2.9% 과산화수소를 함유한 부착형 미백제의 임상적 효능과 안정성에 관한 연구

박은숙,성소래,홍성태,김지은,이소영,황수연,이신재,진보형,손호현,조병훈 大韓齒科保存學會 2006 Restorative Dentistry & Endodontics Vol.31 No.4

2.9%의 과산화수소를 함유한 시험용 부착형 미백제(Medison dental whitening strip, Samsung medical Co.,Anyang,Korea)를 실험군 피험자 23명, 시험용 미백제에서 과산화수소를 제외한 동일한 제재를 대조약으로 대조군 피험자 24명에게 매일 1시간 30분씩, 2주간 적용하여 임상적 효능과 안전성을 평가하였다. 미백 효과는 Shade Vision, Chroma Mete 및 Vitapan classical shade guide를 이용하여 색변화를 측정하여 다음과 같은 결론을 얻었다. 1. 실험군에서의 전체 치아의 색변화량(ΔE^(*))은 세 가지 측정법에서 모두 대조군에 비해 통계적으로 유의한 차이를 보였고 (p < 0.05). 쉽게 인지할 수 있는 정도였다. 2. 색변화는 색좌표 상에서 명도의 증가와 녹색조 및 청색조로의 변화에 의해 얻어졌다. 3. 치아별로는 어두운 견치의 색변화량이 가장 컸고, 측절치, 중절치 순으로 감소하였다. 4. 47명의 피험자 중 5명이 경도의 과민증을 경험하였으나 곧 완화되었다, 치은염증지수와 전기치수검사 결과 시험 전후에 차이가 없어 안전성을 확인하였다. This study evaluated the effectiveness and safety of an experimental bleaching strip (Medison dental whitening strip, Samsung medical Co., Anyang, Korea) containing 2.9% hydrogen peroxide. Twenty-three volunteers used the bleaching strips for one and a half hour daily for 2 weeks. As control group, the same strips in which hydrogen peroxide was not included were used by 24 volunteers with the same protocol. The shade chang (ΔE^(*), color differnce) of twelve anterior teeth was measured using Shade Vision (X-Rite Inc., S. W. Grandville, MI, USA), Chroma Meter (Minota Co., Ltd. Osaka, Japan) and Vitapan classical shade guide (Vita Zahnfabrik, Germany). The shade change of overall teeth in the experimental group was significantly greater than that in the control group (p < 0.05) and was easily perceivable. The change resulted from the increase of lightness (CIE L^(*) value) and the decrease of redness (CIE a^(*) value) and yellowness (CIE b^(*) value). The shade change of individual tooth was greatest in canine, can smallest in central incisor. The safety of the bleaching strip was also confirmed. 〔J Kor Acad Cons Dent 31(4):269-281, 2006〕

FORREST II 궤양 출혈의 적절한 치료 유용성 : 전향적 무작위 연구

김성은,이선영,신정은,주미순,전정현,이경은 이화여자대학교 의과대학 2003 EMJ (Ewha medical journal) Vol.26 No.2

Objectives : This study is to compare the clinical and cost effectiveness of various pharmacologic therapies with of without endoscopic procedure in the Forrest II ulcer. Methods : Between May 2001 and June 2002, total of 58 Forrest II bleeding activity patients (37 cases of NBVV, 6 adherent blood clots, 9 flat red spot, and 6 flat black spot) with gastric ulcer(32 cases) and duodenal ulcer(26 cases) were analyzed. UGI endoscopy was performed within 12 hours of the first bleeding episodes, and underwent repetitive endoscopy after 48h. All the patients were randomly assigned to receive somatostatin(group I), PPI(omeparzole : group II), only H2 blocker (famotidine, group III), or endoscopic injection therapy followed by famotidine (group IV). We compared with rebleeding rates, changes of ulcer size, and modified estimated costs for 3 day-hospital in four groups respectively. Results : 1) Twelve patients experienced rebleeding(20.7%). 2) The rates of rebleeding were 16.6% (2/12) in group I, 28.6%(4/14) in group II, 5.9%(1/17) in group III, 26.7% in group IV. There was no significant difference in rebleeding rate among the groups, but there was low rebleeding tendency in group III, compared with group II(p=0.087).3)Type of stigmata including non-bleeding visible vessels and adherent clots were associated with an increased rate of recurrent bleeding(p=0.01).4) When modified estimated costs were calculated, group III could be treated at the lowest cost(p<0.05). Conclusion : In Forrest II bleeding ulcer, medical therapy, especially famotidine could be suggested prudently as a proper treatment modality for this lesion, considering the cost-effecti-veness. 목적: 위십이지장의 궤양성 출혈은 대부분 특별한 치료없이 보존적인 치료만으로 지혈된다. 그러나 활동성 출혈이 있는 Forrest II 궤양의 경우는 흔히 내시경적인 치료를 하게 되는데 최근 여러 연구에서 약물치료와 비교 연구가 있었으나 다양한 약물들과 내시경 치료의 효과 및 비용-효용성의 비교는 이루어지지 않았다. 방법: 2001년 5월부터 2002년 6월가지 Forrest II 궤양출혈 환자 68명을 전향적으로 포함시켰고 이중 위암으로 진단된 경우와 내시경의 추적 검사를 거부한 경우 또는 다른 중증의 내과적 질환이 동반된 경우를 제외시켜 58명의 환자를 대상으로 하였다. 대상 환자 58명은 위궤양이 32명이고 십이지장 궤양이 26명으로 비출혈성노출 혈관 37명, 신선 부착 혈괴 6명, 적색반 9명, 그리고 흑색반 6명이었다. 초기 상부 위장관 내시경은 내원 후 12시간 이내에 이루어졌고 추적 검사는 48시간 이후에 시행되었다. 치료는 네 개의 군으로 나누어 무작위로 소마토스타틴 투여군(1군), 프로톤펌프 억제제 투여군 (2군), H₂수용체 차단제 투여군(3군), 그리고 내시경적 지혈제 주사군(4군)으로 치료하였고 각 군의 재출혈 여부, 혈압, 수혈, 궤양의 크기, 급성 출혈 흔적 등을 비교 관찰하였고 입원 3일간의 입원치료비용을 계산하였다. 결과: 1) 재출혈은 12명(20.7%) 에서 발생하였다. 2) 각군에서의 재출혈은 제1군이 16.6%(2/12), 제2군에서 28.6%(4/14), 제3군이 5.9%(1/17), 제4군이 26.7%(4/15)로 각 군의 재출혈 빈도는 차이가 없었으나 제3군에서 제2군에 비해 재출혈이 낮은 경향을 보였다.(p=0.087).3) 재출혈에 영향을 미치는 인자는 노출 현환과 신선 혈괴였다(p=0.01). 4)평균 입원치료 비용은 제3군이 가장 적어 높은 치료 비용-효과를 보였다.(p<0.05).

Bortezomib과 Dexamthasone으로 치료한 골수외 형질세포종 4예

백종현,이은영,장리라,손창배,신은경,서정아,이지숙,이호섭,이상민,신성훈,김양수 고신대학교의과대학 2007 고신대학교 의과대학 학술지 Vol.22 No.2

Despite the use of aggressive local and systemic treatment including autologous stem cell transplantation in multiple myeloma, extramedullary recurrences are common and the prognosis of these patients is poor. Many novel drugs such as thalidomide, lenalidomide and bortezomib improve the response of treatment of multiple myeloma, but some reports failed to describe thalidomide has effect in extramedullary plasmacytoma. Recent data report on the successful treatment plasmacytomas with bortezomib in patients with advanced multiple myeloma. We treated 4 relapsed or refractory extramedullary plasmacytomas with bortezomib at our institution. We recognized all these extramedullary plasmacytomas decreased and showed more than partial response. This report lends support to the efficacy of bortezomib in the treatment of plasmacytoma and describes the safe use of bortezomib. Responses may, however, be of short duration. Therefore, despite our limited experience, we propose that bortezomib may be considered a therapeutic option for such patients who have risk of radiation therapy

한국 정신장애의 역학 조사 연구[I] : 각 정신장애의 유병률

조맹제,함봉진,김장규,박강규,정은기,서동우,김선욱,조성진,이준영,홍진표,최용성,박종익,이동우,이기철,배재남,신정호,정인원,박종한,배안,이충경 大韓神經精神醫學會 2004 신경정신의학 Vol.43 No.4

Objectives : This study aims to estimate the prevalence of the DSM-IV psychiatric disorders in Korean population using the Korean version of Composite International Diagnostic Interview (K-CIDI). Methods : Subjects were selected by taking multi-stage, cluster samples of 7,867 adult household residents, 18 to 64 years of age, in ten catchment areas. Total 78 trained interviewers administered the K-CIDI to the selected respondents, from June 1 to November30,2001. Results : Total 6,275 respondents completed the interview. Some 33.5% of respondents reported at least one lifetime disorder, 20.6% reported at least one-year disorder, and 16.7% reported at least one-month disorder. The most common lifetime disorders were alcohol abuse/dependence (17.24%), nicotine dependence/withdrawal (11.19%), specific phobia (5.16%), and major de-pressive disorder (4.25%). The lifetime prevalence of substance abuse/dependence (0.25%) and schizophrenia (0.16%) was very low. Nicotine and alcohol use disorder showed very high male/female ratio. Mood disorder and anxiety disorder were more prevalent among female than male. Conclusion : The prevalence of psychiatric disorders was high. In comparison with other studies, remarkable differences in distributions of psychiatric disorders across the areas and times were observed.

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.

1978년의 국제운송 조약이 해상보험에 미치는 영향

이은섭,서성석 釜山 大學校 經營 經濟 硏究所 1999 經營 經濟 硏究 Vol.18 No.1

1978년 함부르크규칙의 제정을 전후하여 함부르크규칙이 이중보험에 미치는 영향과 관련한 논의가 심각하게 이루어진 이래 지난 20여년간의 논의를 요약해 보면 다음과 같다. 즉 동규칙의 지지자들에 따르면 함부르크규칙의 운송인에 대한 추정과일책임주의 적용이 해운기업의 효율적인 위험관리의 실행 및 운송물건에 대한 주의정도를 높임으로써 사고의 발생을 감소시켜 이중보험 및 전체적인 보험비용을 감소시킬 것이라 한다. 이에 대한 반대론자 등에 따르면 함부르크규칙의 규정은 헤이그나 헤이그-비스비규칙의 그것보다 애매하기 때문에 해석을 둘러싼 소송비용을 증가시키고, 운송인에 의한 책임보험에로의 위험의 전가는 이중보험문제를 더욱 악화시켜 전체적인 보험비용을 증가시킬 것이라 한다. 이중보험과 관련한 함부르크규칙의 평가는 객관적으로 신뢰할만한 실증분석을 통하여 최종적으로 이루어질 수 있겠으나 현재의 상황으로는 이 분석을 위한 자료의 확보가 불가능하다. 이러한 한계점을 염두에 두고 본 논문에서는 동 규칙의 해석을 통하여 결론을 내리고 있다. 함부르크규칙의 해석론적 평가를 한 결과, 단기적으로는 동규칙이 이중보험문제에 대하여 특이할만한 영향을 미칠 것으로 보이지 않으며 결국 함부르크규칙이 지향하는 이중보험문제와 관련한 이상과 현실 사이에는 상당한 괴리가 있음을 발견하였다.

요양병원 환자분류체계 개발

이지윤,윤주영,김정회,송성희,주지수,김은경 대한간호학회 간호행정학회 2008 간호행정학회지 Vol.14 No.3

Purpose: To develop the patient classification system based on the resource utilization for reimbursement of long-term care hospitals in Korea. Method: Health Insurance Review & Assessment Service (HIRA) conducted a survey in July 2006 that included 2,899 patients from 35 long-term care hospitals. To calculate resource utilization, we measured care time of direct care staff (physicians, nursing personnel, physical and occupational therapists, social workers). The survey of patient characteristics included ADL, cognitive and behavioral status, diseases and treatments. Major category criteria was developed by modified delphi method from 9 experts. Each category was divided into 2-3 groups by ADL using tree regression. Relative resource use was expressed as a case mix index (CMI) calculated as a proportion of mean resource use. Result: This patient classification system composed of 6 major categories (ultra high medical care, high medical care, medium medical care, behavioral problem, impaired cognition and reduced physical function) and 11 subgroups by ADL score. The differences of CMI between groups were statistically significant (p<.0001). Homogeneity of groups was examined by total coefficient of variation (CV) of CMI. The range of CV was 29.68-40.77%. Conclusions: This patient classification system is feasible for reimbursement of long-term care hospitals.

오존을 이용한 하수슬러지의 감량화와 안정화

이창근,황은주,강성재,빈정인,이병헌 한국물환경학회 2004 한국물환경학회지 Vol.20 No.3

In this study, ozone was adopted for the reduction and stabilization of waste sludge from the municipal sewage treatment plant. The waste sludge used in the experiments was primary sludge, excess sludge and a mixture of the two. The sludge cells and flocs were disrupted by ozonation resulting in the reduction of TSS and VSS concentrations. In the case of the primary sludge with a concentration of 20 gTS/L, the TSS and VSS concentrations were reduced 28%, 33% and the TCOD concentration was reduced 20% respectively. The consumption of ozone was 0.18 gO₃/gSS. In the case of the excess sludge with a concentration of 7.5 gTS/L, the TSS and VSS concentrations were reduced 37%, 41%, and the TCOD concentration was reduced 19% respectively. The consumption of ozone was 0.33 gO₃/gSS. In the case of the mixed sludge of 9.3 gTS/L, the TSS and VSS concentrations were reduced by 45%, 53%, and the TCOD was reduced 26% respectively. The desirable consumption of ozone was 0.27 gO₃/gSS. As ozonation proceeded, the level of SCOD increased due to the release of intracellular materials. However TCOD was reduced due to mineralization resulting from the transformation of organic materials to inorganic materials.

혐기·호기공정을 이용한 생물막법에서 유기물, 질소 및 인제거에 관한 연구

이성기,송영일,김현중,진성기,김은영 조선대학교 환경연구소 2001 環境硏究 Vol.17 No.1

Anoxic and Oxic process with contact media is used to remove an organic matter, nitrogen and phosphorus in sewage which derives from domestic wastewater. Experiments have been done with various conditions that concentration of oxygen can be 3mg/ℓ, 4∼5mg/ℓ and 5∼6mg/ℓ by controlling an retention time can be 10hr, 12hr and 14hr, return rate can be 0%, 100% and 200%. As the concentration of oxygen is 2∼3mg/ℓ. The rate of removal of BOD. COD. SS. T-N and T-P is 87%, 76%, 82%, 34% and 24%. As the concentration of oxygen is 5∼6mg/ℓ. The rate of removal of BOD, COD, SS, T-N and T-P is 92%, 84%, 88%, 45% and 33%. In the rate of removal of an organism, nitrogen and phosphorus thus It well be known that the rate of removal an organic matter, nitrogen and phosphorus will be increased as the concentration of oxygen becomes higher. As th retention time is increased, the rate of removal of BOD, COD, SS, T-N and T-P is gradually higher in the rate of removal of an organic matter, nitrogen and phosphorus. Because contact time and contact area will be increased, which generates active substrate transfer and metabolic react according to increment of retention time. As the return rate is increased. The rate of removal of BOD, COD and SS is likely to be increased. In the case of T-N. It is also increased by 28% at 0% of the return rate and by 60% at 200% of the return rate. In the case of T-P, however, It is deceased, as the return rate is increased by 42% at 0% of the return rate and by 30% at 00% of the return. As the return rate is increased the retention time is decreased, which causes less activity of bacterial which affects that the rate of removal of Phosphorus is decreased.

혈관모세포종의 임상 분석

김은성,강삼석,이정길,김태선,정신,김재휴,김수한,이제혁 대한신경외과학회 1998 Journal of Korean neurosurgical society Vol.27 No.5