회전근 개 파열 관절중에서 시행한 역구형 관절 치환술 : 2례 보고

문영래,이상홍,노경환 朝鮮大學校 附設 醫學硏究所 2009 The Medical Journal of Chosun University Vol.34 No.1

치아 마모 환자에서 수직고경 증가를 동반하여 단일구조 지르코니아 보철물로 완전구강회복을 시행한 증례

오경철,정문규,김지환,심준성 大韓齒科補綴學會 2012 대한치과보철학회지 Vol.50 No.3

과도한 치아 마모는 교합면에 손상을 야기하고, 치수 병변, 교합 부조화, 기능장애, 심미적 문제 등을 야기할 수 있다. 과도한 치아 마모를 갖고 있는 환자들을 치료하고자 할 때 수직교합고경(vertical dimension of occlusion, VDO)의 상실 여부와 수복을 위한 악간 공간의 적절성 여부에 기반하여 분류를 할 필요가 있다. 본 증례의 환자는 다수 치아들의 마모를 지닌 50세의 남성으로, 과도한 치아 마모가 있지만 수직교합고경의 상실은 없으며 수복을 위한 악간 공간이 부족하였다. 이러한 경우 수직교합고경을 증가시켜 치료를 진행하는 것을 고려할 수 있다. 수직교합고경의 증가를 필요한 범위 내에서 최소로 줄이고, 증가된 수직교합고경 상에서 안정화 기간을 거친 뒤 안정된 교합 접촉을 제공할 수 있다면, 수직고경 증가를 동반한 치료법은 안정성을 가질 수 있다. 본 남성 환자를 치료하기 위해 수직고경의 증가를 동반하여 전치부와 구치부에서 단일 구조 지르코니아를 이용한 고정성 보철물로 수복을 하였다. 일련의 치료과정을 통하여 기능적인 면과 심미적인 면에서 만족스러운 결과를 얻었기에 보고하는 바이다. Excessive occlusal wear results in unacceptable damage to the occluding surfaces, and can cause pulpal injury, occlusal disharmony, impaired function, and aesthetic deformity. Patients with severely worn dentition need to be classified as several categories relative to the vertical dimension of occlusion (VDO) and the interocclusal distance for the prosthetic space. When treating patients classified as those who have excessive wear without loss of occlusal vertical dimension but with limited space, we could consider treating them at an increased vertical dimension of occlusion. Treatments at an increased vertical dimension of occlusion may provide stability, given that the amount of its increase was minimal, and a perfected occlusion was achieved after enough stabilization period. A 50-year-old male visited the department of Prosthodontics in Yonsei University Dental Hospital with the chief complaint of worn teeth on lower anterior area. Reconstruction at an increased vertical dimension of occlusion was planned. After the compatibility of the new vertical dimension of occlusion had been confirmed under interim fixed restorations, definitive fixed restorations composed of full-contour monolithic zirconia prostheses were placed. This case presents that a satisfactory clinical result was achieved by restoring the worn dentition at an increased vertical dimension of occlusion with an improvement in esthetics and function.

한국 정상인에서 연령에 따른 뇌혈류분포와 혈류예비능의 변화 : Tc-99m HMPAO SPECT 에 의한 연구

문대혁,이희경,송호천,이재태,범희승,손혜경,정환정,민정준,김지열 대한핵의학회 1999 핵의학 분자영상 Vol.33 No.3

Purpose: The aim of this study was to evaluate the normal values of regional cerebral blood flow (rCBF) and cerebrovascular reserve (CVR) in normal children to aged volunteers using Tc-99m HMPAO. Materials and Methods: Thirty four right-handed normal volunteers (20 males, 14 females, mean age 40.3±24.9 years, range 4 to 82 years) were underwent rest/acetazolamide (ACZ) brain SPECT using Tc-99m HMPAO and the sequential injection and subtraction method. rCBF was estimated on the basis of a semiquantitative approach by means of right/left ratio, region/cerebellum and region to whole brain ratios in frontal, parietal, temporal, and occipital lobes, basal ganglia, thalami, and cerebellum. CVR was measured by means of % perfusion increase calculated as % mean count change compared to rest rCBF in each regions. Results: Mean values of right to left ratios range from 1.004 to 1.018. rCBF was highest in cerebellum and lowest in basal ganglia and thalami. Frontal and temporal rCBF decreased while occipital and thalami rCBF increased according to age. No sexual difference of rCBF was noted. Mean CVR was 29.9±12.9%. Mean CVR significantly increased to late teens, and declined thereafter. After 6th decade, CVR in both frontal lobes, left parietal lobe and right basal ganglia decreased significantly with advancing age. There was no sexual difference of CVR. Conclusion: Quantitative assessment of CVR was possible by ACZ Tc-99m HMPAO brain SPECT. It revealed that rCBF and CVR changed according to age in normal Korean volunteers. There was no sexual difference.

휴머니즘 : 그 빛과 그림자 Its Light and Its Shade

문경환 연세대학교 인문과학연구소 1995 人文科學 Vol.73 No.-

Everything under the sun has its bright side and dark sid, because it is under the sun. Humanism in the sun is the hues of a rainbow; humanism in the shade is the haze of the limbo. Humanism in its true sense is humility with dignity; humanism in disguise is humiliating indignity. Humanism in the highest is the halo of honor; humanism in the lowest is a hell of a howler. Humanism in a word, is a dilemmatic milestone. It can lead to the mountain peaks of hope and glory or to the bottomless pit of vainglory. Maybe it´s all because of the ´ism´tacked on to its name. For, free of this troublesome appendix, "every human heart is human," as goes a line of a poem I don´t remember whose. But think twice before you damn this poor little word. For every human ism is human also. An ism after all is a human endeavor, in the hope of better understanding human morality, human mortality, human capacities, human infirmities--in short, things human. This paper invites you to the crossroads of humanism, showing you around to its sunny greens of lush pastures and to its gloomy dells of lurking vultures. During your journey you will be ushered once in a while to a resting place so you can stop and think about what the branch of learning called the humanities should be like. At the end of your trip, you will find yourself having made a quick tour, as well, of the historical development of humanism and humanistic scholarship.

결별의 시대에서 조화의 시대로 : (Ⅰ) 19세기의 경우 Ⅰ: What Happened in the 19th Century?

문경환 연세대학교 인문과학연구소 1996 人文科學 Vol.75 No.-

The academia of the past two centuries or so has undergone a crescendo of ramification and compartmentalization, in which 'specialism' is the name of the game. This process has made it possible for the 'specialist', safely enclosed within the limits of his visual field, to succeed in unearthing important facts and concepts that have hitherto been unthought of. These new findings have in turn pulled off redoubtable achievements in science and technology, which bespeak of the possibility of virtually limitless progress in these areas. On the other hand, however, the specialist, throught having to constrain the sphere of his interest and investigation, has been progressively losing contact with other branches of learning. The end­product is a curious type of man who is well informed in his own tiny portion of the universe but professedly and blithely ignorant of all that does not enter into his specialty­­who is, in Ortega y Gasset´s terms, ´learned ignoramus.´ Worse still, this new type of man is perfectly ready to wield his flimsy yardstick with pomp and circumstance, scaling other people´s intellectual concerns and capacities, and turning a deaf ear to what does not seem to tally with his own sciolistic knowledge or belief. At last, on the verge on the century´s curtain time, we are awaking to the grave impacts of specialism with growing apprehensions. Attesting to this is the catchword ´interdisciplinary,´ which is now on the tongues of all but everyone working in the academic circles. No wonder the craze for ´departmental consolidation´ is sweeping over our universities with hurricane force. But what exactly is this ´no­department´ business supposed to mean? Are we now to undo and reverse the whole process of specialization that has so far seemed so beneficial to our intellectual activities? How, in other words, can we deal with the schizophrenia of ´learned ignorance,´ while still taking full advantage of specialism? The term ´inter­disciplinary´ does not carry much force here, since, to my mind, the notion of ´discipline´ itself has become only too nebulous in our educational system. Neither does the now fashionable idea if ´graduate­school­centered university.´ Rendered back into Korean, the original language that accounts for this very terminology, it simply turns out to be a case of oxymoron. To be sure, etiology is a prerequisite for treatment. Before we can imagine how the different academic research areas can be reconciled to a workable degree, we need to know how they have come to a rupture in the first place. Otherwise, the glossy jargon words just cited will prove to be more a matter on empty slogans than anything else, serving a verbal banquet at best. With this as its guiding motif, the present paper makes a brief survey of the main currents of thought and the concomitant social conditions that characterize the 19th century. The discussion centers around the rise of scientism, evolutionism, psychologism, and historicism, looking as well into the run of event ensuing on them. This trend of thought, it is claimed, has contributed to the process of specialization that has continued well into the 20th century. This in fact constitutes only a half of the story that I intend to present under the captioned topic: the space available here does not permit us to span the length of two centuries at one time. In the sequel, which will appear in the following issue, we will go into the status quo of the 20th century, largely focusing on the scholarly atmosphere that accelerated the process of specialization, and the more recent movement toward a new outlook on scholarship, which is on foot as a reaction against the excessiveness of the process in question.

치과진료실에서 황색 포도구균의 감염유형 분석

문상은,이동근,권경환,김강주 大韓顎顔面成形再建外科學會 2003 Maxillofacial Plastic Reconstructive Surgery Vol.25 No.1

To investigate the cross contamination in the dental clinic, Staphylococcus aureus, the pathogen in acute pyogenic infection and one of the important microbes causing nosocomial infection, was isolated from the mouth and anterior nare of healthy personnel and patients and the air in the dental clinic. The patterns of antibiotic susceptibility of the isolated staphylococci were examined. mecA gene from the MRSA was detected by polymerase chain reaction (PCR). The isolation rate of S. aureus in the dental clinic was the highest in the mouth of dentists (29.4%) and the lowest in the air of the dental clinic (1.3%). In the study of PCR, MRSA and some methicillin susceptible staphylococci had mecA positive gene. These results suggest that staphylococci in the dental environment might be one of the important causes of nosocomial infection in the dental clinic.

蒼附導痰丸이 白鼠의 排卵에 미치는 影響

강복환,박종문,박경미,조한백,엄주오,유심근 한국전통의학연구소 2003 한국전통의학지 Vol.13 No.1

Changbudodamhwan(CBH) is used in female infertility caused by ovulation disorder. An attempt was made to evaluate the influences of CBH on the serum concentrations of FSH, LH, estradiol(E_(2)) and progesterone, the histological and optical changes of ovary, ovary weight of rats. The results of the study were as follows : 1. Blood FSH level increased experimental group as compared with control group, which showed no efficacy. 2. Blood LH level increased in experimental group as compared with control group, which showed no efficacy. 3. Blood E_(2) level increased in experimental group as compared with control group, which showed no efficacy. 4. Blood progesterone level increased in experimental group as compared with control group, which showed no efficacy. 5. In optically observations of ovary, weight of ovary increased in experimental group as compared with control group, which showed no efficacy. 6. In histological observations of ovary, ovulation increased in experimental group as compared control group, which showed efficacy. According to these results, CBH influence on the ovulation and ovary of rats.

장기간 고농도 수유후 발행한 고장성 탈수증 2례

김국환,안영준,양은석,박상기,박영봉,문경래 朝鮮大學校 附設 醫學硏究所 1997 The Medical Journal of Chosun University Vol.22 No.2

Hypernatremia(serum sodium>150meq/L) is caused by conditions that produce an excessive gain of sodium or result in an excessive loss of body fluid that is greater than the loss of sodium. The prognosis for hypernatremic dehydration is poorer than isotonic or hypotonic dehydration, because severe hyperosmolarity may result in cerebral damage( seizures, cerebral hemorrhages, thromboses, and subdural effusions). This cerebral injury may result in a permanent neurologic deficit. We experienced two cases of hypernatremic dehydration. Theses cases may have resulted from faulty preparation of infant formulas, as with the use of condensed milk powder. The first case experienced seizures during treatment, but survived, yet the second case died in spite of intensive care.

척추관 협찬증 환자 진료 프로세스 개발

이환모,김호중,김긍년,안풍기,천자혜,김양수,신혜선,김인숙,정혜경,김영아,채형기,박인영 한국의료QA학회 2009 한국의료질향상학회지 Vol.15 No.2

연구배경: 수술적 치료가 필요한 척추관협착증 환자들은 주로 60세 이상의 고령환자로장기간의 입원 시 기회 감염의 증대와 불필요한 의료비의 증대를 가져오게 되며, 수술후환χ}들의 재원일수의 증가는병원의 병상가 동률을감소시키고, 전공의에게는불필요한 업무를 증가시킨다. 연구목적: 비용·효과면에서 최적화된 진료지침의 개발은 불필요한 의료비의 감소및 Hospital Induced Complication을 줄여 환자만족도를증진시킬 수 있으며, 각 환자에 대한전공의 업무를 줄일 수있다. 의료기관: 서울특별시에 소재한 2,075병상의 종합전문 요양기관 연구방법: 정형외과및 신경외과의 척추관협착증환자 의 처방을 비교하여 최적의 표준진료지침을 개발하고 최종적으로 CP Master Program (EMR 프로그램)에 입력하여 환자에게 적용하였다. 연구결과': CP 적용전, 후비교를통해 재원일수는 3.8일 이 감소하였으며, 이에 따라 병상가동률 및 진료수익이 증가했으리라고 예상되며 현재 비교검토중이다. 또한,CP 개발및 CP Master Program의 사용을 통한 전공의 업무감소에 대해 검토하고 있다.

세라믹 브라켓의 제거 시 Er : YAG 레이저의 효능

서충환,장나영,채종문,조진형,김상철,강경화 대한치과교정학회 2009 대한치과교정학회지 Vol.39 No.4

본 연구에서는 세라믹 브라켓 제거에 Er:YAG 레이저 조사가 도움이 되는지 알아보고, 브라켓 제거에 적합한 레이저 조사 방법을 연구하였으며, 또 이렇게 적용된 레이저가 치수와 법랑질에 손상을 주는지도 알아보았다. 총 190개의 치아, 단결정 세라믹 브라켓(MISO), 다결정 세라믹 브라켓(Transcend series 6000)과 KEY Laser3를 사용하였다. 실험군은 세라믹 브라켓의 종류(단결정, 다결정)와 레이저의 에너지(140, 300, 450, 600 mJ)에 따라 분류하였으며, 레이저를 브라켓당 두 곳에 1펄스씩 조사하고, 전단 강도를 측정하였다. 대조군은 레이저를 조사하지 않는 군으로 하였다. 레이저 조사에 의한 열 효과는 브라켓 하방 법랑질과 치수강에서 측정하였으며, 전단 강도 측정 후 치면에 남아있는 접착제의 양을 접착제 잔류 지수(adhesive remnant index)를 이용하여 평가하였다. 레이저 조사로 인한 접착제의 파괴 양상과 법랑질 표면 변화를 주사전자현미경으로 관찰하였다. 모든 세라믹 브라켓군에서 레이저 에너지가 증가 할수록 전단 강도는 유의하게 감소하였다. 또한, 브라켓 하방 법랑질에서 최대 온도 변화는 평균 3.78˚C 상승에 그쳤으며, 치수강에서 최대 온도 변화는 평균 0.9˚C 상승에 그쳤다. 주사전자현미경을 이용한 법랑질과 접착제 단면 관찰에서 접착제 표면이 레이저에 의해 붕괴되어 분화구 모양의 구덩이로 관찰되었으며, 일부 시편에서 약 10 - 30μm의 법랑질 손상이 발견되었다. Transbond XT로 부착된 단결정 도재 브라켓(MISO)의 디본딩에 Er:YAG 레이저를 이용할 경우, 300 - 450 mJ의 레이저 에너지를, 그리고 다결정 도재 브라켓(Transcend series 6000)의 경우는 450 mJ 정도의 에너지를 사용하는 것이 효과적이고 안전할 것으로 생각된다. Objective: The aim of this study was to find out whether Er:YAG laser can aid in debonding ceramic brackets, and to see what kind of method will be the most appropriate for debonding. Methods: One hundred and ninety teeth, monocrystalline brackets (MISO, HT, Ansan-Si, Korea), polycrystalline brackets (TranscendTM series 6000, 3M Untek, Monrovia, CA, USA) and the KEY Laser3 (KavoDental, Biberach, Germany) were used. Experimental groups were classified according to the type of ceramic brackets, and the amount of laser energy (0, 140, 300, 450, 600 mJ). After applying laser on the bracket at two points at 1 pulse each, the shear bond strength was measured. The effect of heat caused by laser was measured at the enamel beneath the bracket and pulp chamber. After measuring the shear bond strength, adhesive residue was evaluated and enamel surface was investigated using SEM. Results: All ceramic bracket groups showed a significant decrease in shear bond strength as the laser energy increased. The greatest average temperature change was 3.78˚C on the enamel beneath the bracket and 0.9˚C on the pulp chamber. Through SEM, crater shape holes caused by the laser was seen on the enamel and adhesive surfaces. Conclusions: If laser is applied on ceramic brackets for debonding, 300 - 450 mJ of laser energy will be safe and efficient for monocrystalline brackets (MISO), and about 450 mJ for polycrystalline brackets (Transcend series 6000).