한기덕,윤성필,이성훈,안종성,박석범,문승현,조항래,김형섭,류지호,황재영,박준홍,손상욱 한양대학교 의과대학 2001 한양의대 학술지 Vol.21 No.1

In recent years, gonorrhea has been pandemic and remains one of the most common STDs in the world, especially in developing countries. For the detection of a more effective therapeutic regimen and assessing the prevalence of Penicillinase Producing Neisseria gonorrhoeae(PPNG), we have been trying to study the patients who have visited the Venereal Disease Clinic of Choong-Ku Public Health Center in Seoul since 1980 by menas of the chromogenic cephalosporin method. In 1998, 93 strians of N. genorrhoeae were isolated, among which 60(64.5%) were PPNG. The prevalence of PPNG in Seoul, which had been decreased to 39% in 1996 after a peak of 74.3% in 1993, is increased to 64.5% in 1998.

분편 인플루엔자백신(split influenza vaccine)의 임상효과 및 면역원성에 관한 연구

우흥정,김동림,정희진,천병철,이주연,안정배,김지희,박찬,신영규,김우주,김민자,박승철 대한화학요법학회 1999 대한화학요법학회지 Vol.17 No.1

목적 : 아단위 인플루엔자 백신 접종 후 백신의 인플루엔자 예방효과, 인플루엔자 방어 항체형성, 인플루엔자 백신의 안전성을 조사하고자 하였다. 방법 : 총 571명을 대상으로 인플루엔자 백신 접종을 하였고, 이들 접종자에서 인플루엔자 양질환의 이환을 조사하여 인플루엔자 백신의 인플루엔자예방효과를 알아보았고, 백신의 접종 전 및 접종 4주 후 혈청에서 혈구응집억제물(Hemagglutination Inhibition : HAI) 항체 검사를 실시하여 백신의 방어항체생성을 조사하였고, 백신의 안전성을 알아보기 위해 백신접종 후 1주일 이내의 부작용을 조사하였다. 결과 :백신 접종군과 백신 비접종군에서 인플루엔자 양 질환의 이환을 조사한 결과 접종군 28.35%, 비접종군 35.88%으로 나왔으며, p 값이 0.001로 통계적으로 접종군에서 유의하게 낮았고, 인플루엔자 양 질환의 예방 효과는 20.97%를 보였다. 백신의 방어항체 형성의 평가를 위해 유럽의 인플루엔자 백신 허가 기준을 조사하였는데 B/Guangdong/5/94균주의 백신접종 후 항체가 40이상의 비율을 제외한 다른 기준은 모두 만족 시켰다. 부작용은 전체 조사자 521명중 149명(29%)으로 주로 접종 부위의 국소 부작용을 호소했고, 전신 부작용은 2% 내외였으며 특별히 심각한 부작용은 발견되지 않았다. 결론 : 분편 인플루엔자 백신은 인플루엔자양질환의 예방과 방어항체생성에 효과 있으며 안전한 것으로 사료된다. Background : The safety and effectiveness of influenza vaccine are well known in developed country. The influenza vaccination has been recommended as one of the tentative immunization schedule for indicated persons since 1997 in Korea. But there are still no available data about them, even though nearly 5 million doses of influenza vaccine were used in 1997-1998 season. So it is immediately needed to investigate the safety. efficacy and immunogenicity of influenza vaccine among Korean. Methods : We studied the clinical efficacy of influenza vaccine by monitoring Occurrence of influenza-like illness in influenza risk group(vaccination ; 300, non-vaccination; 215) from December in 1997 to March in 1998. We used the split quadrivalent influenza vaccine containing 15 microgram of hemagglutinin of A/Beijing/262/95(HlNl), A/Wuhan/359/95(H3N2), B/Mie/1/93 and B/Guangdong/5/94. Hemagglutination inhibition(HA1) antibody titers were determined before immunization and 1 months after vaccination And we evaluated adverse effect of influenza vaccination at 7 days after vaccination. Results : Influenza vaccination was associated with si@icant reductions in influenza-like spptoms(vaccination group; 28.35%, non-vaccination group, 35.88%, p=0.001). The preventive effect of influenza-like i3lne.s among influenza risk goup was 20.97%. And immunogenicity of influenza A and B exceeded all of the European licensure criteria for immunogenicity except postvaccination proportion of titers 240 of B/Guangdong/5/94 strain. And the adverse effects were mainly local injection site problem and no serious adverse effect was noted. Conclusion : Split influenza vaccine is safe, inmunogenic and eff'tive in influenza risk group in Korea.

모 제약회사 근로자들의 직업성 천식 유병률과 약제 분말 노출수준

오성수,최용휴,김은아,이영목,장재길,유장진,박승현,김태균,정수영,김규상,강성규 大韓産業醫學會 2006 대한직업환경의학회지 Vol.18 No.2

목적: 제약회사에서 직업상 천식의 유병 규모를 파악하고 작업공정에 대한 작업환경 측정을 통해 제약회사의 약제 분말에 대한 노출수준을 평가하고자 하였다. 방법: 제약회사에서 약제 분말에 노출되는 근로자를 대상으로 천식을 선별하기 위하여 설문조사 및 진찰, 혈액검사, 폐기능 검사 그리고 피부단자시험을 실시하였고, 각 부서별 공정에 따라서 총분진과 항생제 또는 효소제 분말에 대한 작업환경 측정을 실시하였다. 직업상 천식이 의심되는 근로자에 대하여 기관지과민성에 대한 검사(메타콜린을 이용한 비특이 기관지유발시험)와 약제 분말 기관지유발시험을 실시하여 확진하였다. 결과: 설문조사 및 진찰에서 작업 관련 천식 증상이 있는 근로자는 11명(34.4%)이었고, 약제 분말을 이용한 피부단자시험에서 1+ 이상 반응을 보인 근로자 10명(31.2%)이었다. 비특이 기관지유발시험 결과 8명(25.0%)이 양성(PC20 ≤16 mg/ml)이었다. 약제 분말 기관지유발시험을 통해 직업상 천식으로 확진된 근로자는 5명(15.6%)이었다. 작업환경 측정에서 원료를 충진하거나 투입하는 작업 그리고 정립작업에서 약제 분말에 대한 노출이 많았다. 결론: 제약회사에서 직업상 천식은 주로 제조공정 중 약제 분말에 노출된 근로자에서 발생하여, 증상 및 직업성 천식의 유병률이 높았다. 따라서 원료를 충진 또는 투입하는 작업과 정립작업 등 제조과적에서 약제 분말 노출을 줄이기 위한 세심한 주의가 필요하여, 약제 분말을 취급하는 근로자에 대해서는 천식 증상 조사뿐 아니라 정기적으로 피부단자시험, 비특이 기관지유발시험 등을 실시하여야 할 것이다. Objectives: After the investigation of one worker with occupational asthma, we surveyed the preva- lence of occupational asthma and the exposure level of pharmaceutical dust of 32 workers in a pharmaceutical company. Methods: Thirty-two of the 90 employees participated in the survey which consisted of questionnaire, blood sampling, spirometry and skin prick tests with 8 common allergens as well as 9 antibiotics and 2 enzymes. Various indices of the working environment were also measured. Subjects who had a symptom suggestive of work-related asthma or positive skin prick test were further investigated by PC20 methacholine. Nine subjects who had a PC20 result of 16 mg/ml or less (n=7) or had work-related symptoms and positive skin prick test (n=2) were referred to undergo a specific bronchial provocation test to phar- maceutical dust in an academic allergic disease center. Results: Eleven of 32 workers (34.4%) had a work-related symptom suggestive of occupational asthma. Ten (31.2%) showed positive skin prick test. 8 (25.0%) had a PC20 result of 16 mg/ml or less (indicative of significant bronchial hyperresponsiveness), and 5 (15.6%) had a positive result on the specific bronchial provocation test. Exposure levels of stuffing, input of raw materials and screening process were relatively high. Conclusions: This survey showed that pharmaceutical workers have an increased risk of occupational asthma. Although pharmaceutical factories maintain a relatively good working environment, careful control of respiratory tract exposures, especially during stuffing, input or raw materials and screening process, is important to prevent occupational asthma. Pharmaceutical workers need to undergo regular skin prick and methacholine bronchial provocation tests, as well as asthmatic symptom survey, to ensure the early detection and prevention of occupational asthma.

한의진단명과 진단요건의 표준화 연구 II (표준화 실례) : 2차년도 연구결과 중간 보고

양기상,최선미,최승훈,안규석,박경모,박종현,김성우,신승호,정우열,전병훈,고현,김정범,신상우,김성훈,김동희,권영규,엄현섭,장혜옥 한국한의학연구원 1996 한국한의학연구원논문집 Vol.2 No.1

The diagnostic requirements were suggested and explained regarding the systems of differentiation of symptoms and signs in the second year study of standardization and unification of the terms and conditions used for diagnosis in oriental medicine. The systems were as follows; - differential diagnosis according to condition of body fluid, differentiation of syndromes according to the state of qi and blood, differential diagnosis according to relative excessiveness or deficiency of yin and yang(氣血陰陽津液辨證) - differentiation of diseases according to pathological changes of the viscera and their interrelation - analyzing and differentiating of febrile diseases in accordance with the theory of the six channels(傷寒辨證) The individual diagnosis pattern was arranged by the diagnostic requirements in the following order : another name(異名), notion of diagnosis pattern, index of differentiation of symptoms and signs(辨證指標), the main point of diagnosis, analysis of diagnosis pattern(證候分析), discrimination of diagnosis pattern(證候鑑別), a way of curing a diseases(治法), prescription(處方), herb in common use(常用藥物), diseases appearing the diagnosis pattern(常見疾病), documents(文獻調査). This study was carried out on the basis of the Chinese documents and references.

기계적 협착부를 갖는 근관에서 Root-ZX 의 정확도에 관한 연구

김병현,이영규,김용식 大韓齒科保存學會 1999 Restorative Dentistry & Endodontics Vol.24 No.4

소음 특수건강진단에서의 순음청력검사 방법 및 평가의 적정성 : 청력정도관리 순음청력검사 자료를 중심으로

김규상,김소연,조영숙,정호근 대한산업의학회 2001 대한직업환경의학회지 Vol.13 No.3

목적 : 이 연구는 각 특수건강진단기관의 소음 특수건강진단에서 소음성 난청을 판단하는데 가장 중요한 청각도(audiogram) 등의 자료를 통해 2차 소음 특수건강진단 대상자 선정의 적정설, 순음청력검사방법의 적정성 및 판정의 적정성을 평가하였다. 방법 : 1997년의 청력전도관리의 소음 특수건강진단의 자료 평가 대상기관인 48개 특수건강진단기관에서 1998년 하반기에 특수건강진단을 실시한 근로자수 100-500인 규모의 특수건강진단기관당 사업장 1곳의 특수건강진단 결과표, 소음 특수건강진단 개인표, 2차(정밀) 소음 특수건강진단 대상자의 순음청력검사 자료를 제출받아 2차 소음 특수건강진단 대상자 선정의 적정성, 순음청력검사방법의 적정성 및 판정의 적정성을 분석 평가하였다. 대상자 선정의 적정성은 1999년 현재 2차 건강진단 대상자 건별기준을 적용한 2차 건강진단의 실시 여부, 순음청력 검사방법의 적정성은 주파수별 기도 및 골도 검사 실시, 표준표기방법에 따른 역치 표기, 기도 및 골도 검사 결과의 차이, 적정한 기도 및 골도 음차폐 실시 여부의 평가를 통해 간접적으로 판단하였다. 소음 특수건강진단 판정의 적절성은 특수건강진단기관에서 판정한 구분을 ISO 기준(1964)적응에 의한 역치에 따른 청력장애 정도와 소음성 난청 유소견자 진단기준인 3분법에 의한 청력손실치, 4000 Hz에서의 역치 및 난청의 유형의 적용에 따라 각각 비교하여 적정성을 살펴보았다. 결과 : 2차 건강진단 대상자 선별기준에 따른 2차 건강진단 대상자는 기관 평균 사업장당 34.3명이었으나 18.4명만을 대상으로 2차 건강진단을 실시하여 선별기준 적용의 실시율이 67.7 %로 1/3의 대상이 2차 건강진단에서 누락되었다. 2차건강진단 대상자에 대해 각 주파수별 기도 골도 검사율은 75.7 %로 24.3 %가 골도검사를 시행하지 않고 기도검사만으로 평가 판단하였다. 표준표기방법(오른쪽, 왼쪽 - 비차폐 기도, 차폐 기도, 비차폐 골도, 차폐 골도검사)에 따른 표기에서 70.4 %에서 제대로 표기되고 있으며, 기도 및 골도청력검사의 적정성으로 기도청력역치는 골도청력역치보다 같거나 크게 나와야 하는데 골도청력역치가 기도청력역치보다 크게 나오는 경우(골도-기도청력역치>10)에는 잘못 측정하였다고 볼 수 있는바 이 기준의 적용시 75.5 %만이 검사결과가 적정하였으며, 기도 및 골도 음차폐 검사는 각각 실시 대상자의 15.0 %. 26.2 %만 실시하고 있었다. 48개 기관 중 7개 기관(14.6 %)이 2차 검진을 기도순음청력검사만으로 판정하고 있었으며, 기도 및 골도 음차폐검사는 각각 7개 기관(14.6 %), 13개 기관(27.2 %)에서만 실시하였다. 난청의 유형과 역치에 따른 청력장애의 평가는 소음 특수건강진단 결과 평가의 적정성(ISO 기준(1964)적용에 의한 청력손실 비교)과 판정의 적정성 (소음성 난청 유소견자 진단기준의 적용에 따른 비교)을 특수건강진단기관이 최종 판정한 결과와 비교하였을 때 질환자(D1, D2)의 판정이 과소평가되어 있었다. 결론 : 특수건강진단기관에 대한 청력정도관리와 청력검사자의 질관리가 지속적으로 필요하며 판정에서의 여러 장애 요인을 검토하여 적정하게 판정하여 관리될 수 있게끔 하여야 할 것이다. 그리고 순음청력검사의 정확성과 신뢰성을 확보할 수 있는 제반기준을 설정하여 검사자간, 검사자내 피검자의 역치결과의 오차를 줄여 나가야 할 것이다. Objeotive : This study was undertaken to evaluate that noise-exposed workers have been appropriately selected for the special periodic health examination and that pure-tone audiometry has been correctly applied and the results of these have been properly analyzed. Methods : We obtained health examination data of noise-exposed workers from 48 special periodic health examination agencies. The data consisted of special periodic health examination results and audiograms that had performed examination during the latter half of 1998. We analysed the appropriateness of the subject selection for the second special periodic health examination of noise-exposed workers, the method of pure-tone audiometry, and the evaluation of audiogram. Results : The screening performance rate is 67.65% in the special periodic health examination of noise-exposed workers. Although 34.29 persons per agency should have had a secthird of subjects were omitted. The air and bone conduction performance rate by each frequency is 75.71%. 24.29% persons did not have a bone conduction and were evaluated only by air conduction. The correct use rate of symbols(right, left-unmasked AC, masked AC, unmasked BC, and masked BC) recommended by ASHA(American Speech-Language-Hearing Association) was 70.36%, Generally air conduction threshold is equal to or higher than bone conduction threshold. In the reverse case, especially if the gap is more than 10 dB(BC-AC>10), this is considered to be incorrect. When we applied this criteria, the result indicated that it was correct in 75.46%. The performance rate of air masking was 15.03%, and bone masking was 26.21%. 7 among 48 agencies diagnosed NIHL(Noise-Induced Hearing Loss) only by air conduction, 8 performed air masking and 13 did bone masking. When compared with ISO Standard(1964) and Ministry of Labor Standard, the results of evaluation(D1, D2) on hearing loss according to hearing loss type and threshold were rather low. Conclusions : Hearing Quality Assurance Program about periodic special examination agencies and examiners will continue to be needed and also the evaluation of hearing loss should be performed and controlled using accurate criteria. This will reduce the error among examiners and results in individuals by means of a standard that is capable of being accurate and reliable.

γ-선 조사에 의한 연신된 선형저밀도 Polyethylene의 열자극 전류

김영전,이기선,이종규,고병준 충남대학교 자연과학연구소 1986 忠南科學硏究誌 Vol.13 No.2

We observed three TSC peaks at the temperature of 33℃, 42℃ and 58℃ from linear low density polyethylene which had been excited by γ-ray or electric field . Especially further experiment on elongated sample showed that the peak at 42 ℃ increased until the draw ratio reached 200%, but decreased above 200%. These peaks are closely related to the traps of the crystalline, amorphous and crystal interfacial regions. As a result of elongation non-uniformity of molecular chains caused physical cavities at the crystal interfacial region. Therefore the depth of the trap changed and the rate of the release of the carriers were increased. Because of the elongation the splitted phenomena of the lamellae structure of the sample has been suggested by the infrared absorption spectra of the elongated linear low density polyethylene film at the room temperature.

기능성 소화불량증에서 증상에 따른 고형식의 반위배출시간의 차이

김영호,이풍렬,성인경,손희정,김재준,고광철,백승운,이종철,최규완 大韓消化器病學會 1998 大韓消化器病學會誌 Vol.32 No.3

물리화학적 영향에 의한 백서 대뇌피질 Mitochondria Monoamine Oxidase활성도의 변경

김영준,신용규,이정수 중앙대학교 의과대학 의과학연구소 1990 中央醫大誌 Vol.15 No.3

Various factors influencing monoamine oxidase activities of mitochondria obtained from rat cerebral cortex were investigated. These factors included pH and temperature of incubation media, anions, divalent cations, hydrogen peroxide, sulfhydryl inhibitor, compounds containing SH groups and sonication. With kynuramine, the maximum MAO activity was observed at the concentration of 0.1mM and increasing the concentratin beyond 0.1mM was accompained by a decrease in the enzyme activitv. The MAO activity -was considerably altered by change of the pH of the incubation medium and the maximum value was observed at pH 8.0. MAO was resistant to temperature of incubation medium and the activity was not significantly affected at the temperature range of 0˚C -37˚C, but thereafter the activity was decreased with temperature, Among anions and cations tested, sulfite ion, Ag^++, Cu^++ and Cd^++ markedly inhibited MAO activity. Specific inhibitors for SH group such as, HgCl_2, PCMB and PCMBSA significantly inhibited MAO activity. Inhibitory action of Hg^++ was reverse by cysteine, GSH and MPG. Hydrogen peroxide weakly inhibited the MAO activity. MAO activity was decreased by sonication. The results suggest that factors influencing the cellular environment can alter MAO activity.