4종 전자근관장측정기의 정확성과 일관성에 관한 in vitro 연구

조재현,금기연,이승종 대한치과보존학회 2006 Restorative Dentistry & Endodontics Vol.31 No.5

이번 연구는 서로 다른 4개의 전자근관장측정기의 정확성을 측정하고 각각 0.5지점과 Apex지점에서의 일관성을 비교하고자 하였다. 40개의 발치된 상하악 소구치를 대상으로 치수강 개방 후 alginate model에 고정시키고 근관장을 측정하였다. 사용된 전자근관장측정기는 Root ZX (Morita, Tokyo, Japan), SmarPex (META, Seoul, Korea), Elements Diagnostic Unit (SybronEndo, CA, USA), E-Magic Finder Deluxe (S-Denti, Seoul, Korea)이다. 먼저 모든 치아에서 4개의 전자근관장측정기를 사용하여 0.5지점과 Apex지점에서 근관장을 측정하여 한 치아당 8개의 측정값을 얻었다. 다음으로 치아를 각 전자근관장측정기당 10개씩 4개의 그룹으로 나누어, 각각 제조사의 지시대로 Root ZX, Elements Diagnostic Unit 및 E-Magic Finder Deluxe는 "0.5"지점에서, SmarPex는 ''Apex" 지점에서 file을 치아에 cement로 고정시켰다. 이후 치근단부 4 mm를 삭제하여 100배율의 Image ProPlus로 관찰하여 file 끝에서 주근단공의 외연까지의 실제거리를 측정한 후, 4개의 전자근관장측정기의 0.5지점 및 Apex지점에서 file 끝과 주근단공 사이의 거리를 계산하여 비교하였다. 그 결과 Root ZX와 E-Magic Finder는 실험군 100%, SmarPex는 90%, Elements Diagnostic Unit는 70%에서 주근단공과의 거리가 임상적 허용범위인 土0.5 mm 이내에 있었다. 또한 각 전자근관장측정기마다 0.5지점과 Apex지점에서의 근관장의 표준편차와 사분위 범위를 구하여 두 지점간의 일관성을 비교한 결과, Root ZX, E-Magic Finder는 0.5지점과 Apex지점에서 비슷한 일관성을 보였으며 SmarPex와 Elements Diagnostic unit는 Apex지점에서 0.5지점보다 더 높은 일관성을 보였다. 전자근관장측정기는 근관 내의 조건에 관계없이 근첨협착부에서 항상 일정한 거리를 재현해 낼 수 있는 일관성이 중요하므로, 이렇게 0.5지점 또는 Apex지점에서의 일관성이 증명된다면 실제 임상에서 사용할 때 전자근관장에서 일정한 거리를 가감하여 사용할 수 있다. The purpose of this study was to evaluate the accuracy and the consistency of four different electronic apex locators in an in vitro model. Fourty extracted premolars were used for the study. Four electronic apex locators (EAL) were Root ZX, SmarPex, Elements Diagnostic Unit (EDU), and E-Magic Finder Deluxe (EMF). After access preparation, the teeth were embedded in an alginate model and the length measurements were carried out at "0.5" and "Apex" mark using four EALs. The file was cemented at the location of the manufacturers' instruction (Root ZX, EDU, EMF: 0.5 mark, SmarPex: Apex mark). The apical 4mm of the apex was exposed and the distance from the file tip to the major foramen was measured by Image ProPlus (× 100). The distance from the file tip to the major foramen was calculated at 0.5 and Apex mark and the consistency of 0.5 and Apex mark was compared by SD and Quartile of Box plots. In this study, Root ZX and EMF located the apical constriction accurately within ± 0.5 mm in 100%, whereas SmarPex and EDU located in 90% and in 70% respectively. For Root ZX and EMF, there was no significant difference between the consistency of 0.5 and Apex mark. However, for the EDU and SmarPex, Apex mark was more consistent than 0.5 mark. From the evaluation of the consistency in this study, for Root ZX and EMF, both 0.5 and Apex mark can be used as a standard mark. And for EDU and SmarPex, the Apex mark can be recommended to be used as a standard mark.

急性 骨髓性 白血病 患者 1例에 對한 臨床報告

조정효,유화승,최우진,이용연,서상훈,이연월,손창규,조종관 대전대학교 한방병원 2000 惠和醫學 Vol.9 No.2

AML is the most common type of leukemia in adults. AML(acute myeloid leukaemia) is characterised by a rapid accumulation of abnormal white blood cells in the blood and bone marrow, resulting in severe anemia, and possibly infection, and hemorrhage during the course of the disease. In general the prognosis of patient with relapsed AML is poor. At this time, however, the only potentially curative therapy for relapsed patients is allogeneic BMT(bone marrow transplantation). This clinical study were carried out 1 case of female patient aged 44 with relapsed AML treated by herb medicine. At the time of admission, she complained of mild fever, nausea, vomitting, abdominal pain, anorexia and no sign of bleeding. For the 10 days of admission, she was treated with Oriental-Western medicine and all the symptoms were disappeared. After that, the syptoms were aggravated because of secondary infection. Anyway, above result showed the possibility of Oriental therapy as Supportive Care in AML.

기종성 신우신염의 임상양상 및 사망위험인자

조수연,이호재,조용현,이승주 대한감염학회 2009 감염과 화학요법 Vol.41 No.1

Background : Emphysematous pyelonephritis (EPN) is an acute gas forming necrotizing infection of the renal parenchyma with high mortality. Although its incidence is relatively low, it mostly occurs in patients wiith diabetes mellitus. The aim of the study is to identify the risk factors related to mortality and assess the outcome of managements according to the radiologic classification. Materials and Methods : The clinical records of 23 patients diagnosed with EPN were reviewed retrospectively. The cases were grouped into two types on the basis of computed tomography scan. Type 1 EPN was defined as renal necrosis and gas formation with total absence of fluid content. Type 2 EPN was defined as the presence of renal or perirenal fluid in association with bubbly or loculated gas pattern. The patients' symptoms, performed investigations, and treatments were analyzed. Results : All patients had diabetes mellitus. Escherichia coli (78.6%) was the most common pathoqen in urine and blood cultures. The factors showing statistically significant differences between survivors and non-survivors were age (P=0.013), the presence of obstructive uropathy (P= 0.008), and type 1 group (P=0.030). Multivariate logistic regression showed that factor significantly related to death was age (odds ratio=1.20, 95% confidence interval 1.01-1.38, P=0.037). Conservative treatment including antibiotics and percutaneous drainage was successful in type 2 group, Overall mortality was 26.1%; all expired patients were from type 1 group. The mortality of conservative treatment and nephrectomy in type 1 group was 83.3% and 20.0%, respectively. Conclusion : These results suggest that old age is a significant risk factor for mortality in patients with EPN. Nephrectomy should be considered as the main treatment option in patients with type 1 EPN.

抗癌丹을 投與한 各種 癌患者 320例에 對한 考察

曺政孝,兪和承,李淵月,孫彰奎,趙鍾寬 대전대학교 한의학연구소 2004 혜화의학회지 Vol.12 No.2

The purpose of this study was to investigate the effects of Hangamdan(抗癌丹). The clinical study was carried out 320 cases of patients with cancer treated by Hangamdan(抗癌丹) from May 1st 1998 to September 1st 1999. The results were summarized as follows; 1. The effects of improvement in the symptoms with traditional oriental cancer therapy(47.6%) were higher than combined treatment of western and oriental therapy(37.4%). 2. In the analysis of hematology, maintenance and increasing of WBC(86.2%), Hgb(87.2%), Platelet(97.6%) RBC(81.1%) were Observed. In the analyses of tumor marker, maintenance and decreasing of CEA(76%), CA19-9(88.8%), AFP(69.2%) were observed. 3. In the analysis of safety, maintenance and decreasing of AST(93.1%), AL.T(95%), BUN(92.2%), Creatinine(93.6%) were observed. 4. In the analysis of QOL attached by cancer, combined treatment of western and oriental therapy(maintenance and improvement; 91.8%) was higher than traditional oriental cancer therapy(maintenance and improvement; 79.3%) 5. In the analysis of survival in patients with terminal cancer, above 6 months(46.3%), 12 months( 19.2%). 6. In the analysis of antitumor effects, combined treatment of western and oriental therapy(maintenance 71.6% improvement 12.8%) was higher than traditional oriental therapy (maintenance 66.7% improvement 9.5%). 7. In the analysis of curative evaluation, combined treatment of western and oriental therapy(maintenance 40.4% improvement 41.8%) was higher than traditional oriental therapy (maintenance 23.8% improvement 46.1%). 8. In the analysis of IL-12 and IFN-γ attached by cancer, increasing of IL-12(32.3%), IFN-γ(41.5%) were observed. From the above results, it is suggested that Hangamdan has significant effects of antitumor and immune activity, also could be usefully applied for cancer patients by combination with western therapy or alone.

급성세균성전립선염의 임상적 특징 및 치료 결과

조수연,배웅진,조용현,이승주 대한감염학회 2009 감염과 화학요법 Vol.41 No.1

Background : Acute bacterial prostatitis is an uncommon male urinary tract infection that is the result of severe prostatic infection mainly by gram-negative bacteria. We conducted a retrospective study to report clinical outcomes of patients with acute bacterial prostatitis. Materials and Methods : The clinical records of 49 patients diagnosed with acute bacterial prostatitis were reviewed retrospectively and patients' symptoms, investigations, and treatments were analyzed. Results : All patients presented with fever and voiding symptoms. Some patients (22.4%) had a history of prior manipulation of the lower urinary tract including transrectal prostate biopsy. Urine cultures were positive for 51% of the patients. The most common pathogen was Escherichia coli (60%), followed by Pseudomonas aeruginosa (20%) and Staphylococcus aureus (12%). The ciprofloxacin susceptibility against E. coli was 80%. All patients were treated with parenteral antibiotics in the hospital followed by oral antibiotics for average of three weeks. The major drugs used for empirical treatment were cephalosporins, aminoglycosides, and fluoroquinolones. Prostatic abscess was found in two (4.1%) Patients and chronic pelvic pain syndrome developed in six (12.2%) patients during follow-up. Conclusion : The currently used empirical antibiotics were mostly effective in the treatment of acute bacterial prostatitis. Continuous monitoring on antimicrobial susceptibility of acute bacterial prostatitis was necessary for providing proper treatment guideline.

용혈성 빈혈과 흑수열을 동반한 Chloroquine저항성 수입 열대열 말라리아 1예

조희충,국기용,박일,최연수,이승일 조선대학교 1994 The Medical Journal of Chosun University Vol.19 No.1

저자들은 최근 아프리카를 여행하는 도중 말라리아의 예방약제인 chloroquine을 복용하였음에도 불구하고 용혈성 빈혈과 흑수열을 동반한 chloroquine 저항성 수입 열대열 말라리아를 Fansidar를 투여하여 치료가 된 1예를 경험하였기에 문헌고찰과 함께 보고하는 바이다. This previously healthy 26 year-old student was admitted to Cho Sun university hospital due to paroxysmal high fever, dizziness of 2 weeks duration and he also noted passage of dark brownish colored urine of 3 days duration. He had made journey to Africa for 2 months before admission. He had taken chloroquine 1 week before his jurney and continued this weekly throughout his stay. On admission, there was fever of 38.5℃ and numerous parasitemia of ring form of P. falciparum in the peripheral blood smear. On physical examination, he had jaundice and splenomgaly. On laboratory examination, he had jaundice and splenomegaly. On laboratory examination hemoglobin was 5.Og / dl, reticulocytecount was 11%, plasma hemoglobin was 7.5mg /dl and urine hemoglobin was 2.5mg /dl. He received Fansidar on 2nd day of admission. Five days later, his blood was completely clear of parasite and 7th day after admission, all symptoms were almost improved and then he was discharged.

Rat의 복강에 삽입한 Fluorouracil-Polyglycolic acid 제형의 Fluorouracil 용출에 관한 연구

노승무,정경수,오정연,김진향,양준묵,강대영,송규상,최정목,최선웅,이진호,조준식,민병무,김용백,김창식,박근성,김승영,김학용,인현빈 忠南大學校 癌共同硏究所 1998 癌共同硏究所 硏究誌 Vol.2 No.1

A common form of relapse in adenocarcinoma of the stomach is intraperitoneal dissemination, in fact, among gastric adenocarcinoma patients who have undergone surgery intended to cure, approximately 50% of the patients develope initial recurrence in the peritoneal cavity regardless of the anatomic site of the primary tumor within the stomach. The efficacy of systemic postoperative chemotherapy to prevent peritoneal recurrence of gastrric adcnocarcinoma is not satisfactory. There is still a great need for improved therapeutic strategies on the disseminated microscopic disease and small miliary nodules remaining on the peritoneal surface or lymphatics after operation. The authers have made fluorouracil-polyglycolic acid composite disks(Fu-PGA disks) with fluorouracil and biodegradable polymer: polyglycolic acid for more effective intraperitoneal chemotherapy. We inserted the Fu-PGA disk(s) in the peritoneal cavity of rat and pharmacokinetic study was performed to measure fluorouracil concentration in the peritoneal fluid, plasma, liver, kidney and heart tissue at 24 hour, 72 hour and 168 hour after insertion of Fu-PGA disk(s). Myelosuppressive action of this composite also was determined following its administration. The data of this study suggested that Fu-PGA composite will be a new device releasing drugs in a controlled manner and having targetability to peritoneum, and this device will be improving the efficacy of intraperitoneal chemotherapy for gastric adenocarcinoma.

Rat의 복강에 삽입한 Filorouracil-Polyglycolic acid제형의 Fluorouracil용출에 관한 연구

노승무,정경수,오정연,김진향,양준묵,강대영,송규상,최정목,최선웅,이진호,조준식,민병무,김용백,김창식,박근성,김승영,김학용,인현빈 충남대학교 의과대학 지역사회의학연구소 1998 충남의대잡지 Vol.25 No.1

A common form of relapse in adenocarcinoma of the stomach is intraperitioneal dissemination, in fact, among gastric adenocarcinoma patients who have undergone surgery intended to cure, approximately 50% of the patients develope initial recurrence in the peritoneal cavity regardless of the anatomic site of the primary tumor within the stomach. The efficacy of systemic postoperative chemotherapy to prevent peritoneal recurrence of gastrric adenocarcinoma is not satisfactory. There is still a great need for improved therapeutic strategies on the disseminated microscopic disease and small miliary nodules remaining on the peritoneal surface or lymphatics after operation. The authers have made fluorouracil-polyglycolic acid composite disks(Fu-PGA disks) with fluorouracil and biodegradable polymer: polyglycolic acid for more effective intraperitoneal chemotherapy. We inserted the Fu-PGA disk(s) in the peritoneal cavity of rat and pharmacokinetic study was performed to measure fluorouracil concentration in the peritoneal fluid, plasma, liver, kidney and heart tissue at 24 hour, 72 hour and 168 hour after insertion of Fu-PGA disk(s). Myelosuppressive action of this composite also was determined following its administration. The data of this study suggested that Fu-PGA composite will be a new device releasing drugs in a controlled manner and having targetability to peritoneum, and this device will be improving the efficacy of intraperitoneal chemotherapy for gastric adenocarcinoma.

소아에서 간질발작의 임상양상과 뇌파검사의 관계

이승현(Seung Hyeon Lee),손동우(Dong Woo Son),은병욱(Byung Wook Eun),심소연(So Yeon Sim),최덕영(Deok Young Choi),선용한(Yong Han Sun),조강호(Kang Ho Cho0, 류 일(Eell Ryoo),전인상(In Sang Jeon0, 차 한(Hann Tchah) 대한소아신경학회 2009 대한소아신경학회지 Vol.17 No.2

목적:발작의 분류는 발작의 원인, 예후를 추정하거나 항경련제를 선택하는 데 있어 매우 중요하며 뇌파검사는 발작의 종류를 구분하고 적절한 치료를 하기 위해 시행하는 중요한 검사이다. 저자들은 소아에서 임상적 발작이 확실한 경우 간질발작의 임상양상과 뇌파검사 간의 일치 정도를 알아보고자 한다. 방법:2000년 1월 1일부터 2008년 9월 30일까지 1회 이상의 간질발작을 주소로 가천의대 길병원 소아청소년과에 방문한 환자 중 본원에서 처음으로 뇌파검사를 시행한 환자를 대상으로 하였다. 발작의 임상양상은 목격자와 본인의 설명을 기록한 의무기록지를 기준으로 하여 부분발작과 전신발작으로 분류하였고 뇌파검사는 발작간간질양방전을 기준으로 정상과 비정상으로 분류하였으며 각성과 수면상태 모두에서 시행하였다. 결과:총 461명의 환자의 뇌파검사 시의 평균 연령은 6.7세였고 남자는 247명, 여자는 214명이었다. 전체 환자에서 발작의 임상양상은 부분발작이 310명, 전신발작이 187명이었다. 각성뇌파검사에서 비정상은 158명으로 부분발작파가 118명, 전신발작파가 59명, 두 가지 발작파가 한 환자에서 나온 경우가 19명이었고, 수면뇌파검사에서는 비정상이 239명으로 부분발작파가 196명, 전신발작파가 77명, 두 가지 발작파가 한 환자에서 나온 경우가 34명이었으며 전체 환자에서는 비정상이 273명으로 부분발작파가 216명, 전신발작파가 97명, 두 가지 발작파가 한 환자에서 나온 경우가 40명이었다. 간질증후군은 전체 환자 중 90명에서 관찰되었다. 146명(41.5%)의 부분발작과 44명(23.4%)의 전신발작 및 79명(87.8 %)의 간질증후군이 뇌파소견과 일치하였다. 결론:영유아 및 소아에 있어 발작을 진단할 때에는 발작양상 분 아니라 정확한 뇌파소견을 세심하게 고려하여야 한다. Purpose:Electroencephalography(EEG) is an essential method carried out for classifying seizures and taking appropriate treatment. The aim of this study is to investigate the concordance between clinical findings of epileptic seizures and EEG in children. Methods:We enrolled 461 patients from those who visited Gil hospital from January 1, 2000 to September 30, 2008 with the chief complaint of epileptic seizure more than once and checked their first EEG at the same hospital. The clinical findings of seizure were based on the charts and interictal waking and sleep EEGs were done. Results:The mean age of the patients was 6.7 years old. 497 epileptic seizures occurred and its clinical finding included 310 of partial seizures and 187 of generalized seizures. In 315 waking EEG 158 were abnormal including 118 of partial seizures, 59 of generalized seizures and 19 of both seizures, in 431 sleep EEG 239 were abnormal including 196 of partial seizures, 77 of generalized seizures and 34 of both seizures, and in waking and/or sleep EEG 273 were abnormal including 216 of partial seizures, 97 of generalized seizures and 40 of both seizures. Epileptic syndromes were observed in 90 patients. 146(41.5%) of partial seizures, 44(23.4%) of generalized seizures, and 79(87.8%) of epileptic syndromes accorded with EEG. Conclusion:When diagnosing seizures in children, we must consider not only clinical findings but also accurate EEG findings.

위암환자의 복강내에 투여한 Mitomycin C-Carbon Particle의 Mitomycin 용출에 관한 연구

노승무,조영훈,정경수,오정연,김진향,양준묵,강대영,송규상,조준식,최선웅,이진호,민병무,김용백,김창식,박근성,인현빈,정현용,김학용 충남대학교 의과대학 지역사회의학연구소 1998 충남의대잡지 Vol.25 No.1

Locoregional recurrence is the most common type of recurrence in surgical operation of gastric adenocarcinoma, and peritoneal dissemination is one of the most difficult problems in advanced gastric adenocarcinoma treatment. Because the peritoneal cavity is the most common site of the first recurrence after gastric cancer resection, intraperitoneal chemotherpy seems a logical choice for cancer chemotherapy. The Mitomycin C(MMC) adsorbed by the activated charcoal particles(CH) is relatively released when the drug concentration surrounding the carbon particles becomes low in the peritoneum of the peritoneal cavity. For the intraperitoneal chemotherapy on the advanced gastric adenocarcnoma, mitomycin C adsorbed on activated carbon particles was administered in the peritoneal cavity just before abdominal wall closure. The closed drainage tubes were inserted in the peritoneal cavity and clamped for tuo hours after completion of operation. MMC concentrations were serially measured in peritoneal fluid, plasma and urine at 2hour, 48 hour, 72 hour and 168 hour following its administration in order to study the efficacy of the MMC-CH as a drug delivery system. There were minimal toxicities in born marrow, liver, and gastrointestinal system after intraperitoneal MMC-CH administration. The data of this study suggested that MMC-CH may have a somewhat more beneficial effect than surgery alone when administered in optimal dose and schedules, but the MMC concentration of the peritoneal fluid was not sufficient to eradicate remnant cancer cells, and effective duration of maintenance was only below 24 hours in the peritoneal fluid and plasma.