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Miniscrew implant를 이용한 상악 구치부 압하와 개방교합 치료의 효과 및 안정성
이한아,박영철 대한치과교정학회 2008 대한치과교정학회지 Vol.38 No.1
최근 절대적인 고정원의 등장으로 다른 부작용 없이 구치부 압하 치료를 가능하게 하였고, 비수술적으로 개방교합의 심미적인 치료를 가능하게 하였다. 그러나, 이러한 치료법의 장기적인 안정성에 대한 연구는 많이 부족한 실정이다. 이에 본 연구에서는 miniscrew implant를 이용하여 상악 구치를 압하시켜 치료한 성인 개방교합 환자 11명 (남자 1명, 여자 10명)을 대상으로 치료 전후, 그리고 유지기의 골격성, 치아 치조성 변화를 측모 두부 방사선사진을 이용하여 평가하였으며 계측치의 치료 전후 변화량간의 상관관계와 치료에 의한 변화량과 재발량과의 상관관계를 규명하여 상악구치의 압하를 통해서 개방교합을 치료할 때의 안정성을 평가하였다. 그 결과로 상악 구치는 2.22mm 압하(P < 0.001)가 일어났고, 평균 17.4개월 유지 후 0.23 mm의 정출(P = 0.359)이 나타났으며, 재발율은 10.36%로 나타났다. 전치부의 수직피개는 평균 5.47 mm의 증가(P < 0.01)가 나타났고 평균 17.4개월 유지 후 0.99 mm의 감소(P < 0.05)가 나타나서, 재발량은 18.10%로 계산되었다. 치료 전후 수치 변화량의 상관분석을 통해 상악구치 압하량과 하악 평면각 변화량이 상관관계(P < 0.05)가 있었다. 치료 전의 개방교합량, 하악 평면각, 전하안면고경과 치료 후의 수직피개 재발량과는 상관관계가 없었다. 상악 구치 압하량과 수직피개 개선량에서 치료에 의한 변화량과 재발량이 통계적으로 유의한 상관관계를 보였고, 이를 토대로 재발량을 예측할 수 있었다. 이상의 결과를 통하여 성인 개방교합 환자에서 miniscrew implant를 이용한 상악구치부의 압하는 비수술, 심미적 접근방법으로 효율적이고 안정적인 치료방법으로 유용하게 사용할 수 있을 것으로 생각된다. Objective: This study investigated the skeletal and dentoalveolar changes after intrusion of maxillary posterior teeth using miniscrew implants during the treatment and posttreatment period. Method: The subjects consisted of 11 adults (1 male, 10 females) whose open bites were treated by posterior teeth intrusion with miniscrew. The lateral cephalometric x-rays of pre-treatment, post-treatment, and the retention period were evaluated. Results: The average intrusion of maxillary posterior teeth at the end of the treatment period was 2.22 mm (P < 0.001) and the average extrusion of maxillary posterior teeth at the end of the 17.4 month retention period was 0.23 mm (P = 0.359). The relapse rate was calculated at 10.36%. A decrease in overbite after the 17.4 month retention period was 0.99 mm (p < 0.05). The relapse rate was calculated at 18.10%. The skeletal changes and vertical height change of maxillary posterior teeth during the retention period was statistically insignificant, but there was a significant decrease in overbite (mean 0.99 mm, P < 0.05). The amount of intrusion and the overbite improvement from treatment significantly correlates to the degree of relapse. Conclusions: The results indicate that intrusion of the maxillary posterior teeth using miniscrews is an effective, non-surgical treatment modality which can reasonably be used to address adult open bite.
The efficacy of treatment for hepatocellular carcinoma in elderly patients
이한아,이상헌,이해림,송정은,이동현,한소정,심주현,김보현,최종영,임현철,김도영 대한간암학회 2023 대한간암학회지 Vol.23 No.2
Background/Aim: Despite the increasing proportion of elderly patients with hepatocellular carcinoma (HCC) over time, treatment efficacy in this population is not well established. Methods: Data collected from the Korean Primary Liver Cancer Registry, a representative cohort of patients newly diagnosed with HCC in Korea between 2008 and 2017, were analyzed. Overall survival (OS) according to tumor stage and treatment modality was compared between elderly and non-elderly patients with HCC. Results: Among 15,186 study patients, 5,829 (38.4%) were elderly. A larger proportion of elderly patients did not receive any treatment for HCC than non-elderly patients (25.2% vs. 16.7%). However, OS was significantly better in elderly patients who received treatment compared to those who did not (median, 38.6 vs. 22.3 months; P<0.001). In early-stage HCC, surgery yielded significantly lower OS in elderly patients compared to non-elderly patients (median, 97.4 vs. 138.0 months; P<0.001), however, local ablation (median, 82.2 vs. 105.5 months) and transarterial therapy (median, 42.6 vs. 56.9 months) each provided comparable OS between the two groups after inverse probability of treatment weighting (IPTW) analysis (all P>0.05). After IPTW, in intermediate-stage HCC, surgery (median, 66.0 vs. 90.3 months) and transarterial therapy (median, 36.5 vs. 37.2 months), and in advanced-stage HCC, transarterial (median, 25.3 vs. 26.3 months) and systemic therapy (median, 25.3 vs. 26.3 months) yielded comparable OS between the elderly and non-elderly HCC patients (all P>0.05). Conclusions: Personalized treatments tailored to individual patients can improve the prognosis of elderly patients with HCC to a level comparable to that of non-elderly patients.
A Purely Cystic Giant Sacral Schwannoma Mimicking a Bone Cyst: A Case Report
이한아,전세정,최시성,김혜원,김헌수 대한영상의학회 2014 대한영상의학회지 Vol.71 No.1
Schwannomas are benign tumors arising from the myelinated nerve sheath. These tumors are generally solid, and degenerative changes can occur. However, cystic degeneration is usually noted only in parts of the tumor, and complete cystic change is rare; only a few such cases have been reported. To our knowledge, only one case of a completely cystic giant schwannoma in the lumbosacral area has been reported. Here, we report a similar case with the descriptions of the magnetic resonance imaging and pathological findings.
경피적 귀 미주신경 자극이 자율신경계의 활동 및 식후 혈당 변화에 미치는 영향
이한아,김현,김도용,이민주,조승관,김한성 대한의용생체공학회 2023 의공학회지 Vol.44 No.1
Transcutaneous auricular vagus nerve stimulation (taVNS) is known to be effective in improving symp- toms of numerous diseases such as depression and epilepsy by increasing vagus nerve activity through electrical stimulation. The purpose of this study is to investigate the effect of vagus nerve stimulation on the activity of auto- nomic nervous system and the changes in postprandial blood glucose levels. Seven healthy adults participated in a non-invasive transcutaneous auricular vagus nerve stimulation experiment. taVNS (25 Hz, 200 µs, biphasic pulse) was applied to the cymba concha (taVNS group) or the earlobe (Sham-taVNS group) of the left ear. As autonomic nervous system signals, skin conductance level, skin temperature, and heart rate were recorded during the appli- cation of taVNS. Postprandial blood glucose changes due to food intake were recorded at 5 min intervals for 25 min- utes after taVNS or sham-taVNS. The taVNS showed a significantly lower skin conductance level than the sham- taVNS (p < 0.05). The increase rate of postprandial blood glucose was significantly lower in the taVNS than in the sham-taVNS (p < 0.05). These results showed that taVNS reduced the activity of the sympathetic nerve system and alleviated early rise in postprandial blood glucose. Although further studies in diabetic patients are needed, this study suggest that taVNS has a potential for clinical use to improve postprandial blood glucose.