교정용 밴드 제거 후 미생물 분포 및 치주 조직의 임상적 변화

양유미,김성식,전은숙,박수병 대한치과교정학회 2006 대한치과교정학회지 Vol.36 No.4

본 연구는 밴드 제거 직후 및 4주 경과 후 치주조직의 임상적인 환경변화와 미생물 분포 변화를 알기 위해 시행하였다. 최후방 구치에 밴드를 포함하는 고정식 교정 장치를 장착하고 교정 치료를 1년 이상 시행한 17명의 환자를 대상으로 하였다 (평균 나이 22세, 남자 6명, 여자 11명). 최후방 구치의 밴드를 제거한 직후와 제거 후 4주가 경과한 다음에 치주조직의 탐침 깊이와 출혈 빈도를 측정하였으며, 치은 연하의 치태를 채취하여 미생물의 분포를 조사하였다. 치주질환에 관련성이 깊은 미생물 중 Porphyromonas gingivalis, Tannerella forsythia, Treponema denticola를 직접 Polymerase Chain Reaction 방법으로 존재 여부를 확인하였다. 밴드 제거 직후와 제거 후 4주가 경과한 시점의 치주조직의 탐침 깊이와 출혈 빈도, 병원성 미생물의 존재 여부를 통계적으로 비교하였다. 탐침 깊이와 출혈 빈도는 모두 하악 좌측 구치 협면에서 감소율이 가장 크게 나타났고, 상악 우측 구치 설면에서 감소율이 가장 작게 나타났다. 병원성 미생물 중 T. denticola가 밴드 제거 4주 후에 가장 높은 감소율을 보였으며, 하악보다 상악에서 감소율이 더 크게 나타났다. 이는 비록 밴드를 장착하여 치주 환경이 불량해졌다 하더라도 올바른 구강 위생 관리가 시행된다면 밴드를 제거한 후 정상적인 치주 상태로 회복될 수 있음을 예시한 것으로 생각되었다. Objective: The purpose of this study was to evaluate clinical and microbiological changes in periodontal tissue around the banded molars after debanding. Methods: This study included 17 young adult patients treated with fixed orthodontic appliances including bands on the last molars more than 1 years. Probing depth and bleeding frequency were measured and plaque samples were collected from the last banded molars in all quadrants of each patient. All the data were collected immediately after debanding and 4 weeks after debanding. Results: Using polymerase chain reaction based on 16S rDNA, the presence of Porphyromonas gingivalis, Tannerella forsythia and Treponema denticola was detected. After debanding, probing depth, bleeding frequency, and prevalance of periodontopathogens were reduced. Probing depth and bleeding frequency were most decreased in the buccal site of the mandibular left molar and were least decreased in the lingual site of the maxillary right molar. Conclusion: The results of this study indicated that proper management of oral hygiene after debanding can recuperate unfavorable periodontal condition caused by orthodontic treatment.

정신분열병과 Neurotensin 수용체 유전자 다형성의 연합 연구

이유상,김형배,한진희,채영규,이정식,이혜순,주연호,김형섭,최인근,양병환 大韓神經精神醫學會 1999 신경정신의학 Vol.38 No.6

연구목적: Neurotensin(NT)은 NT수용체와 결합하여 그 효과를 나타내는 neuromodulator 혹은 neurotransmitter로서 대뇌에서 도파민의 분비를 조절하는데 중요한 역할을 한다. 근래의 연구에 의하면 NT와 그 수용체는 대뇌에서 항정신병 약물의 효과를 매개하는 것으로 생각되고 있으며 약물치료를 받지 않은 정신분열병 환자의 뇌척수액에서 NT의 양이 적으로 보고되고 있어 이들은 정신분열병과 깊은 관련을 가지고 있을 것으로 추정된다. 최근 NT수용체의 유전자의 3`인접영역에서 정보가치가 높은 4 염기반복 다형성이 발견되어 이를 유전 표지자로 하여 정신분열병과의 연합을 알아보았다. 방 법: 서로 혈연관계에 있지 않은 정신분열병 환자 120명(남자 91명, 여자 29명)과 정상 대조군 106명(남자 84명, 여자 22명)을 대상으로 하였다. PANSS를 사용하여 양성 및 음성을 알아보았다. 말초혈액에서 DNA를 분리한 후에 중합효소연쇄반응을 사용하여 3`인접영역에 있는 4 염기 반복 다형성을 증폭하였고 silver staining한 후에 유전자형을 관찰하였다. chi-square 검증과 Bonferroni`s correction을 사용하여 환자군과 정상 대조군간의 대립유전자 빈도의 차이를 알아보았다. 또한 양성 및 음성 환자군으로 나누어 차이를 알아보았다. 결 과: 총 23개의 대립유전자가 관찰되었으며, 399bp의 대립유전자(A10)의 빈도가 환자군보다 정상대조군에서 통계적으로 유의하게 높았다(χ²=16.49, df=1, p<0.001). 음성 정신분열병 환자군과 정상대조군 사이의 비교에서는 정상대조군의 A10의 빈도가 환자군보다 유의하게 높았다(χ²=21.33, df=1, p<0.001). 성별 비교에서 남자 정신분열병 환자군은 대조군에 비하여 A10의 분포가 유의하게 적었다. (χ²=13.71, df=1, p<0.001) 결 론: NT 수용체 유전자와 정신분열병사이에 음성연합이 관찰되었다. NT 수용체 유전자가 일부 정신분열병의 발병과정에서 확실하지는 않지만 어떤 종류의 보호기능을 할 수도 있다는 것을 암시한다. Objectives: Neurotensin(NT), of which functions are evoked by its interaction with neurotensin receptors(NTR), coexists with mesolimbic dopamine and regulates endogenous dopamine release. Recent studies have shown that NT with NTR exerts neuroleptic-like activity within the central nervous system and may play an important role in the pathogenesis and in the treatment of schizophrenia. We have examined the gentic association between schizophrenia and tetranucleotide repeat polymorphism in the 3-flanking region of the NTR gene to investigate the possible contribution of the NTR gene to the schizophrenia susceptibility. Methods: Among 23 alleles identified, the subjects were 120 patients(male 91, female 29)with schizophrenia and 106 normal healthy controls(male 84, female 22). They were unrelated native Korean. PANSS was used to determine positive or negative subgroup in the schizophrenic patients. Using polymerase chain reaction and polyacrylamide gel electrophoresis, tetranucleotide repeat polymorphism(CCTT and CTT) in the 3`-flanking region of NTR gene was observed. For a comparison of NTR gene`s allelic frequencies between patients with schizophrenia and normal healthy controls, chi-square test and Bonferroni`s correction was performed. Results: The frequency of A10 allele(base pair size=399)was significantly higher in normal healthy controls than schizophrenia(χ²=16.4902, df=1, p<.000). In the comparison between schizophrenic patients with negative symptoms and normal controls, the frequency of A10 allele was significantly higher in normal healthy control subjects than patients with schizophrenia(χ²=21.33, df=1, p<0.001). In the case of male, the frequency of A10 allele of schizophrenia was significantly higher than normal controls(χ²=13.71, df=1, p<0.001). Conclusions: NTR gene was negatively associated with schizophrenia. NTR gene`s tetranucleotide repeat polymorphism may provide some protective function against schizophrenia.

고비중 Bupivacaine과 Tetracaine에 의한 척추마취의 비교

조남수,유병식,박은주 최신의학사 1989 最新醫學 Vol.32 No.11

악성림프종 환자에서 복합화학요법으로 유발된 백혈구 감소증에 대한 인형 재조합 과립구 집락형성-촉진인자(rhG-CSF: Neutrogin)의 효과

박성규,전진우,기신영,유병우,김홍수,백승호,원종호,홍대식,박희숙 순천향의학연구소 1995 Journal of Soonchunhyang Medical Science Vol.1 No.1

Clinical effects of rhG-CSF were investigated in 17 patients receiving chemotherapy for non-Hodgkin's lymphoma. Patients were given G-CSF 2㎍/㎏/day after 2nd cycle chemotherapy for least 14 consecutive days, and clinical and laboratory results were compared to results of the first cycle. Treatment with G-CSF resulted in increase of mean WBC count(952.9±152.2㎜³vs 1882.4±350.4/㎜³) and neutrophil count(212.9±53.0/㎜³vs 841.5±238.0/㎜³), reduced the duration of leukocytopenic days(12.4±1.3 days vs 5.5±1.0 days, WBC count less than 4000/㎜³) and neutropenic days(4.5±0.9 days vs 2.3±0.7 days, neutrophil count less than 500/㎜³), and reduced the duration of neutropenic fever(5.8±1.1 days vs 0.9±0.5 days). The side effects of G-CSF were not so significant. These results demonstrated that G-CSF is safe and useful for the treatment of neutropenia induced by anticancer chemotherapy of non-Hodgkin's lymphoma and reducing the incidence of febrile periods and duration of antibiotic administration.

수술후 경막외강에 주입한 ketamine의 진통효과에 관한 연구

정기호,조남수,임경준,유병식,정종달,김용일 朝鮮大學校 附設 醫學硏究所 1993 The Medical Journal of Chosun University Vol.18 No.1

Author divided 60 patients who got lower abdomen or lower extremity surgical operation into three groups. Each group consisted of 20 patients. We injected ketamine 10㎎, 20㎎, and 30㎎ respectively into the epidural space when the patient complained of pain postoperatively and observed the postoperative analgesic effect of ketamine. Finally, we concluded the following : 1) The onset time of analgesic effect. : The analgesic effect appeared within 10 minutes in 3 groups and the significant difference among them was not seen. 2) The duration of analgesic effect : The duration of analgesia was relatively short with less than 1 hour on an average in all 3 groups and was not constant. 3) Cardiopulmonary system. : The significant change of blood pressure, pulse and respiratory rate was not seen in all three groups and and the difference among them also was not seen. 4) Side effects. : Sedative action(16%), nausea(10%), dizziness(5%), headache(3.3%) From above results, the epidural administration of ketamine is not suitable for postoperative pain management because of a lot of side effects as well as short and inconstant duration of analgesic effeet.

Eisenmenger씨 증후군 산모의 긴박 제왕절개술시 전신마취 경험

김준,고우석,정종달,유병식,임경준,소금영,안태훈,한승룡 朝鮮大學校 附設 醫學硏究所 2007 The Medical Journal of Chosun University Vol.32 No.1

Eisenmenger's syndrome describes a situation in which the left-to-right intracardiac shunt is reversed as a result of increased pulmonary vascular resistance. The patients with Eisenmenger's syndrome are poorly tolerated and markedly increased maternal mortality to 30 - 50% during pregnancy, Physiological change of pregnancy decreases systemic vascular resistance that further aggravates the bi-directional or left shunt associated with Eisemnenger's syndrome. We report a case of 37 weeks a pregnant woman with an urgent cesarean section under general anesthesia for preterm labor. She was a pregnant patient with Eisenmenger's syndrome and did not receive antenatal care during pregnancy. Anesthesia was induced with ketamine-midazolam-fentanyl and maintained with ketamine-midazolam. The patient was ventilated with 100% O₂. Blood pressure was maintained with intravenous phenylephrine, crystalloid solution, and blood. Phenylephhne was used to maintain systemic vascular resistance (SVR). Even though the patient was carried rapid and adequate medical management, the patient was transferred to the ICU in an intubated state and died 2 days after surgery. We conclude that the parturients with Eisenmenger's syndrome require more regular, careful antenatal care, monitoring, and adequate management.

척수강내 Bupivavacain에 첨가한 소량의 Neostigmin의 진통효과와 부작용

소금영,정종달,김병철,유벙식,안태훈,김훈정,임경준 조선대학교 2000 The Medical Journal of Chosun University Vol.25 No.2

Background : Spinal cholinergic receptor has been shown to have a antinociceptive action, an effect that can be mimicked by spinal cholinesterase inhibitor. Intrathecal injection of neostigmine cause analgesia and adverse effect in a dose-dependent pattern in the patients. The purpose of this study was to determine whether small doses of intrathecal neostigmine (10, 25 and 50 ㎍) produce analgesia and any side effects. Method : After getting informed consents, 60 patients scheduled for orthopedic surgery of lower extremities under spinal anesthesia were randomly assigned to one of four groups. Using dose-ranging design, patients received either normal saline or neostigmine l0, 25 or 50 ㎍ in a 1-㎎ solution of 5% glucose in normal saline with heavy bupivacaine 12 ㎎. Heart rate, blood pressure, degree of motor and sensory block were recorded. The assessment of postoperative analgesia included time to first rescue, total number of rescue medication and pain score on visual analog scale (VAS) at 1, 3, 6, 9, 12, 24 hour. Nausea and vomiting were assessed by using the visual analog scale at 24 hr postperatively and the incidence of them was recorded postoperatively. Result : There were no significant differences among the four groups in characteristics of spinal blocks. Compared to saline, neostigmine groups significantly prolonged time to first rescue medication and decreased total number of rescue medication and pain visual analog scale score, but incidence of nausea and 24hr nausea VAS score were not increased in neostigmine group compared to control group. Conclusion : These data in patients injected intrathecal neostigmine suggest that analgesia may occur at doses less than neostigmine 50 ㎍ and neostigmine 50㎍ has a better analgesia effect with fewer side effects than other doses for postoperative analgesia.

Gullian Barre Syndrome 患者 1例에 대한 症例報告

임승민,안정조,최영,조현경,김민상,유병찬,오병렬,김윤식,설인찬 대전대학교 한방병원 2002 惠和醫學 Vol.11 No.1

Gullian Barre Syndrome is an acute symmetric polyradiculoneuropathy that typically presents as a progressive flaccid paralysis. The pathology is believed to be caused by both cellular and humoral immune processes The possibility of death is 3-5% and About 20% of patients require mechanical ventilaton. Recently We have experienced a patient who had suspected Gullian Barre Syndrome for 60days, his condition weakness and pain was impoved through the herb and acupucture Therefore I reported it for the treatment.

골관절염 환자에서 관절내 Sodium Hyaluronate(Hyruan®)의 투여가 슬관절통에 미치는 영향

김훈정,임경준,위상우,정종달,유벙식,안태훈,소금영 조선대학교 2000 The Medical Journal of Chosun University Vol.25 No.2

Background : Sodium Hyaluronate has been found to be deficient in the synovial fluid of patients with osteoarthritis. We evaluate the effect of intraarticular Sodium Hyaluronate(Hyruan®) on the knee joint pain in patients with osteoarthritis. Method : Ten patients with osteoarthritis of the knee were participated in this study. Sodium Hyaluronate was injected into knee joints weekly for 5 weeks consecutively. Clinical evaluations were performed using visual analogue scale(VAS) for pain, tenderness and swollen joint counts weekly for the first 5 weeks and at 10 weeks postinjection. Result : VAS, tenderness and swollen joint were all significantly improved from 2 weeks to 10 weeks. There was no complication, except pain on injection site in two patients. Conclusion : Intraarticular injection of Sodium Hyaluronate has been shown to be effective on the treatment of patients with osteoarthritis of the knee.

Polyphenols of Rubus coreanum Inhibit Catecholamine Secretion from the Perfused Adrenal Medulla of SHRs

Yu, Byung-Sik,Na, Duck-Mi,Kang, Mi-Young,Lim, Dong-Yoon The Korean Society of Pharmacology 2009 The Korean Journal of Physiology & Pharmacology Vol.13 No.6

The present study was attempted to investigate whether polyphenolic compounds isolated from wine, which is brewed from Rubus coreanum Miquel (PCRC), may affect the release of catecholamines (CA) from the isolated perfused adrenal medulla of the spontaneously hypertensive rats (SHRs), and to establish its mechanism of action. PCRC $(20\sim180\;{\mu}g/ml)$ perfused into an adrenal vein for 90 min relatively dose-dependently inhibited the CA secretory responses to ACh (5.32 mM), high $K^+$ (56 mM), DMPP $(100\;{\mu}M)$ and McN-A-343 $(100\;{\mu}M)$. PCRC itself did not affect basal CA secretion (data not shown). Also, in the presence of PCRC $(60\;{\mu}g/ml)$, the CA secretory responses to veratridine (a selective $Na^+$ channel activator $(10\;{\mu}M)$, Bay-K-8644 (a L-type dihydropyridine $Ca^{2+}$ channel activator, $10\;{\mu}M$), and cyclopiazonic acid (a cytoplasmic $Ca^{2+}$-ATPase inhibitor, $10\;{\mu}M$) were significantly reduced, respectively. In the simultaneous presence of PCRC $(60\;{\mu}g/ml)$ and L-NAME (an inhibitor of NO synthase, $30\;{\mu}M$), the inhibitory responses of PCRC on the CA secretion evoked by ACh, high $K^+$, DMPP, and Bay-K-8644 were considerably recovered to the extent of the corresponding control secretion compared with that of PCRC-treatment alone. The level of NO released from adrenal medulla after the treatment of PCRC $(60\;{\mu}g/ml)$ was greatly elevated compared with the corresponding basal level. Taken together, these results demonstrate that PCRC inhibits the CA secretion from the isolated perfused adrenal medulla of the SHRs evoked by stimulation of cholinergic receptors as well as by direct membrane-depolarization. It seems that this inhibitory effect of PCRC is mediated by blocking the influx of calcium and sodium into the adrenal medullary chromaffin cells of the SHRs as well as by inhibition of $Ca^{2+}$ release from the cytoplasmic calcium store at least partly through the increased NO production due to the activation of NO synthase.