법랑아세포종의 임상병리학적 연구

성일용,류성호,신상훈,김욱규,김종렬,정인교,변기정 大韓顎顔面成形再建外科學會 2003 Maxillofacial Plastic Reconstructive Surgery Vol.25 No.1

The authors analyzed retrospectively the 60 patients with ameloblastoma who were treated at Department of Oral and Maxillofacial Surgery, Pusan National University Hospital from MArch, 1990 to December, 1995. The results obtained were as follows: There were 26 males (43.3%) and 34 females (56.7%). The peak age of patients was the third decade (41.7%). The majority of cases occurred in the mandible 93.3%, especially in the angle region (91.1%). Eighteen of 60 patients (30.0%) were associated with an impacted tooth, by impacted 3rd molar teeth (16.6%), molar (10.0%), and premolar and canine (3.4%) in order., Fifteen of 60 patients (25%) were associated with an odontogenic cyst, by dentigenous cyst(13.3%), odontogenic keratocyst(8.4%), and radicular cyst(3.3%) in order. Radiographically, there were 32 unilocular types(54.2%) with average age of 24.9±10.8 years, 14 multilocular types(23.7%) with average age of 35.7±17.7 and 13 mixed types(22.0%) with average age of 41.4±15.8. Histopathologically, there were 42 follicular types(70.0%) with average age of 33.7±15.1 years and 18 plexiform types(30.0%) with average age of 26±14.6. Conservertive treatment was performed in the 33 patients(55.0%) and their average age was 25.2±13.9 years and radical treatment in the 27 patients(45.0%) and their average age was 39.3±41.8. Overall recurrence rate was 10%. A consistent correlation between the age of the patient and the radiographic or histologic type of mandibular ameloblastoma was observed. There was a tendency for ameloblastomas of the follicular type to show a multilocular or mixed appearance and for those of the plexiform type to show a unilocular appearance.

구순구개열환자에서 자기늑골을 이용한 일차성 골이식

김종렬,정기돈,진성준,조영철,변준호,손우성 대한악안면성형재건외과학회 2000 Maxillofacial Plastic Reconstructive Surgery Vol.22 No.5

Alveolar bone grafting is an essential component of successful surgical rehabilitation in many common cleft deformities. Primary alveolar bone grafting is defined as alveolar bone grafting which takes place before eruption of the primary dentition or before 1 years of age. The major objective in primary alveolar bone grafting is to prevent significant maxillary segmental collapse and arch disturbances. If severe, this can make secondary rehabilitation difficult, costly, and protracted. Such early stabilization may eliminate or, at least, decrease the amount of orthodontic arch expansion required during the transitional dentition period. Furthermore, early obliteration of alveolus fistulae improves speech and dental hygiene. It is critical that abutting maxillary segmental alignment be achieved(generally when the patient is 8 to 10 months of age) before grafting. Otherwise, the amount of dissection necessary to develop mucosal flaps for bone graft coverage will be more extensive, thus risking increased scar formation with potential adverse effects on growth. We report a preliminary result of 4 cases of primary alveolar bone graft using rib bone, performed by limited dissection and onlay graft technique at 8 to 10 months of age. They showed satisfactory clinical results especially in terms of growth up to now.

구순구개열환자에서 자가입자망상골을 이용한 이차성 치조골이식에 관한 임상적 연구

김종렬,진성준,조영철,표세정,변준호 대한악안면성형재건외과학회 2001 Maxillofacial Plastic Reconstructive Surgery Vol.23 No.2

Purpose : This study is conducted to evaluate the clinical success of secondary alveolar bone grafting using autogenous iliac particulate cancellous bone marrow in cleft maxilla. Materials and methods : We evaluated 107 cleft patients who had been admitted to the Dept. of Oral and Maxillofacial Surgery of Pusan National University Hospital from January 1, 1991 to January 31, 1999 and had been performed secondary alveola bone grafting with autogenous particulated cancellous bone marrow from iliac crest. Results : 1. Men were 70 and women were 37, which shows 65.4% and 34.6% and the proportion of males to females was 1.9: 1. Unilateral cases were 89(83.2%) and bilateral cases were 18(16.8%). 2, Age of bone grafting is widely distributed from 7 to 29, and the average was 13.2. 3. Success rate was 97.8% in unilateral cases, 94.4% in bilateral cases. Overall success rate was 96.7%. 4. We evaluated the bone graft contour by the percentage of bone attachment level adjacent to the alveolar cleft and the menial side showed 82.4% and the distal 87.7%. 5. The amount of notching the alveolar ridge at the grafted site through the ratio of notching length up to the most apical base to the length of proximal segment anatomic root was 0.19.

STR3과 STR35 이종마찰용접재의 피로수명 예측에 관한 연구

이상열,김동길,정재강 朝鮮大學校 機械技術硏究所 2001 機械技術硏究 Vol.4 No.1

본 연구에서는 Ni과 Cr이 많이 첨가되어 있는 오오스테나이트계 스테인레스강 STR35와 Si가 많이 첨가되어 있는 마르텐사이트계 스테인레스강 STR3을 마찰용접하여 모재, 열영향부 및 접합선(bond line)에 인공결함을 가공하여 피로크랙 전파거동을 고찰하였다. 평활재의 피로한도시험 결과 STR3의 피로한도는 429.0MPa이며, STR35는 409.4MPa로서 STR3의 피로한도가 약 20MPa이 높게 나타났다. 실험으로부터 얻어진 재료상수를 이용하여 Nisitani의 피로크랙전파속도 예측식에 적용하여 피로수명을 예측한 결과 마찰용접 및 미소원공결함의 위치에 관계없이 약 5%내외의 낮은 오차를 보이며 잘 일치함을 알았다. The fatigue lifes were investigated and predicted for two kind of heat-resisting steels, STR3 and STR35, to look over the fatigue life of dissimilar friction welding zone by rotary bending fatigue test. The mechanical factor. C(2a)^p. proposed by Nisitani, was employed in the present study to compare the results of fatigue life obtained from experiment and prediction. The fatigue lifes were predicted with an equation of the fatigue crack propagation proposed by Nisitani, d(da/dN)=C(2a)^P, the results were found to be within 5.0% error by comparison with experimented results.

스트렙토조토신으로 유도된 당뇨 백서에 티타늄 임프란트 매식 후 주위 골형성에 관한 연구

신상훈,김종렬,박봉수 대한악안면성형재건외과학회 2000 Maxillofacial Plastic Reconstructive Surgery Vol.22 No.5

Use of osseointegrated implants for missing teeth has been widely utilized in clinical dentistry. Allthough the procedure has been highly successful, there have also been unavoidable failures. The success of osseointegration depends in part on the host bone and its healing capacity, and concerns have been raised about various conditions affecting its quality and quantity. Diabetes mellitus, which is a major health problem for the elderly, represents a reduction in collagen synthesis, delayed wound healing and osteoporosis. The underlying clinical problem is a deficiency of bone mass. Because age and gender are reported to be an important risk factor for diabetes mellitus, the rate of implant loss caused by failure of osseointegration may also be expected to increase correspondingly. Thus, a large population of the target population for dental implants may have a high risk for implant failure. There are, however, few histologic reports regarding tissue reaction to implants in diabetes patients. Streptozotocin is the current diabetogenic agent of choice for producing experimental diabetes mellitus. The toxic acts specifically on the β- cells of the pancreas and the metabolic conditions which result from the use of streptozotocin are reported to resemble those observed in humans. The purposes of this study were to histologically examine the tissue reaction to titanium implants inserted into the tibiae of streptozotocin induced diabetic rats using light microscopy and to assess over time the quantitative differences between the newly formed bone of diabetes-induced rats and controls using image processing systems and immunohistochemistry with fibronectin and CD44 antibody. Seventy adult rats of both sexes were used in this study. In thirty-five rats, streptozotocin was injected intraperitoneally to induce diabetes and the serum glucose concentration was checked to ensure the induction of diabetes prior to implant placement and at the time of sacrifice. The titanium screw implants (diameter, 2.0mm; height, 3.5mm) were inserted into left tibiae of 70 rats, 35 in the control group and 35 in the DM group. The experimental rats were sacrificed at different time interval(1st, 2nd, 3rd, 4th, 6th, 8th and 12th week) for histologic examination, histomorphomeric analysis and immunohistochemistry with fibronectin and CD44 antibody. The results obtained from this study were as follows : 1.A rapid bone formation was observed in control group compared with DM group based on histological examination. However the pattern of bone formation in both groups was similar. 2.According to the histomorphometric analysis, the control group showed significantly higher in marrow bone density, marrow bone-implant contact ratio, and total bone-implant contact ratio compared with DM group. 3.The level of fibronectin expression was the most abundant at 3 and 6 weeks, which maintained to 6 and 12 weeks in control and DM group, respectively. From 8 weeks, the level of fibronectin expression decreased gradually in control but not in DM group. 4.The level of CD44 expression was the most abundant at 4 weeks, which decreased gradually to 12 weeks in control group while high level of CD44 expression was observed with no significant change to 12 weeks in DM group. From these results, it could be stated that although the rate of bone formation was delayed in DM group, dental implant procedure was not a contraindication and longer healing period was necessary in diabetes mellitus.

구조용강의 유한요소해석 및 온도변화에 따른 피로수명 평가에 관한 연구

이동길,이상열,정재강 朝鮮大學校 機械技術硏究所 1999 機械技術硏究 Vol.2 No.2

본 연구에서는 국산 승용차의 전륜구동축 재료인 S43C와 S5OC를 대상으로 유한요소해석과 회전굽힘피로실험을 통해 고주파열처리와 온도조건에 따른 피로크랙의 발생, 전파거동을 고찰하였다. 유한요소해석 결과 하중이 가해지는 방향에 따라 반복적으로발생되는 인장응격 및 압축응력은 미소원공결함 부분에서 가장 크게 나타났다. 이러한원인은 미소원공결함이 응력의 국부적인 집중원으로 작용했기 때문으로 생각되며, 이러한 응력의 반복으로 인하여 미소원공결함을 기점으로 크랙이 발생∙성장하였음을 알 수있다. 회전굽힘피로실험 결과 두가지 재료 모두 저온(-3O℃) 피로수명은 비열처리재의 경우 상온(25℃)보다 약 110% 증가하였고, 열처리재는 약 120% 증가함으로서 온도의 저하가 피로수명을 크게 증가시킨 반면 고온(80℃) 피로수명은 상온 피로수명과 비교시 비열처리재가 약 35%. 열처리재가 약 5%의 피로수명 감소를 나타냈다. In this study, the rotary bending fatigue test was carried out with two kind of material, S43C and S5OC, using in the front engine and front wheel drive shaft of vehicle. The specimens were heat-treated by high frequency induction method and tested at room(+25℃), high(+80) and low temperature(-3O℃) in order to look over the fatigue crack initiation and propagation behavior by the heat treatment and the temperatures. Based on the FEM result, the tensile and compressive stress repeatedly generated by load direction were largest on the small circular defect due to the stress concentration. So the small crack was initiated and grew from the defect Fatigue lifts of the specimens tested at low temperature showed about 110% for as-received. 120% for heat-treated higher than at room temperature, It was found that low temperature increased so much the fatigue life. At room and high temperature, the fatigue life of as-received specimens were decreased about 35%, but that of heat-treated specimens were decreased about only 5% at high temperature more than at room temperature, Therefore, fatigue life under high temperature will be considered at design of front engine and front wheel drive shaft materials of vehicle.

경부도상 피판을 이용한 구강내 결손부의 재건

양동규,신상훈,서종천,이성근,김종렬 大韓顎顔面成形再建外科學會 1995 Maxillofacial Plastic Reconstructive Surgery Vol.17 No.3

Various cutaneous as well as myocutaneous flaps have been designed for the reconstruction of tissue defects caused by the excision of oral cancer. Among these flaps, cervical island skin flap have been introduced by Farr et al and more have developed by Tashiro et al. This flap has many advantages. The flap minimizes donor size by use of cervical operation wound, flap size available is adequate for most oral defects and the procedure is relatively simple and time saving. However, this flap is not applicable in patients where there are large tissue defects and metastasis is suspected. We used this flap for it's rapid simple, and effective, primary closure of oral defects after cancer ablation and we have found this flap very useful for the reconstruction of relatively small oral defects.

한국인 직무 스트레스 측정도구의 개발 및 표준화

장세진,고상백,강동묵,김성아,강명근,이철갑,정진주,조정진,손미아,채창호,김정원,김정일,김형수,노상철,박재범,우종민,김수영,김정연,하미나,박정선,이경용,김형렬,공정옥,김인아,김정수,박준호,현숙정,손동국 大韓産業醫學會 2005 대한직업환경의학회지 Vol.17 No.4

Background and Purposes: Over the past three decades, numerous studies performed in Korea have reported that job stress is a determinant risk factor for chronic diseases and work disability. Every society has its own culture and occupational climate particular to their organizations, and hence experiences different occupational stress. An occupational stress measurement tool therefore needs to be developed to estimate it objectively. The purpose of this study is to develop and standardize the Korean Occupational Stress Scale (KOSS) which is considered to be unique and specific occupational stressors in Korean employees. Subjects and Methods: Data were obtained from the National Study for Development and Standardization of Occupational Stress (NSDSOS Project: 2002-2004). A total of 12,631 employees from a nationwide sample proportional to the Korean Standard Industrial Classification and the Korean Standard Occupational Classification were administered. The KOSS was developed for 2 years (2002-2004). In the first year, we collected 255 items from the most popular job stress measurement tools such as JCQ, ERI, NIOSH and OSI, and 44 items derived from the a qualitative study (depth interview). Forty-three items of KOSS, in the second year, were retained for use in the final version of the KOSS by using Delphi and factor analysis. Items were scored using conventional 1-2-3-4 Likert scores for the response categories. Results: We developed eight subscales by using factor analysis and validation process: physical environment (3 items), job demand (8 items), insufficient job control (5 items), interpersonal conflict (4 items), job insecurity (6 items), organizational system (7 items), lack of reward (6 items), and occupational climate (4 items). Together they explained 50.0% of total variance. Internal consistency alpha scores were ranged from 0.51 to 0.82. Twenty-four items of the short form of the KOSS (KOSS-SF) were also developed to estimate job stress in the work setting. Because the levels of the subscales of occupational stress were gender dependent, gender-specific standard norms for both the 43-item full version and the 24-item short form using a quartile for the subscales of KOSS were presented. Conclusion: The results of this study suggest that KOSS might be an appropriate measurement scale to estimate occupational stress of Korean employees. Further and more detailed study needs to be conducted to improve the validity of this scale.

左則 上두骨 및 頰骨에 發生한 殲維性 骨異形成症의 治驗例

梁棟奎,朴相俊,金秉民,金基元,金鍾烈 大韓顎顔面成形再建外科學會 1990 Maxillofacial Plastic Reconstructive Surgery Vol.12 No.3

Fibrous dysplasia is an idiopathic skeletal disorder in which medullary bone is replaced and disturbed by poorly organized, structually unsound fibroosseous tissue, which may produce cortical expansion. When facial bones are involed, considerable esthetic deformity may result. The term monostotic fibrous dysplasia has been applied when one bone is involved : when more than one bone is affected, the term polyostotic used. The polyostotic form may be accomplished by pigmented skin lesion (Jaffe type), or by pigmented skin lesions with endocrine disturbance (Albright syndrome). No general agreement exists on the cause of fibrous dysplasia. A few authors have suggested that fibrous dysplasia arises as a resujlt of trauma. It occurs predominantly in infant, adolescent females and runs a variable clinical course. When several bones are involed, it tends to be unilateral. Involements of alveolar bone may produce displacement of teeth with malocclusion, or loss of teeth, or both. Radiographycally, ti shows an indistinctly delimited osteolytic defect with a bubble - like pattern, but without a sclerotic rim. The preferred treatment is almost always surgery. If the lesion is extensive, surgical intervention with use of recontouring procedures aimed at the correction of esthetic or funtional disturbances is preferred treatment. Now, we present a case of fibrous dysplasia on the left maxilla and the zygoma treated by bony contourign via hemicoronal flap and intraoral approach with good results.

직무스트레스가 실업에 미치는 영향

정윤경,김형렬,박소영,홍정연,고상백,장세진 대한산업의학회 2007 대한직업환경의학회지 Vol.19 No.2