진정법을 이용한 치과 치료 시 소아 환자의 진정 후 반응에 대한 연구

구정은,백광우 大韓小兒齒科學會 2009 大韓小兒齒科學會誌 Vol.36 No.2

The purpose of this retrospective study was to examine twenty four hour postsedation events after discharge in children sedated for dental treatment. The sedation sheets of 355 children were selected. Selection criteria excluded no midazolam or nasal route of midazolam, no ASA class I, absent or incomplete questionnaire, Children received orally Chloral hydrate and hydroxyzine, nitrous oxide was maintained during the sedation. Midazolam was injected to buccal submucosa with titration. Parents were interviewed via telephone within twenty four hours after sedation. Questionnaire included sleeping response, sleeping time, sleeping behavior, vomiting response at home. Two hundred twenty four(67.8%) children slept and twenty one(6.3%) children had abnormal sleeping behavior. One hundred four(31.0%) children had abnormal behavior after sleep and ten(3.0%) children had vomiting response. In the children took the higher dose of midazolam, there were the great tendency to sleep after discharge(p<0.05), the more negative response to sleeping behavior(p=0.055), the longer sleeping time(p=0.054). In this study many children slept after sedation and a few children showed negative response. However there were not any considerable emergency events. Further study is required to determine the postsedation safety for the use of submucosal midazolam combination with Chloral hydrate and hydroxyzine. Chloral hydrate와 hydroxyzine을 경구 복용한 후 midazolam을 협점막하로 추가 투여한 진정법은 진정 심도를 깊게 해주고 안정적인 진정 상태를 유지해 준다고 보고된다. 진정 중 나타나는 반응에 대한 연구는 활발하나 퇴원 기준에 따라 환자를 귀가시킨 후 나타나는 반응에 대한 연구는 아직 부족하다. 이 연구에서는 진정법을 이용하여 치과 치료를 받은 소아환자의 진정 후 행동 반응 및 부작용에 대해 알아보고자 한다. 이화여자대학교 목동병원 소아치과에 2005년 4월부터 2007년 12월까지 내원하여 진정법으로 치료받은 환아를 대상으로 귀가 후 24시간 이내에 전화를 이용하여 설문 조사하였다. 조사 항목은 진정 후 수면 유무, 진정 후 수면 시간, 진정 후 수면 행동, 수면에서 회복 후 행동, 진정 후 구토 유무이다. 귀가 후 227명(67.8%)이 잠을 잤고 21명(6.3%)이 비정상적인 수면 행동을 보였다. 104명(31.0%)이 수면에서 회복 후 비정상적인 행동을 하였고, 10명(3.0%)이 구토 반응을 보였다. Midazolam 용량이 많으면 진정 후 잠을 잘 가능성이 크고(P<0.05), 괴로워하면서 자거나 자다 깨다를 반복할 수 있으며 (p=0.055)수면 시간도 길어질 수 있다(p=0.054). 이번 조사에서는 진정 후 수면이 많았고, 비정상적인 행동 및 구토 반응도 있었으나 우려 할 만한 응급상황은 나타나지 않았다. Midazolam의 협점막하병용 투여는 안전한 진정법으로 보이며 장기적 연구, 전향적 연구 등이 필요할 것이다.

치외치로 인한 봉와직염 환자에서 MTA를 이용한 치험례

구정은,백광우 大韓小兒齒科學會 2009 大韓小兒齒科學會誌 Vol.36 No.2

치외치는 치아의 교합면에 부가적인 교두나 돌기(tubercle)를 가진 치아의 형태 이상이다. 치외치는 1-4%의 유병율을 보이며 하악 소구치에서 발생 빈도가 높다. 치외치의 돌기는 쉽게 마모되거나 파절되어 치수 노출, 치수 생활력 상실, 안면부 감염, 골수염 등을 일으킬 수 있다. 또한, 돌기가 파절될 때 치외치의 치근단이 미성숙 상태인 경우가 많아 근관 치료가 쉽지 않다. 미성숙 영구치의 근관치료 시 수산화칼슘이 널리 사용되어 왔으나 내원 빈도 단축을 위해 여러 대체 재료들이 제안되어 왔다. 그 중 하나인 Mineral Trioxide Aggregate는 우수한 생체적합성과 변연 폐쇄성을 특징으로 하며, 미성숙 영구치의 근관치료 시 치료 기간을 단축시킬 수 있다. 본 증례보고에서는 치외치로 인한 치수 괴사로 봉와직염이 발생한 환자를 Mineral Trioxide Aggregate로 치료하였다. 미성숙 치근단을 가진 하악 소구치에 Mineral Trioxide Aggregate를 이용한 치근단형성술(apexification)을 시행하여 임상적 및 방사선학적으로 양호한 결과를 얻었으며, 한 증례에서는 치근단유도술(apexogenesis)의 결과와 같이 계속적인 치근 성장이 관찰되었다. Dens evaginatus is a dental anomaly involving an extra cusp or tubercle that protrudes from the occlusal surface of the affected tooth. The prevalence of dens evaginatus is 1 to 4 percent, and dens evaginatus is observed most commonly in premolars. It can be worn or fractured easily, resulting in pulpal exposure, pulpal infection, loss of vitality, facial infection and osteomyelitis. Since the tooth frequently has the immature apex when the tubercle is fractured, there is difficulty in treatment. Although calcium hydroxide is widely used for pulp treatment of an immature permanent tooth, several alternatives have been suggested to reduce patient' s appointments. Mineral trioxide aggregate is considered biocompatible and has excellent marginal sealing ability. In addition, it can minimize patient's visits. In this case report, apexification with MTA was attempted on the immature premolars in patients with cellulitis patient, caused by pulp necrosis due to dens evaginatus. Favorable clinical and radiologic results were achieved. In one case, continued root formation was observed.

PC 카메라를 이용한 핑거 마우스

鄭求昌,崔祐榮 明知大學校 産業技術硏究所 2005 産業技術硏究所論文集 Vol.24 No.-

Finger mouse is proposed by using PC camera. Finger tip position is detected from the input image captured by PC camera and its position is mapped to the position on the monitor. Instead of existing mouse, finger tip is used as a mouse. In simulation result, the proposed finger mouse is expected to be applicable for simple systems which don't require high resolution accuracy.

조선업 용접공의 용접흄 생애누적노출량을 이용한 환기기능 평가

정춘화,임현우,구정완,박정일 大韓産業醫學會 2002 대한직업환경의학회지 Vol.14 No.4

목적 : 조선업 용접공들의 용접흄 생애 누적노출량을 이용하여 그들의 환기기능을 평가하기 위하여 본연구를 실시하였다. 방법 : 1개 대규모 조선소에서 용접흠에 5년이상 노출된 남자근로자 241명과 대조군으로 사무직 남자 근로자 80명을 대상으로 개인별 생애 누적노출량을 산출하였고 환기기능으로서 노력성폐활량(FVC), 1초량(FEV_1), 1초율(FEV_1%), 최대중간호기 속도(MMF), 최고호기기류속도(PEER)와 호기 FVC의 50%, 75% 시점에서의 최대호기기류인 FEF_50, FEF_75를 얻고저 노력성 호기곡선과 최대호기기류-용량곡선을 측정하여 분석한 결과는 다음과 같았다. 결과 : FEF_50과 FEF_75의 예측치에 대한 백분율(%pred)의 평균은 노출군이 대조군보다 유의하게 감소하였고 MMF는 감소하는 경향을 보였다. 현재의 노출수준 증가에 따라 감소하는 유의한 환기지수는 없었다. 환기지수 중 MMF, FEF_50 및 FEF_75는 노출 기간이 길수록 유의하게 감소하였다. 노출수준×노출기간으로 산출한 용접흄 누적노출량(C1)이 증가함에 따라 최대노출군에서 유의하게 감소한 환기지수는 FEF_75 뿐이었다. 노출수준, 노출기간, 환기시설, 생산량, 보호구사용, 용접봉 및 와이어 종류 등의 변수들을 고려하여 산출한 용접흠 누적 노출량(C2)이 증가함에 따라 최대노출군에서 유의하게 감소한 환기지수는 FEF_75이었으며 MMF 및 FEF_50은 감소하는 경향을 보였다. 또한 환기지수중 MMF, FEF_50 및 FEF_75의 경우 생애 누적노출량(C2)이 증가함에 따라 비정상적인 환기기능을 보인 근로자 비율이 유의하게 증가하였다. 결론 : 본 연구결과는 노출 관련 요인들을 고려하여 산출한 생애 누적노출량(C2)을 이용하여 용접흠에 노출된 근로자들의 환기기능을 평가하는데 있어서 MMF, FEF_50 및 FEF_75가 유용한 지수이었다. Objectives : This study was conducted to evaluate the ventilatory function in shipyard welders using the lifetime cumulative exposure to welding fumes. Methods : Ventilatory function tests were performed on 241 male welders at one large shipuad. exposed to welding fumes for over five years, and was compared to 80 male control subjects. Ventilatory function indices, such as forced vital capacity(FVC). one-second forced expiratory volume(FEV), rato of FEV_1 to FVC(FEV_1%), maximal mid-expira-tory flow(MMF). peak expiratory flow rate(PEER) and maximal expiratory flow at 50 and 75% of expited FVC(FEF_50 and FEF_75), were obtained by analuyzing forced expiratory spirograms and maximal expiratory flowvolume curves that were simultaneously mea-sured by an Impulse ocillometry(IOS) program in the standing position. Results : FEF_50 and FEF_75 expressed as a percentage of the predicted values were significatly lower in the exposure group than in the controls, and the MMF tended to decrease. The mens of all the ventilatory indices, expressed as percentage of the predicted values, were not significantly increased at the current exposure levels. The MMF, FEF_+50 and FEF_75, expressed as a percentage of the predicted values, were significantly decreased with an increase in exposure duration. Onlu the FEF_75, expressed as a percentage of the predicted value, was significantly decreased with an increase in the cunulative exposure to welding fumes(C1). The FEF_75, expressed as a percentage of the predicted value, was significantly decreased with an increase in the cumulative exposure to welding fumes(C2), The above parameters were calculated to consider the durrent exposure level, exposure duration, application of the ventilator sustem, production rate, personal protection device, electrode and swelding wire. The MMF and FDF_50, expressed as a percentage of the predicted value, tended to decrease, The proportion of workers with abnormal MMF, FDF_50 and FDF_75 were significantly increased with an increase in the cumulative exposure to welding fumes(C2). Conclusions : These findings suggested that the MMF, FDF_50 and FDF_75 are sensitive and practical indices for the evaluation of the ventilatory function of workeers exposed to welding fumes, when the lifetime cumulative exposure(C2) is considered as a factor affedting exposure.

Murine Melanoma B16 세포주의 항암제감수성 시험에 관한 실험적 연구

구명삼,진우정 全北大學校 齒醫學硏究所 1992 전북치대논문집 Vol.10 No.1

Anticancer drug sensitivity assays were performed using cotorimetric[3-(4.5-dimethylthiazol-2-yl)-2, 5-diphenyl-tetrazolium bromide(MTT)] assay and dye exclusion assay <DEA> on cell line. Comparison of the MTT assay with DEA is essential prior to its use in clinical screening study. Murine melanoma B16 cell lines were exposed to bleomycin, CDDP, Vinblastine for one hour(2.0×10^4 viable cells/well) and then cultured for four days in MEM containing 10% bovine serum for dye exclusion assay. In [MTT] assay, cells to be tested were exposed for one hour and continuously(5.0×10^3 viable cells/well). Four Hour before the culture end, added the MTT on media measured the absorbance with an ELISA reader at a wavelength of 490㎚. The results were as follows ; 1. Cancer cells were sensitive to bleomycin, CDDP at all concentrations and bleomycin revealed relatively good cytotoxicity than that of CDDP in [DEA] assay(P<0.05). 2. In [MTT] assay, cancer cells were sensitive to high concentration of all drygs and medium concentration of vinblastine for 1 hour exposure(P<0.01). 3. In [MTT] assay, cancer cells were sensitive to medium and high concentration of all drugs and low concentration of VINB for vinblastine continuous exposure(P<0.01). 4. In the comparision of chemosensitivity test between [DEA] and [MTT] assay, the result was correlated(γ=0.99, P<0.05).

중소규모 제조업체 근로자의 인구·사회학적 특성이 건강행동변화단계에 미치는 영향

구명회,임현우,박정일,이강숙,구정완 大韓産業醫學會 2002 대한직업환경의학회지 Vol.14 No.1

목 적 : 근로자 건강증진을 위한 사업장 건강증진 사업 프로그램 기획실에 건강 위험요인을 평가하고 근로자 특성에 4따른 행동변화단계를 조사하여 행동 변화단계에 따른 성공적인 근로자 건강증진전력을 위한 기초자료를 제공하고자 본 연구를 진행하였다. 방 법 : 경인지역이 중소 기업 제조업체 근로자 282명을 대상으로 설문조사를 수행하였으며, 일반적 특성에 대한 조사, 건강위험평가, 위험요인에 대한 행동변화단계를 조사하였다. 결 과 : 건강위험평가에서 흡연자는 남자 근로자에 서 65.7 %, 규칙적인 운동을 하지 않는 남자 근로자는 70.5 %, 여자 근로자는 86.1 %이었고 음주는 남자 근로자의 78.6 %, 여자 근로자인 50 %이었고 과음은 남자 근로자의 29.5 %, 여자 근로자의 11.1 %이었다. 건강한 생활습관으로의 행동변화단계로 계획전단계, 계획 단계, 실천단계, 유지단계 등 4개의 단계로 보면 근로자에서의 금연에 대하여 각각 40.5 %, 23.7 %, 12.1 % 및 23.7 %, 운동에 대하여는 18.4 %, 37.6 %, 17.7 % 및 26.3 %, 음주하였던 사람중 절주에 대하여는 20.9 %, 15.4 %, 10.0 % 및 53.7 %이었다. 흡연을 하는 보건관리자의 행동단계가 일반근로자 보다 유의하게 많았다. 운동에 대해서는 근로자중 50세 이상과 생산직 근로자에서 계획전단계가 다른 근로자보다 유의하게 많았다. 결 론 : 이상의 결과로 대부분의 근로자가 금연을 제외하고는 건강한 생활습관으로의 행동변화를 원하는 것을 알 수 있었으며 근로자의 특성에 따라 행동 변화단계가 다르므로 이를 고려한 다양한 건강증진 프로그램을 개발함으로써 참여율 및 성공율을 높일 수 있으리라 사료된다. Objectives : This research attempts to investigate the relationship between health risk factors and workers' behavioral changes based on individual worker's characteristics to allow the development of more effective health promotion programs in businesses places. Methods : A questionnaire survey was conducted with 282 workers employed in small to medium sized enterprises in the Kyong-in area of Korea. The questionnaire was composed of general characteristics, a health risk assessment and an evaluation of the stage of behavior change for health promotion strategy in the workplace. Results : The health risk assessment revealed that 65.7 % of male workers smoke, 70.5% of male workers do not exercise on a regular basis, 86.1 % of female workers do not exercise at all, and 78.6 % of male workers and 50 % of female workers drink alcohol. In addition, the survey identified that 29.5% of male workers are addicted to excessive drinking, as are 11.1% of female workers. Based on the four stages of behavioral changes that lead to health, the pre-contemplation stage, contemplation stage, action stage, and maintenance stage, 40.5 %, 23.7 %, 12.1 % and 23.7 % of workers are in these stages, respectively, with regards to quitting smoking. As for regular exercises, 18.4 %, 37.6 %, 17.7 %, and 26.3 % of workers belong to each stage, respectively. As for moderation in drinking, 20.9 %, 15.4 %, 10.0 %, and 53.7 % are in each stage, respectively. The rate of health managers in the active stage of quitting smoking is significantly higher than that of general workers. Among the workers who do not exercise on a regular basis, workers over 50 years-old and blue color workers are more common in the precontemplation stage than any other worker groups. Conclusions : The results of this study suggest that the stages of behavioral change vary with worker characteristics. An awareness of the effects of the high risk factors is essectial for promoting workers' attendance in health promotion programs.

보건관리 대행사업장 근로자에서 건강증진에 대한 5년 사이의 지식, 태도 및 실천의 변화

임현우,김정아,안병용,박정일,구정완,이강숙 大韓産業醫學會 1998 대한직업환경의학회지 Vol.10 No.2

Before and after conducting the health promotion program by group occupational health service during 5 years, we surveyed knowledge, attitude and practice about general health (30 items) and occupational health(30 items) among 25 small and medium scale industry workers(before: 355 workers, after: 279 workers) for evaluation of effectiveness. The scores of knowledge for smoking, drinking, cholesterol, mental stress, management of hypertension, and risks in younger or women workers were significantly increased after conducting group occupational health service. The scores of attitude for controlling of fatty food consumption and cleaning workplace and bathing for health and that of practice for taking the periodic health examination and checking blood pressure were significantly increased but most of items in attitude and practice didn't be changed after services. According to sex, the scores of men were significantly increased in knowledge of general health, but there were not significant differences in age, job status and work duration group. In conclusion, through the group occupational health service during 5 years, only the scores of knowledge in general health were increased. It suggested that the effective program which can change workers' attitude and practice for health promotion, should be developed and conducted in small and medium scale industry workers.

모 컴퓨터 회사 근로자 건강증진 사업 전개를 위한 수요조사

임현우,안병용,최환석,박정일,김경수,이강숙,김정아,구정완 가톨릭대학산업의학쎈타 산업의학연구소 1997 韓國의 産業醫學 Vol.36 No.4

Before conducting the health promotion program, we surveyed the health risk appraisal(HRA) of 210 workers (186 men and 24 women) in a computer company, for the need assessment, selection of target population, priority setting, and as a standard for comparision after performing the program. The smokers were 115(88.6%), and drinkers (over 1 bottle of Soju per week) were 91(44.8%) in men. Entire women and 148(78.0%) men never or irregularly exercise. Type A personality were 73(39.2%) in men, 8(33.3%) in women, and 26(14.0%) of men and 6(25.0%) of women were high stress risk group. 53(25.2%) of men and 2(8.3%) of women were obese (BMI ≥25kg/m²), and workers who consumed exess of total calory compared with recommendation were 142(76.3%) in men and 18(75%) of women. By the health risk appraisal, it was suggested that smoking cessation program, drinking counselling, exercise prescription, stress management, and weight control program should be conducted effectively for the high risk group.

근골격계 악성 종양치료에서 동소 자가골 이식술을 이용한 사지 구제술

강용구,우영균,김정만,문영상,송영오 가톨릭 중앙의료원 가톨릭 암센터 1993 가톨릭 암센터 論集 Vol.7 No.1

Stage II B형 골육종에 대한 술전 항암화학요법 및 수술적 치료 결과

김정만,우영균,김형민,김훈교,이승구,강용구 가톨릭중앙의료원 가톨릭암센터 1997 암심포지움 Vol.- No.1

Recent advances in imaging techniques, surgery and combination anti-cancer chemotherapy have brought high survial rates in osteosarcoma. To investigate the survival rate, local recurrence and complications in treatment, we analysed 25 osteosarcoma cases who had been treated with preoperative neo-adjuvant chemotherapy, surgery and post operative chemotherapy at Department of Orthopedic Surgery, Catholic University. From May 1988 to April 1995, 42 cases of stage IIB osteosarcoma were admitted in Department of Orthopedic surgery. Among them, 17 cases who didn't follow our treatment guidance were excluded in this study. The average age were 19 years. There were 21 males and 4 females. The involved sites were 4 humerus, 10 femur, 10 tibia and 1 talus. Eleven cases had received intra-arterial cisplatin and intravenous adriamycin chemotherapy, and 7 T-10 protocol and 7 intravenous ifosfamide, ADR, methotrexate, cisplatin. Among twenty-three cases were treated with limb salvage surgery, and 2 amputation. The average follow-up was 35 months(3-82). There were 14 cases of continuous disease free, 9 cases of died of desease, 1 case of alive with disease, and 1 case of no evidence of disease at final follow-up. There were three cases of local recurrence at 6,8 and 12 months after operation. The Estimated kaplan-Meier's 5 year survival rates for all, ADR-cisloatin group, T-10 protocol group, and ifosfamide regimen group were 66%, 73%, 44% and 72%, respectively.