Carboxymethylchitin을 부형체로 이용한 Letosteine의 약제학적 연구

전상규,서성훈 한국분자생물학회 1994 분자생물학뉴스 Vol.22 No.-

압박 고 나사로 치료한 대퇴골 전자부 골절 : 고정 실패의 인자에 대한 분석 Analysis of Factors associated with Failure of Fixation

유찬훈,김홍태,변영수,남준모,조영호,문성건 대한골절학회 2002 대한골절학회지 Vol.15 No.4

목 적 : 압박 고 나사로 치료한 대퇴골 전자부 골절의 고정 실패에 영향을 미치는 요소에 대하여 분석하고자 하였다. 대상 및 방법 : 1995년 5월부터 2000년 7월까지 대퇴골 전자부 골절을 압박 고 나사를 이용하여 치료하고 1년 이상 추시가 가능했던 97예를 대상으로 하였다. 골절의 분류는 Jensen 분류법을, 골다공증의 정도는 Singh 지수를 이용하였다. 술후 방사선 검사에서 경체각, 정복 상태, 지연 나사의 대퇴골 두 내 위치, tip-apex distance(TAD) 및 지연 나사의 활강 거리를 측정하였고 고정 실패에 미치는 영향을 통계학적으로 분석하였다. 결 과 : 97예 중 17예(17%)에서 고정 실패가 발생하였고 그 중 지연 나사의 과도한 활강으로인한 경우가 15례(15.4%), 골두 천공 1얘, 10도 이상의 외반 변형 1예였다. 고정 실패의 발생과 80세 이상의 고령, 불안정성 골절, telescoping 정복, 원위 골편의 내측 혹은 전방 전위, 대퇴골 두 내 지연 나사의 위치와 밀접한 관계가 있었다. 결 론 : 압박 고 나사를 이용한 대퇴골 전자부 골절의 치료에서 고정 실패를 방지하기 위해서는 정확한 정복이 필요하고 대퇴골 두 내에서 지연 나사의 전방 위치를 피하는 것이 좋을 것으로 사료된다. Purpose : This study was performed to analyze the significant factors that may affect failure of fixation in trochanteric fractures of the femur treated with the compression hip screw. Materials and Methods : From May 1995 to July 2000, the authors analyzed 97 cases of trochanteric fracture of the femur treated with the compression hip screw and followed more than one year. We classified the fracture type by Jensen's method. We used Singh index for the degree of osteroporosis. In the post-operative radiograph, we checked neck-shaft angle, state of reduction, position of the lag screw within the femoral head, tip-apex distance, and sliding distance of the lag screw. The relationship between these factors and failure of fixation was statistically analyzed. Results : There were 17 cases(17.5%) of failure of fixation ; 15 cases(15.4%) of excessive sliding of the lag screw, 1 case (1%) of cutting out of the lag screw, and 1 case (1%) of valgus malunion. There were significant relationship between failure of fixation and old age over 80 , unstable fracture, telescoping reduction, anterior or medial displacement of the distal fragment, and anterior placement of the lag screw within the femoral head. Conclusion : Accurate reduction and avoidance of the placement of the lag screw in the anterior part of the femoral head were important factors to prevent failure of fixation in trochanteric fractures of the femur treated with the compression hip screw.

구내 접근법에 의한 하악골 골절 치료에 대한 임상적 고찰

정성훈,박형식,권준호 大韓顎顔面成形外科學會 1989 Maxillofacial Plastic Reconstructive Surgery Vol.11 No.1

This is a retrospective study on the transoral approach to open reduction of the Mandibular fractures. Our study was based on a series of 64 patients with mandibular fractures among 99 patients of facial bone fractures who had been treated by transoral approach with or without extraoral approach at Department of Oral and Maxillofacial Surgery, Yonsei Medical Center, Yonsei University from January 1981 to October 1988. We studied favorite sites of open reduction, fixation methods, results and prognosis related to transoral approaches of Mandibular fractures, and which compared with extraoral approaches. The results obtained are as follows : 1. The transoral open reduction was used more frequently in Mandibular fractures(64.6%) than Midfacial bone fractures(35.4%). Among 64 patients of mandibular fractures, 47 patients(73.4%) were treated only by transoral approach and others(26.6%) were treated by both trans and extraoral approach. Among 92 sites of mandibular fractures 75 sites(81.5%) were treated by transoral approach and 17(18.5%) were treated by extraoral approach. 2. The most favorite site for transoral approach compared with extraoral approach was symphysis(100%), and Angle(62.5%) was next in order of frequency on Mandibular fractures. 3. Direct Interosseous Wiring(DIW) was most commonly used for fixation(64.6%) and Miniplate osteosynthesis was used next in 28.1%. 4. Simple(39.1%) and Compound(52.2%) fractures were frequently indicated for transoral approach, however comminuted fractures were rarely indicated. 5. The direction of fracture lines on Angle of the mandible did not influence to determine whether transoral approach should be selected or not. However this area seemed to be more difficult to reduce exactly by transoral procedure than other areas because simultaneous superior and inferior fixation was applied predominantly on this area. 6. The success rate of reduction and fixation analyzed from us was more excellent in Direct Interosseous Wiring(29/53=54.7%) than in Rigid Internal Fixation(9/29=31.0%). But it might be depended upon various factors as like as sugeon's skill. 7. The postoperative complication due to transoral open reduction of mandible was not high(12.0%) and this rate was similar with other published reports.

상순과 턱의 수직 비율(vertical lip-chin ration)에 대한 선호도 조사

권성준,최갑림,임성훈,김광원 대한치과교정학회 2004 대한치과교정학회지 Vol.34 No.5

일반인들이 선호하는 상순과 턱의 수직 비율(Sn-Stm/Stm-Me')을 알아보기 위해 남녀 각 2명의 연조직 측모(profile)를 상순과 턱의 수직비율에 따라 상악의 변화없이 하악만을 변화시켜 1/1.8, 1/1.9, 1/2.0, 1/2.1, 1/2.2 비율의 5개의 측모 사진을 만들어 치과의사 44명(남자 22명. 여자 22명)과 일반인 430명(남자 303명, 여자 127명)을 대상으로 하여 설문조사를 통하여 선호도를 조사하여 다음과 같은 결과를 얻었다. 대상의 가장 선호하는 안모에 대한 성별간의 선호도 차이는 통계적으로 유의하지 않았다. 대상의 가장 선호하는 안모에 대한 치과의사와 일반인 집단간의 선호도 차이는 통계적으로 유의하지 않았다. 남녀 측모 모두에서 가장 선호하는 측모의 상순과 턱의 비율은 1/1.9이었으며 가장 선호하지 않는 비율은 1/2.2 로 나타났다. 이상의 결과를 종합하여 볼 때, 이전의 연구 비해 상순과 턱의 수직비율에서 턱의 비율이 다소 작은 측모, 즉 상순과 턱의 수직 비율이 1/1.9인 안모를 가장 선호하는 것으로 나타났다. The purpose of this study was to investigate the preference of Vertical Lip-Chin Ratio (= Sn-Stm /Stm-Me' hereafter VLCR) in Koreans. The assessors consisted of 44 dentists (male 22, female 22) and 430 lay persons (male 303, female 127). The survey was performed using a questionnaire asking the order of preference. The profiles presented in the questionnaire were based on the profiles of two males and two females, each morphed according to the VLCRs of 1/1.8, 1/1.9, 1/2.0, 1/2.1, 1/2.2. The results were as follows: The difference between males and females, and the difference between dentists and lay persons in the preference of VLCR were not statistically apparent. The most preferred VLCR was 1/1.9, and the least preferred VLCR was 1/2.2. These results indicate that the preferred VLCR is smaller than the previously reported VLCR ratios based, on the cephalometric evaluation of samples with favorable facial esthetics.

근위 대퇴정을 이용한 대퇴 전자부 골절의 치료

안성준,박종훈 대한골절학회 2004 대한골절학회지 Vol.17 No.1

GIS를 위한 홍수유출해석에 관한 연구

박준일,함계운,성오경,장영태,김경훈 경상대학교 생산기술연구소 2003 工學硏究院論文集 Vol.19 No.-

In the rainfall-runoff simulation, it is crucial problem to extract the hydrologic topographical factors that are used as the model input parameters. Those factors are drawn out from DEM(Digit a1 Elevation Model) along with GIS(Geographic Information System) techniques represent a wide range of topographical informations. GIS is employed to estimate the parameters and examine application. Also, the results from different GIS data and analysis methods are examined. In the study, spatial data are calculated using WMS(Watershed Modeling System) v.6.1, which is hydrologic analysis software coupled with GIS, and flood analysis is accomplished by HEC-1 included in WMS, and applied to Dukchon River basin. To calculate the effective rainfall CN values of NRCS are used. Clark, Snyder and NRCS methods are selected to derive unit hydrograph respectively. In addition, the characteristics of runoff responses according to the selection of GIS spatial data for NRCS CN, TIN or Grid used to extract hydrologic topographical informations. and the number of partitioning sub-basin are investigated.

계승치의 결손을 동반한 상, 하악 유구치의 다발성 유착에 대한 증례보고

정회훈,최형준,김성오,최병재,이제호 大韓小兒齒科學會 2005 大韓小兒齒科學會誌 Vol.32 No.3

치아유착은 치근의 상아질 또는 백악질이 치조골과 융합된 것으로 치아의 맹출이상을 야기하여 치조골 성장의 장애를 일으킨다. 본 6세 여아는 유구치의 유착과 영구 소구치의 결손을 주소로 본과에 의뢰되었으며 특이할 만한 의과적, 치과적 병력은 없었다. 구강검진 소견상 상, 하악의 좌, 우측 유구치에서 저위교합이 관찰되었으며, 다수의 치아우식증이 존재하였다. 방사선 사진 검사 소견상 상악의 좌, 우측 영구 견치와 계승 소구치의 결손, 상악 유구치의 치근흡수와 하악 유구치의 치주인대공간의 소실 및 미약한 치근흡수가 관찰되었다. 계승 영구치의 결손을 동반한 유구치 유착시 치료목표는 적절한 치조골 성장과 유치의 유지이며, 유착의 발현 시기와 치근의 흡수 정도에 따라 관찰, 수복 또는 발치 등의 치료를 고려할 수 있다. 유착치아의 발치는 인접 치조골 성장에 문제가 없고 인접치의 경사가 일어나지 않도록 최대성장점(growth spurt)을 고려하여 그 시기를 결정해야 한다. Ankylosis is defined as a fusion of cementum or dentine with alveolar bone. Due to the loss of the periodontal ligament on the ankylotic area, the tooth is incapable of continued eruption and hence is unable to follow the normal vertical development of the neighboring teeth and alveolar process. A 6-year-old female was referred to the Dept. of Pediatric Dentistry for ankylosis of primary molars and congenital missing of permanent premolars on both jaws. She had neither specific past medical history nor trauma and infection history in oral and maxillofacial region. Radiographic finding is that the maxillary primary molars were the early onset of ankylosis and had fast root resorption rate. However the mandibular primary molars were ankylosed later and being resorbed slower than maxillary primary molars. The object of treating this case is to maintain the proper alveolar bone growth and retention of deciduous molars. The point of managing this case is as follows: Proper treatment (observation, restoration, of extraction) should be established after thorough consideration of the time of onset, the root resorption rate, progression of infraocclusion and the development of alveolar bone support. We should consider the timing of extraction of the ankylosed teeth without problem of neighbouring alveolar bone growth and tilting of adjacent teeth in the view of growth spurt. Early diagnosis is important to avoid many of the complications with infraoccluded primary molars.

심초음파로 결정된 응급 심낭천자술의 천자부위

김성환,황성오,이강현,조준휘,강구현,문중범,이승환,윤정한,최경훈,김영식 대한응급의학회 2000 대한응급의학회지 Vol.11 No.3

Background: The aim of this study was to determine whether the conventional subcostal approach is suitable for emergency pericardiocentesis in patients with cardiac tamponade or impending cardiac tamponade. Methods: This study was a prospective, observational study conducted at the emergency department of a tertiary hospital, Patients who had symptomatic pericardial effusion and who needed emergency pericardiocentesis in the emergency department were included in this study. We measured the epicardium-to-pericardium distance at the subcostal, parasternal, and apical area with two-dimensional echocardiography to determine the appropriate puncture site for pericardiocentesis. An epicardium-to-pericardium distance of more than 1.0 cm was considered as the primary safety factor in determining the Puncture site for pericardiocentesis. The skin-to-pericardium distance was considered as secondary safety factor. Results: Ninety-five consecutive patients(55 males and 40 females; total mean age: 53 year old) with cardiac tamponade or impending cardiac tamponade were enrolled in this study. The puncture site for pericardiocentesis, as determined by echocardiography, was the subcostal area in 43 patients(45%), the apical area in 40 patients(42%), the left parasternal area In 11 patients(12%), and the right parastemal area in one patient(1%). Pericardiocentesis failed in 2 patients(2%) with the subcostal approach and in one patient(1%) with the apical approach. The average epicardium-to-pericardium distance was 31 ±21 mm in patients with the subcostal approach and 21±8 mm in patients with other approaches. There were no differences in the amount of pericardial fluid and in the intraperical pressure among patient groups according to puncture site. There were two procedure related complications: a puncture of the right ventricle with the subcostal approach and a ventricular tachycardia with the apical approach.

알코올 사용 장애 환자에서 알코올 사용의 심각도에 따른 불안 및 우울 증상과의 연관성

천은진,이준엽,구본훈,문보영,정진영,정성훈 대한생물치료정신의학회 2011 생물치료정신의학 Vol.17 No.2

Objectives:The purpose of this study was to examine the relationships of anxiety& depressive symptoms according to the severity of alcohol use in patients with alcohol use disorder. Methods:A total of 85 patients with alcohol use disorders were enrolled in this study. The severity of alcohol use was measured by the Korean version of alcohol use disorders identification test(AUDIT-K)& National Alcohol Screening test(NAST). Anxiety and depressive symptoms were measured by using the Beck Anxiety Inventory(BAI) and the Beck Depression Inventory(BDI), respectively. Pearson’s correlation test was applied to correlate among the severity of alcohol use, anxiety and depressive symptoms. Results:The mean scores of AUDIT-K, NAST, BAI and BDI were 22.22(±8.28), 6.24(±3.25), 18.64(±13.08), and 22.05(±10.13), respectively. Pearson’s correlation test showed that between the score of AUDIT-K and NAST, BAI or BDI, there were positively significant correlations(r=.534, p<.01 r=.231, p<.05 r=.334, p<.01), respectively. And in cases of≥26 score of AUDIT-K, there were much more positive correlations with BAI(r=.425, p<.05). Conclusion:The results of this study demonstrated that patients with alcohol use disorders have high co-morbid anxiety and depressive disorders. Overall, the greater severity of alcohol use may be associated with more anxiety and depressive symptoms. However, it is suggested that in the patients with severe alcohol use, correlation appeared to be positive only for anxiety symptoms.

쇄골 간부 골절 불유합의 수술적 치료 : 재건 금속판 고정 및 골 이식술 Reconstruction Plate Fixation and Bone Grafting

변영수,유찬훈,안혁수,문성건,신동주,박준우 대한골절학회 2003 대한골절학회지 Vol.16 No.2

목 적: 쇄골 간부 골절 불유합에 대하여 관혈적 정복, 재건 금속판 고정 및 골 이식을 시행하고 술후 조기 관절 운동을 허용한 저자들의 경험을 보고하는 것이다. 대상 및 방법: 1997년 1월부터 2001년 12월까지 수술적 치료를 시행한 쇄골 간부 골절 불유합 16예를 대상으로 하였다. 위축성 불유합이 10예, 비후성 불유합이 6예였으며, 수상 후 불유합에 대한 수술까지의 기간은 평균 6.5개월이었다. 수술적 치료로 불유합 부위를 노출시켜 섬유조직을 제거하고 골수강을 천공하였으며, 골편을 정복하고 재건 금속판으로 고정하였으며, 자가 골 이식을 하였다. 수술 후 관절 운동은 1주일 이내에 시작하였다. 결 과: 평균 추시 기간은 22.0개월이었으며, 전 예에서 평균 10.0주에 골유합을 얻었다. 최종 추시 시의 견관절 운동범위는 전 예에서 정상으로 회복되었으며, 나이가 50게 이상인 6예 중 3예에서 동측 견관절에 간헐적인 동통을 호소하였다. 술후 감염, 재검 금속판의 파손, 고정상실, 불유합, 재골절 등의 합병증은 발생치 않았다. 결 론: 쇄골 간부 골절 불유합에 대한 관혈적 정복, 재건 금속판 고정 및 골 이식은 안정성 고정으로 조기 재활이 가능하고 견고한 골유합을 얻을 수 있어 안전하고 확실한 치료방법으로 사료된다. Purpose: The purpose of this study is to present out experience with open reduction, 3.5-㎜ reconstruction plate fixation, bone-grafting, and postoperative early mobilization for nonunions of midshaft clavicular fratures. Materials and Methods: Sixteen patients were treated operatively for nonunions of the midshaft of the clavicle from 1997 to 2001. Ten nonunions were atrophic and six were hypertrophic. Nonunion had been present for an average of 6.5 months. The operative technique included removing the fibrous tissue from the nonunion site and opening the medullary canal, reduction of the fracture and fixation with a 3.5-㎜ reconstruction plate, and bone-grafting. Postoperative mobilization started within one week. Results: The average duration of follow-up was 22.0 months. All fracture were united in an average of 10.0 weeks. All patients had full range of motion of the ipsilateral shoulder, but 3 our of 6 patients who were more than 50 years old complained occasional pain in the ipsilateral shoulder at the final follow-up examination. There were no major complications of postoperative infection, metal failure of the plate, loss of fixation, nonunion, and refracture after removal of the implant. Conclusion: The technique of open reduction, reconstruction plate fixation, and bone-grafting is a safe and reliable method to allow early rehabilitation by stable fixation and to predict a high rate of union for nonunions of midshaft clavicular fractures.