열공형과 비열공형 피질하 혈관성 치매에서 위험인자의 차이에 관한 비교 연구

배희준,정지향,유경호,나덕렬,김상윤,최경규,양동원,손의주,이상도,김재우,박경원,김응규,이재홍,박미영,한일우,함동석,최문성,하충건,최성혜,이애영,이병철,한설희 대한치매학회 2003 Dementia and Neurocognitive Disorders Vol.2 No.2

Backgrounds and Objectives: Vascular dementia is a group of dementing disoders arising from various stroke syndrome. Among these. subcortical ischemic vascular dementia (SIVD) is regarded as a relatively distinct clinical entity. However, MRI patterns of SIVD are not homogenous. In some patients, lacunes are dominant, and in others, subcortical white matter changes are. This study was designed to compare risk factor profiles between SIVD with and without multiple lacunes. Methods: We divided 47 subjects (22 males, mean age. 68 years) recruited from VADAPET (Multicenter Trial For Evaluation Of The Changes In the PET Images Of Subcortical Vascular Dementia Patient) study into two groups one with more than 5 lacunes in deep gray matter (lacune group) and the other with 5 or less(non-lacune group) Clinical characteristics and laboratory findings of two groups were compared. Results: Nineteen of 47 patients (40%) belonged to the lacune group. The lacune and non-lacune groups d d not differ in the following variables: age, hypertension, diabetes mellitus, hyperlipidemia heart disease, history of stroke or TIA, history of trauma or major surgery, family history of hypertension stroke, or dementia, age at diagnosis of dementia, body mass index, white blood cell count, ESR, CRP, fibrinogen, hemoglobin A1C, total cholesterol. LDL cholesterol creatinine, proteinuria, glucosuria, and microhematuria. However, male sex, smoking alcohol. hemoglobin, and HDL cholesterol were possibly associated more with lacune group SIVD than with non-lacune group (p<0 1) Multivariate analyses revealed that smoking, hemoglobin, and HDL cholesterol were independent predictors of SIVD with multiple lacunes Conclusion: Our study suggests that SIVD with multiple lacunes may be significantly different in smoking habits hemoglobin, and HDL cholesterol from SIVD without multiple lacunes.

관광의 지속가능성(ST)구조 : 개념 모델의 개발

최병길,송재호 한국관광정책학회 2000 觀光政策學硏究 Vol.6 No.3

The purpose of this research is to build up the theoretical model which is structural and conceptual for the measurement of the Sustainability of Tourism(ST) in the tourist destination, founded upon the philosophy that environments, natural, cultural and social, should be preserved from the tourism as well as for the tourism. For the designation of the study model are chased and recombined previous related research results, which are roughly divided into four categories; ① Environments→Tourism System→Environments Model, ② Tourism Impacts as the Social Exchanges and Destination Residents' Attitude Model, ③ Tourism pro or anti Circulation Model, ④ Pressure→State→Response Model. As the result of these literature and article reviews is composed the exploratory study model in the context of conceptualization and structuralization as bellows, which can be applied to the practical measurement of the ST in the tourist destination. ◁그림삽입▷(원문을 참조하세요) Finally is proposed the methods and procedures for the empirical application of this study model to the measurement of ST and is discovered the policy implications, after which is discussed study subjects in need of continued research. The contents of this article are as follows : Ⅰ. Introduction Ⅱ. Conceptualization of ST and Related Research Trends Ⅲ. Development and Application of ST Model Ⅳ. Concluding Remarks and Policy Implications

Methotrexate 치료를 받고 있는 활동성 류마티스 관절염 환자에서 etanercept의 유효성과 안전성에 관한 연구

최병렬,강태영,정청일,이혜순,엄완식,김태환,전재범,유대현,배상철 대한내과학회 2004 대한내과학회지 Vol.66 No.5

목적 : 류마티스 관절염을 앓고 있는 한국인 중에 기존 DMARDs로 치료 실패하였고, 고정용량의 MTX를 복용하고 있는 환자들에 있어서 etanercept의 유효성과 안전성을 평가하고자 하였다. 방법 : 기존 DMARDs로 치료 실패한 활동성 류마티스 관절염 환자 76명을 대상으로 하여 단일군, 공개시험을 하였다. 대상 환자들은 고정용량의 MTX를 복용하면서 etanercept 25 mg을 1주일에 두 번 피하 주사하였으며 12주간 투여하였다. 유효성은 ACR 20, ACR 50,조조강직 시간으로 평가하였고, 약제의 안전성은 이상반응 등으로 평가하였다. 결과 : 대상 환자는 총 76명으로 평균 연령은 45.2세, 남자 5명, 여자 71명이었다. 84.4%인 54명이 12주째에 ACR 20을 만족하였고, 53.1%인 34명이 12주째에 ACR 50을 만족하였다. 조조 강직 시간은 치료 전 203.3분에서 치료 12주째 42.6분을 평균 74.5% 호전되었다. 가장 흔한 이상반응은 주사부위 반응이었다. 이외에도 상기도 감염, 오심, 안면부종 등이 발생하였으나 심각한 부작용은 없었다. 결론 : etanercept는 효과적이고, 안전한 류마티스 관절염 치료 방법이며 특히 MTX치료에도 불구하고 활동성인 류마티스 관절염에 기대되는 치료라고 할 수 있다. Background : This study was performed to investigate the efficacy and safety of etanercept in active rheumatoid arthritis patients with stable dose of methotrexate in Korean. Methods : In a 12 week, single arm, open trial, we assigned 76 patients with active rheumatoid arthritis who had an inadequate response to disease-modifying antirheumatic drugs. Patients received twice-weekly subcutaneous injections of etanercept 25 ㎎ while containing to receive methotrexate at a stable dose of 7.5~25 ㎎ per week. The clinical response was defined as the percent improvement in disease activity according to the criteria of the American Collage of Rheumatology (ACR) at 12 weeks. Results : Etanrecept led to significant improvements in disease activity and was safe and well tolerated. At 12 week, 84.4% of the patients receiving 25 ㎎ of etanercept achieved a 20% ACR response, and 53.1% of those receiving etanercept achieved a 50% ACR response. The most common adverse event was injection-site reaction. Other advanse events were upper respiratory infection, nausea, and facial edema, but there were no serious adverse events associated with etanercept. Conclusion : In active rheumatoid arthritis patients, etanercept was safe, well tolerated, and provided rapid clinical improvements.

축전지 사업장에서 공기 중 납 농도의 허용노출기준 초과율 변화에 관한 연구

최재욱,김남수,함정오,이병국 순천향대학교 의학연구소 2007 Journal of Soonchunhyang Medical Science Vol.13 No.2

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Nd: YAG 레이저 조사가 Clacium Fluoride 형성 및 치아 내산성에 미치는 영향

최병재,김성오,손흥규,이제호,박광균 大韓小兒齒科學會 1999 大韓小兒齒科學會誌 Vol.26 No.2

불소도포시 주로 형성되는 calcium fluoride는 구강내 환경에서 pH에 의해 조절되는 불소의 저장고 역할을 하여 치아우식 예방에 있어서 중요한 역할을 하는 것으로 알려져 있다. 따라서 불소도포의 우식예방 효과는 calcium fluoride를 얼마나 많이 형성시켜 오래 지속시키는 가에 달려있다. 이에 치아 내산성 증가에 효과 있다고 알려진 Nd:YAG 레이저 조사가 calcium fluoride형성 및 치아 내산성에 미치는 영향에 대해 알아보기 위해서 실험을 시행하였다. 소의 영구전치에서 276개의 시편을 제작하여 아무런 처치를 하지 않은 군을 대조군으로 하고 1.23% acidulated phosphate fluoride (APF) 5분, 30분 도포 및 Nd:YAG 레이저 조사에너지 밀도 20J/㎠,40J/㎠의 조건에 따라 불소 도포군, 레이저 조사군, 불소 도포후 레이저 조사군, 레이저 조사후 불소 도포군으로 분류하였다. 불소도포를 시행한 경우 이를 다시 KOH 처리 여부에 따라 나누어 23개의 실험조건을 만들었다. 각 실험조건에 12개의 시편을 배정하고 이중 10개의 시편은 불소 및 무기인 측정에, 나머지 2개의 시편은 표면 관찰에 사용하였다. KOH 비처지군에서 0.1N HCIO4로 enamel biopsy를 시행하여 탈회 법랑질의 불소농도 및 탈회깊이를 측정하였으며, KOH 처치군에서는 1 M KOH로 24시간 처리하여 calcium fluoride를 정량 후 enamel biopsy를 시행하였다. 실험결과 얻어진 자료 및 주사 전자현미경 관찰 소견을 비교하여 다음의 결과를 얻었다. 1. KOH 비처치군에서 탈회된 법랑질의 불소농도는 레이저조사 후 불소도포시 레이저 에너지 밀도 증가에 따라 증가되는 경향을 보였다. 2. KOH 비처치군에서 법랑질 탈회깊이는 불소를 5분 도포후 레이저 20J/㎠를 조사한 경우를 제외하고는 레이저와 불소를 병행하여 처치시 각각을 단독으로 치치시보다 탈회깊이가 작았다 (p<0.05). 3. Calcium fluoride의 양은 레이저의 조사에 의해 유의 있게 증가하지 않았다 (p>0.05). 4. Calcium fluoride 입자는 불소만 도포한 경우에 비해 레이저 조사후 불소도포시 입자크기가 증가되었으며, 불소도포후 레이저 조사시 입자크기의 증가와 함께 일부 융합된 양상을 보였다. 5. KOH 처치군에서 법랑질의 불소농도는 불소를 30분 도포후 레이저를 조사한 경우를 제외하고는 대조군의 불소농도와 유의한 차이가 없었다(p>0.05). 6.KOH 처치군에서 불소와 레이저를 병행한 경우, 불소만 도포한 경우보다 탈횐된 법랑질의 깊이가 작았다 (p<0.05). 7. KOH 비처치군에서 탈회된 법랑질의 불소농도와 탈회깊이의 상관관계 (Spearman correlation coefficient: -0.6281)는 KOH 처치군 (Spearman correlation coefficient: -0.3792)에 비해 높은 음의 상관 관계를 보였고, 동일한 조건으로 불소도포 및 레이저 조사를 시행한 경우에 있어서 KOH 처리 여부에 따른 탈회법랑질 깊이의 유의차가 있는 경우 calcium fluoride의 형성량이 많았다. 이상의 실험결과로 미루어 보아 레이저 조사가 calcium fluoride의 형성량에 영향을 미치지 않았으나 레이저 조사의 영향으로 calcium fluoride의 용해가 감소하는 것으로 판단된다. 또한 불소도포 및 레이저 조사의 병행은 각각을 단독으로 처치한 경우에 비하여 치아 내산성 증가면에서 유리하므로 임상에서 불소도포주기 연장과 같은 유용한 결과를 얻을 수 있을 것으로 생각된다. Calcium fluoride. created by topical fluoride application, is the reservoir for fluoride ion regulated by pH in the oral environment. Therefore, the amount and the maintenance of calcium fluoride have an important role in preventing dental caries. The aim of this study is to evaluate the effect of Nd:YAG laser irradiaiton on the generation of calcium fluoride and the acid resistance of tooth enamel. The bovine anterior permanent teeth were prepared (n=276), and divided into following groups: no treatment(control), fluoride application alone, laser irradiation alone, laser irradiation after fluoride application, and fluoride application after laser irradiation. And each group was subdivided based on the application time of 1.23% acidulated phosphate fluoride (APF) (5 min and 30 min) and the irradiation energy of Nd:YAG laser (20J/㎠ and 40J/㎠). In case of fluoride application, each group was divided according to KOH treatment. Twenty three treatment conditions were made for this experiment and twelve specimens were assigned to each treatment condition. In each treatment condidtion, ten specimens were used for chemical analysis and two specimens were observed under SEM. In groups without treating KOH, fluoride content and the depth of enamel dissolved were measured using enamel biopsy technique. In groups with treating KOH, the amount of calcium fluoride was measured by the treatment with 1 M KOH for 24 hours and enamel biopsy was performed after KOH treatment. The results were analyzed by the fluoride content and the depth of enamel dissolved by enamel biopsy, amount and thickness of calcium fluoride, and the surface structures of enamel. The results are as follows: 1. In groups without treating KOH, the fluoride content of removed enamel showed a positive relationship with the energy density of laser when the laser irradiated before fluoride application. 2. In groups without treating KOH, the depth of enamel dissolved decreased more with the combined laser and fluoride treatment than with laser or fluoride treatment, except for the case of 20J/㎠ laser irradiation after 5 minute fluoride application (p<0.05). 3. The amount of calcium fluoride did not increased by laser treatment with no statistical significance(p>0.05). 4. The particle size of calcium fluoride increased in case of fluoride treatment after laser irradiation, compared with fluoride application alone. In case of laser treatment after fluoride application, the particle size of calcium fluoride increased and some of the particles fused as well. 5. There were no significant differences in the fluoride content of dissolved enamel between groups without treating KOH and control group, except for the case of laser irradiation after treatment of APF for 30 minutes (p>0.05). 6. In groups with treating KOH, depth of removed enamel in the groups of combined treatment with laser and fluoride was shallower than that in fluoride application groups (p<0.05). 7. In groups without treating KOH, the relationship between fluoride content and the depth of enamel dissolved showed more negative (Spearman correlation coefficient: -0.6281)than in groups with treating KOH (Spearman correlation coefficient: -0.3792). The greater amount of calcium fluoride could be found in case where there was a significant differences of the depth of enamel dissolved between groups with and without treating KOH. From these results, it can be concluded that laser seems to be a little effects on the amount of calcium fluoride formation, but has some effect on the lowering the solubility of calicium fluoride. As the combined treatment of laser and fluoride application showed more effective acid-resistant property, more extended recall period for fluoride application can be achieved with this combined treatment in the clinic.

구강점막의 배양에 관한 연구

최병호,유재하 大韓顎顔面成形再建外科學會 1995 Maxillofacial Plastic Reconstructive Surgery Vol.17 No.4

To use cultured mucosa as a graft of full thickness, our laboratory has been involved in the development of techniques to grow epidermis together with connective tissue. Human oral mucosa was obtained at dental surgery. Under sterile conditions the tissues were cut into explants of 0.1 cm² which were placed in the center of 24 well tissue culture dishes and incubated in a growth medium. The growth medium used for epithelial was MEM(Minimum Essential Medium) supplemented with 10% fetal calf serum, 0.5% dimethyl sulfoxide, glutamine (0.292 g/l), epidermal growth factor (40 ug/ml), cholera toxin (30 ng/ml), hydrocortisone(2 ug/ml), insulin (40 ug/ml) and transferin (5 ug/ml). The medium for stratification of epithelial cells was MEM supplemented with 10% fetal calf serum, 0.5% dimethyl sulfoxide and glutamine (0.292 g/l). The medium used for fibroblasts was MEM supplemented with 10% fetal calf serum. With the three types of media used alternatively, a mucosa composed of epidermis and connective tissue was obtained after 3 weeks of culture.

흰쥐의 발치아에 이식된 태아 치아싹의 발육

최병재,장석철,정한성,이제호,김성오 大韓小兒齒科學會 2006 大韓小兒齒科學會誌 Vol.33 No.1

정상적인 치열의 형성 및 치아의 생성과정을 분석하고 실제로 임상에 적용하기 위해 치아의 발생과정을 연구하는 것은 매우 중요하다. 본 연구는 이식된 태아 치아싹의 석회화가 가능하고 정상적인 구조로 발육할 수 있는지 밝히기 위해, 그리고 악골 자체가 새로운 이식 공여부로 사용가능한지 알기 위해 흰쥐의 발치와에 치아싹을 이식하여 치아의 형성을 살펴보고자 하였다. 이를 위하여 성숙한 흰쥐의 상악 제 1구치를 발거한 발치와에 13.5일된 태아쥐의 치아싹을 이식한 후 4,8주 후에 희생하여 조직학적 및 방사선학적으로 관찰하여 다음과 같은 결과를 얻었다. 1. 이식된 치아싹에서 상아질과 백악질, 치수, 치주인대의 소견을 갖는 석회화된 조직이 형성되었다. 2. 형성된 경조직 및 연조직은 정상적인 치아형성과정에 비해 발육이 늦었으며 유착 및 골양상아질(osteodentin)과 같은 비정상적 조직이 관찰되었다. 3. 석회화된 조직은 8주내에 악궁으로 맹출하는 소견이 관찰되지 않았다. The developmental process of a tooth is being presented as an important study subject to analyze formation of normal dental arch and tooth. The purpose of this study was to see the formation of tooth from a tooth bud transplanted in a white rat regarding that the jawbone could be used as a new donor site of a trasplant. The first molar of a matured white rat was extracted and the tooth bud of a 13.5 day rat embryo was transplanted. The histological and radiographical results after 4 and 8 weeks respectively are as the following. 1. Calcification in dentin, cementum, pulp and periodontal ligament was formed from the tooth bud transplanted in the alveolar socket. 2. The development of hard and soft tissue was delayed compared to the normal tooth formation and abnormal histologic features such as ankylosis and osteodentin were found. 3. The formed hard tissue did not erupt into the jaw within 8 weeks.

치주적 손상을 유발하는 latex-elastic ring의 부적절한 사용에 대한 증례보고

최원경,손흥규,최병재,이제호 大韓小兒齒科學會 1997 大韓小兒齒科學會誌 Vol.24 No.3

This paper presents improper use of latex-elastic ring in movement of teeth and its consequence. Simple orthodontic movement of teeth including closure of diastema may be achieved by the use of simple method with fixed or removable appliance associated with latex-elactic ring. But, if it is used alone, it acts as a local irritant and then produces localized periodontitis. In case of localized periodontitis resulting from latex-elastic ring, diagnosis is difficult because the patient is usually unaward of the presence of the rings on the roots of the involved teeth and because the ring is not probed and is radiolucent and therefore not discernible radiographically and clinically. Occasionally, surgery is requred for the detection. This case emphasizes the necessity that the use of latex-elastic ring in closing diastema should be accompanied with removable or fixed appliance as well as close professional supervision. Its use without adequate provision for stabilization or retention on the crowns of teeth results in destruction of periodontal support and the teeth may be lost.

Hypophosphatasia 환아의 치료 증례

최병제,최형준,이제호,김기덕,박수정 大韓小兒齒科學會 1998 大韓小兒齒科學會誌 Vol.25 No.3

1. Hypophosphatasia 는 골조직 및 치아조직의 비정상적인 석회화를 나타내는 대사장애로, 특징적구강내 소견 인 우치의 조기탈락 양상으로 치과에서 조기진단이 가능하다. 2. 본 증례에서 상악궁 확장을 동반한 의치 제작으로 심미적, 기능적으로 양호한 결과를 얻었으며, 영구치열기 까지 장기적 관찰 및 치료가 필요할 것으로 사료된다. hypophosphatasia is a rare metabolic disorder which manifests characteristics such as abnormal mineralization of bone and dental tissues, diminished serum and tissue alkline phosphatase, and increased urinary secretion of PEA. It ingerited as an autosomal recessive or dominant trait and occurs in all races. In general, hypophosphatasia can be classified in 4 subtypes which are the perinatal, infantile, childhood, adult type depending upon the age at presentation and severity. In young children with Hypophosphatasia the long bones show irregular defects, and the skull showes poor calcification. In older children with premature closure of the skull sutures there may ve multiple lucent area called gyral or convolutional markings, described as resimbling beaten copper, presumably resulting from increased intracranial pressure,Examination of the jaws reveals a generalized lucency of the maxilla and mandible, the cortical bone and lamina dura are thin, and the alveolar bone may be deficient. Clinical features of Hypophosphatasia imclude premature loss of deciduous teeth, especially incisors, hypoplasia of aplasia of root cementum, enamel hypoplasia, irregular calcification of dentin, large pulp chamber, and resorption of marginal alveolar bone and roots. Our report involves a patient with a chief complaint of early loss of both Mx. and Mn. deciduous ncisors. after conducting a through clinical and radiographic examination this patient was referred to pediatrics under the suspicion of hypophosphatasia, the diagnosis proved to be correct and successful results were accomplished through a denture made to improve esthetics and function.

肝硬變症에 있어서 水分과 電解質의 區劃分布와 移動에 關한 硏究 : Ⅰ. 血淸과 腹水內 電解質의 分布 Part 1. Distribution of Electrolytes in the Serum and Ascitic Fluid

崔炳梓 全南大醫大 1964 전남의대학술지 Vol.1 No.1