뇌동맥류파열에 의한 뇌지주막하출혈 환자의 수술시기에 따른 예후 분석

손진열,박인성,황수현,백선하,김은상,정진명,김재형,한종우 대한신경외과학회 1999 Journal of Korean neurosurgical society Vol.28 No.3

요부 외측구역 협착증에서 단순감압술과 기구고정술을 병행한 요추체간 골유합술과의 임상적 비교

손병길,최은석,정을수,신종현,김명진,지용철 대한척추신경외과학회 2004 Neurospine Vol.1 No.1

Objective: The lumbar spinal canal can be devided into the central zone and the lateral zone. The divisions of the lateral zone are the subarticular, the foraminal, and the extraforaminal zone. A common causes of the operation for the spinal stenosis are related to the association with the spondylolisthesis and the central stenosis. There is a paucity of data, however, regarding the operative intervention in the lateral zone stenosis(LZS). Our aim was to analyze the surgical result by the anatomical type and the operative method. Methods: 72 patients of LZS excepting the association with the spondyolisthesis have been operated by six neurosurgeons of our hospital from 30th April, 1994 through 30th September, 2002. The patients had been interviewed about surgical result through telephone by third party persons. The surgical results were analyzed by the four score rating system: ① medication, ② ADL(Ability of daily living), ③ the degree of improvement, ④ the degree of satisfaction. Results: Among 72 patients, there were 25 males and 47 females. The age group of the patients were in their thirties(1), forties(9), fifties(21), sixties(36) and seventies(5). Surgical methods were used on decompression(22), posterior lumbar interbody fusion(PLIF) with cage(1) and PLIF with transpedicular screw fixation system(49). The types of stenosis were subarticular(24), foraminal(16) and extraforaminal(30) and double crush(2). The overall surgical results were Excellent(18), Good(34), Fair(19), and Poor(1). The Non-success rate according to the methods of surgery were decompression(34.8%), PLIF with transpedicular fixation system(24.4%). The overall success rate was(53/72: 73.6%). The success rate according to the types were subarticular(17/24: 70.8%), extraforaminal(21/30: 70%), and foraminal(12/16: 75%). Conclusion: It is suggested that the result was more favorable on the cases of lateral zone stenosis operated with PLIF and transpedicular fixation system. According to the method used, the success rate of decompression was worse than PLIF with transpedicular fixation system.

일부 초등학교 급식 식단의 평가(1) : 구성 식품의 다양성과 영양소 공급량 Based on Food Diversity and Nutrient Content

손은정,문현경 대한영양사협회 2004 대한영양사협회 학술지 Vol.10 No.1

The sound dietary habit is formed in childhood, which is basic foundation for keeping health. The school foodservice is practiced to provide proper nutritions, to establish the sound dietary habit. Continuous evaluation and improvement are necessary to operate school foodservice effectively. This study was conducted to evaluate the quality of meals served in elementary school based on nutrient content, food diversity. A questionnaire was mailed to dietitian of each school requested for menus of one week. Menus served in 77 schools from each province and major cities in Korea were analyzed. The results of this study were summarized as follows; Compared to 113 of RDA for children, many schools provide lower amounts of energy, calcium and Vitamin A. Proportions of energy from carbohydrate, protein and fat were 59.64%, 17.43% and 20. I 1 YO, respectively and were not significantly dif-ferent by the area, the foodservice system, and the number of persons served. NAR(nutrient adequacy ratio) were lowest for calcium(0.67) and Vitamin A(0.65). MAR(mean adequacy ratio) was 0.83. The results of comparison of NAR and MAR by the area, the foodservice systcm, and the number of persons served were similar to those of nutrient contents. Comparing foods served by the nutrient density were different by nutrient contents, NAR and MAR. Mean nutrient density per meal were higher in large cities than in small cities and rural area, in conventional than in commissary foodservice system. Mean number of dishes and food items per meal were 5.86 and 19.87, respectively. The mean of total quantity of each food group per meal was 352g. The mean of total quantity of each food group per meal were higher in small cities and rural area than in large cities, in commissary than in conventional foodservice system. This study is based only on served menus, and the evaluations of meals based on actual consumption of children are needed. These results suggest that in order to improve the quality of school food service, realistic standard should be suggested and basic study should be done continuously.

청소년 정신과 환자 중 외톨이 혹은 왕따 특성을 보이는 환자에 대한 예비 연구

손정우,김은정,홍성도,이시형,홍강의 대한소아청소년정신의학회 2000 소아청소년정신의학 Vol.11 No.2

본 연구는 청소년 정신과 환자 중 외톨이 혹은 왕따 특성을 보이는 환자에 대한 예비연구이다. 청소년 정신과 환자 25명에게 외톨이 설문지, 왕따 설문지 등 8개 설문지를 시행하였고, 일반적인 친구 관계를 질문하였다. 외톨이 설문지 및 왕따 설문지의 점수를 근거로 15명의 외톨이-왕따 집단과 10명의 비외톨이 집단으로 나눈 뒤 일반적 친구 관계와 8개 설문지의 점수를 비교하였다. 또한 5명의 외톨이-왕따 환자 사례를 분석하였다. 이때 SCL-90-R의 우울 차원 점수, 불안 차원 점수, 편집 차원 점수, SCL-90-R의 4가지 차원의 총합, 사회 불안 설문지 점수 등에서 두 집단이 유의한 차이를 보였다. 5명의 외톨이-왕따 환자의 사례 분석 결과, 병원을 찾은 청소년 정신과 환자는 언어 발달 및 인지 발달의 지연 등 발달에서의 문제가 동반되는 경우에 외톨이-왕따를 당할 가능성이 높은 경향을 보인다. 중심 단어 : 외톨이ㆍ왕따ㆍ청소년ㆍ발달. This study was a preliminary study on the adolescent psychiatric patients that show the characteristics of peer group neglect or rejection. We divided the adolescent psychiatric patients (n=25) into neglect-reject group(n=15) and non-neglect group(n= 10). Each patient answered 8 scales and several questions about general relationships with friends. And, both the score of each 8 scales and answer about qusetions were examined. Lastly, records of 5 cases from neglect-reject group were analyzed. The depression dimension score of SCL-90-R, anxiety dimension score of SCL-90-R, paranoid dimension score of SCL-90-R, interaction anxiousness scale(IAS) score were significantly different between 2 groups. On the result of case analysis about 5 patients of neglect-reject group, the adolescent psychiatric patients had a tendency to be rejected or neglected in case of having developmental problems(for example, language development or cognitive impairment). KEY WORDS : Peer neglectㆍPeer rejectionㆍAdolescentㆍDevelopment.

골격성 Ⅲ 급 부정교합자의 두개안모 성장예측에 대한 평가

손우성,강은희,정미라,성지현 대한치과교정학회 2003 대한치과교정학회지 Vol.33 No.1

본 연구는 성장에 의한 변화를 예측하는 현재의 방법이 실제로 골격성 Ⅲ급 부정교합자의 진단과 치료계획에 적절히 사용될 수 있는 지를 판단해 보기 위해 초진 시 골격성 Ⅲ급 부정교합으로 진단받고 성장 종료 후 악교정 수술을 받기위해 재내원한 골격성 Ⅲ 급 부정교합자 25명(남자 13명, 여자 12명)을 대상으로 시행되었다. 초진시 채득된 측모 두부방사선 사진에서 Ricketts의 성장예측법을 통해 성장 종료 후의 상태를 예측한 후, 악교정 수술을 위해 재내원 했을 때 채득된 측모 두부방사선 사진에서 계측된 실제 성장량과 비교분석 함으로써 다음과 같은 결론을 얻었다. 1. 예측치와 관측치의 일치정도를 평가해본 결과 Porion Location, Ramus Position, Facial Depth, Facial Axis, Mandibular Plane angle, Maxillary Convexity에서의 예측치가 관측치와 차이를 보이고 있어 이 항목에 대한 Ricketts 성장예측법의 예측치가 실제 성장량을 잘 설명해주지 못함이 관찰되었다. 2. 하악골체의 성장량은 정상 성장량과 유사하였으나 Porion Location, Ramus Position이 정상적인 성장과정을 벗어나면서 하악골의 전방위치를 유도하였다. 3. 골격성 Ⅲ 급 부정교합자에서는 성장의 양과 방향이 비정상적인 성장변화를 나타내어 정상 성장에서라면 변화를 보이지 않을 하악지의 전방 위치, 하악이부의 전상방 회전 등이 일어난 하악 전돌의 경향이 악화될 수 있다. This study was performed to evaluate whether growth prediction method can be used to diagnose and make treatment plan in skeletal Class Ⅲ malocclusion patients or not. The sample was consisted of 25 patients(13 males, 12 females) who had been diagnosed with skeletal Class Ⅲ malocclusion at first visit and after that had returned to take orthognathic surgery. Growth prediction performed with Ricketts' growth prediction method from first cephalogram was compared with actual growth of the second cephalogram. The findings of this study were as follows ; 1. There was significant difference between actual growth and growth prediction in Porion Location, Ramus Position, Facial Depth, Facial Axis, Mandibular Plane angle, Maxillary Convexity. So, for these items Ricketts' growth prediction method is not proper to predict growth. 2. Although the growth amount of mandibular body was similar to normal growth amount, mandible was positioned anteriorly because of Porion Location and Ramus Position. 3. In skeletal Class Ⅲ malocclusion patients, the tendency of mandibular prognathism might be aggreviated because of anterior placement of ramus and anterosuperior rotation of pogonion.

유아교육기관에서의목공놀이활성화를위한프로그램개발

손지현,정은주 서울여자대학교 2007 아동연구 Vol.13 No.-

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미용사들의 이직욕구에 관한 연구 : 직무스트레스, 근골격계 증상을 중심으로 Focusing on Musculoskeletal Symptoms and Occupational Stress

서은경,문덕환,박명희,김정원,황용식,손병철,김대환,이창희,김휘동,이채언 인제대학교 백병원 2002 仁濟醫學 Vol.23 No.5

Objective : This study was conducted to prepare the fundamental data on desire of job transfer in hairdresser and prevent the health impairment of hairdresser due to occupational stress and musculosketetal symptoms. Methods and Material : The author surveyed the desire of job transfer and muscurlosketetal symptoms and occupational stress with self-reported questionnaire to 105 hairdresser who were working in beautyshop of Busan area and also 121 student in department of cosmestology as control group. Results : The results were as follows: 1. The rates of self reported symptom were 81.0% for shoulder, 72.4% for back, 67.6% for knee, 58.1% for hand in hairdresser, and 79.3% for shoulder, 71.9% for back, 66.9% for neck, 64.5% for hand and knee in student. 2. The rate of musculoskeletal symptom by NIOSH criteria was 36.2% in hairdresser, it was higher than student group(24.8%)(p<0.1). Occupational stress of the groups by occupational stress category was high as decision latitude, skill discretion, psycological job demand, decision authority in order. 3. The results of logistic regression of related varibles with desire of quitting job by logistic regression were statistical bordline significance between desire of quilting and social support(p<0.1). Conclusion : As above results, the author suggest to prepare the preventive program an musculoskeletal symptoms in hairdresser, especially shoulder, and also to control the occupational stress to hairdresser in beauty shop because occupational stress can be a factor of desire of quitting job.

수입 외국산 모발세정용 화장품의 중금속 농도에 관한 연구

문정아,문덕환,박명희,안진홍,김종은,손병철,김대환,이창희,김휘동,이채언 인제대학교 백병원 2002 仁濟醫學 Vol.23 No.5

Objective : For the purpose of preparing the fundamental data and preventing the health impairment due yo heavy metals in hair cleaner. Methods and Material : The author determined the concentration of heavy metals(Fb, fn, Cr, Ni and Cu) in hair cleaner with flameless atomic absorption spectrophotometer. Results : The results were as follows : 1. The mean concentration of heavy metals in total hair cleaner were 0.046㎍/g for Pt, 0.O67㎍/g for Mn, 0.069㎍/g for Cr, 0.046㎍/g for Ni, and 0.022㎍/g for Cu, respectively. 2. There was not statistically significant difference to mean concentrations of each heavy metal in hair cleaner by producing nation. 3. The highest mean concentration of each heavy metal in hair cleaner by type of use were 0.140㎍/g for Mn in sensitive hair cleaner(p<0.05), 0.053㎍/g for Cu in others products(p<0.01). 4. The mean concentration of heavy metals in hair cleaner by type of hair cleaner were high at 0.O54㎍/g for Pb in shampoo products(p<0.O5), 0.120㎍/g for Cr and 0.06㎍/g for Cu in combination products(p<0.01). 5. The mean concentration of heavy metals in hair cleaner by acidity were high at 0.056㎍/g for Pb, 0.124㎍/g for Cr, and 0.032㎍/g for Cu in alkali products (p<0.05). 6. Correlation coefficient of heavy metal concentration in hair cleaner were 0.175 for Pb and Cr, 0.165 for Pb and Mn, 0.824 for Cr, and Mn, 0.189 for Cr, and Ni, 0.406 for Cr, and Cu, 0.197 for Mn and Ni, and 0.375 for Mn and Cu(p<0.05). 7. Exposure amount of heavy metals per when we used lOg of hair cleaner (onetime using amount) were 0.46㎍ for Pb, 0.67㎍ for Mn, 0.69㎍ for Cr, 0.46㎍ for Ni, and 0.22㎍ for Cu, respectively. Conclusion : As above results, there was very low level concentration of heavy metal in hair cleaner but we are using the hair cleaner everyday, therefore we can exposed to heavy metals as cronic exposure so the author suggest to prepare the program of preventing the health impairment due to heavy metals.

연쇄알구균 감염에 의한 급성 인후염 후 반응성 관절염 1예

박은하,도연실,양정채,강미라,서현주,정숙인,손준성,기현균,오원섭,백경란,송재훈 대한감염학회 2004 감염과 화학요법 Vol.36 No.6

연쇄알구균에 의한 급성 인후염 후 발생한 반응성 관절염은 급성 류마티스열의 개정된 진단기준을 충족하지 못하면서, 지속적 혹은 재발성의 비이동성 관절염과 발열, 홍반성 결절, 일시적 간기능 이상 등을 보이면서 심장염과 무도증을 드물게 동반하는 질환이다. 따라서, 발열을 동반한 급성 관절염 환자에서 감별해야 할 질환 중의 하나이며, 심근염 예방을 위한 페니실린 요법의 적응증 및 기간에 대해서는 아직 이론이 많은 상황으로, 보다 광범위한 연구가 필요하다. 저자들은 연쇄알구균에 의한 급성 인후염 1주 후에 발생한 하지의 다발성 비이동성 관절염과 함께 결절홍반 및 일시적 간기능 이상을 보인 환자에서 PSRA로 진단하고 비스테로이드성 항염증제 및 스테로이드로 성공적인 치료를 하였기에 이를 문헌 고찰과 함께 보고하는 바이다. Poststreptococcal reactive arthritis (PSRA) is associated with recent streptococcal infections. However, PSRA is distinct from acute rheumatic fever by its clinical manifestations: non-migrating arthritis, erythema nodosum or erythema multiforme, and transient elevation of serum transaminases. We experienced a 33-year-old man who presented with fever, arthritis of both knees and ankles, and erythema nodosums on extensor surfaces of lower legs which developed 6 days after the onset of pharyngitis symptoms. Blood and urine cultures were negative. Throat culture was negative for group A β-hemolytic streptococcus. The ASO titers increased up to 2080 IU/mL in sequential monitoring. The result of bone scan was compatible to arthritis of both knees and ankles. There were no signs or symptom of carditis. He showed clinical improvement with anti-inflammatory drugs (naproxen 1,000 mg/day and prednisolone 7.5 mg/d). PSRA should be included in the differential diagnosis of patients presenting with arthritis combined with fever.

계승영구치가 선천적 결손된 유치의 치근 흡수

이정은,이제호,최형준,김성오,송제선,손흥규,최병재 대한소아치과학회 2009 大韓小兒齒科學會誌 Vol.36 No.4

유치의 정상적인 치근 흡수는 계승 영구치의 맹출 압력으로 단핵구 세포가 방출되어 파골세포로의 분화가 촉진되어 일어나며, 계승 영구치의 맹출 경로를 따라 유치의 치근이 흡수되어서 유치가 탈락하게 된다. 계승 영구치가 선천적으로 결손되었을 때에도 유치의 치근은 흡수될 수 있는데, 유치의 비정상적 치근흡수는 외상이나 염증, 교합압의 증가, 지지조직의 약화 등으로 발생할 수 있다. 치아의 선천적 결손은 인간에서 가장 흔한 발육이상이며, 영구치가 결손되었을 때 유치는 만기 잔존할 수 있다. 영구치의 선천적 결손은 전신질환이 있는 경우뿐만 아니라 국소적 원인이나 인류 진화에 따른 영향 등에 의해서도 발생한다. 이 증례들은 계승 영구치가 선천적으로 결손된 어린이에서 유치의 치근이 비정상적으로 흡수된 경우로 계승 영구치가 결손 된 유전치와 유견치, 유구치의 치근이 1/2 ~ 3/4정도까지 흡수 되었으며 흡수 부위는 불규칙적인 형태를 보였다. 원인으로는 흡수에 감수성이 높은 유치의 치주인대, 그리고 성장에 따라 증가되는 저작근육과 저작력, 혼합치열기에 유발되는 비정상적 교합 등을 생각할 수 있다. 계승 영구치가 결손된 유치가 비정상적인 치근 흡수를 보이는 경우에 유치는 유지될 수도 있지만, 여러 요인에 의하여 탈락될 경우에는 공간을 유지 할 것인지 판단해야 하며, 향후 보철치료나 교정치료를 요하므로 장기적인 치료계획을 수립해야 한다. Root resorption of primary teeth usually occurs as the succeeding permanent teeth erupt, which induces differentiation of the hemopoietic cells into osteoclasts. Their root resorption pattern reflects the eruption path of the succeeding permanent teeth, and eventually the primary teeth shed as their succeeding permanent teeth erupt. Even when a permanent tooth germ is congenitally missing, root resorption of the corresponding primary tooth may still occur due to various factors, such as inflammation, traumatic occlusal force, and weakness of periodontium etc. Such congenital missing of permanent teeth is a commonly observed phenomenon in human be ing, and it often accompanies delayed retention of primary teeth. The etiologic factors for congenital missing in elude not only systemic diseases, but also local factors and human evolution process. In the radiographs of the cases in this report, the primary teeth without succeeding permanent teeth show pathologic root resorption. Root resorption progressed about 1/2~3/4 of the roots, and the surfaces of the resorption area were irregular. Considering high susceptibility of the periodontal ligament of primary teeth to root resorption, pathologic root resorption of primary teeth with delayed retention can be explained by the increased masticatory muscle force and abnormal occlusion developed during the mixed dentition. When the primary teeth without succeeding permanent teeth are lost, decision for space maintenance is required and long-term treatment plan for further prosthetic or orthodontic treatment should be establsihed.