응급실을 내원한 구강악안면외과 안면골 골절 환자의 변화에 대한 비교 연구

신상훈,성화식,강영훈,황대석,김용덕,김욱규,김종렬,정인교 부산대학교 병원 암연구소 2008 부산대병원학술지 Vol.- No.24

Although there have been many clinical studies about the facial trauma in the recent as well as in the past, severity and frequency of facial trauma are reported multifarious. It seemed to be because of variety of social, cultural, and environmental factors, and the view point of investigators. In this study, we investigated about the patients visiting emergency room during recent 4 years(2004-2007), and compared with retrospective study during former 10 years(1992-1996, 1999-2003) in Dept. OMS Pusan National University Hospital. We assessed the cause, type, demographic, etc, and analyzed alterations of facial bone fractures during past 3 periods. The results were as follows. The total number of patients was increased. 429 patients treated for maxillofacial fractures between January 1992 and December 1996, 466 patients treated between January 1992 and December 1996 and 764 patients treated between January 2004 and December 2007. The male-to-female ratio were 4.6:1, 3.9:1, and 4.16:1, respectively. Patient in the age groups of 10-19 years and 20-29 years increased in the latter two periods. Assaults and falls are decreased gradually, but slip down s are increased. Traffic accidents are still major cause of facial trauma. The mandibular fractures showed the highest incidence thorought three periods. Symphysis fractures of mandible was increased and condyle fractures of mandible was drecreased in the third period.

측두하악관절염에서 발생한 희귀한 골화현상

신미정,안상헌,박재범,장헌수,김종필,안재진 大韓顎顔面成形再建外科學會 1996 Maxillofacial Plastic Reconstructive Surgery Vol.18 No.2

Osteoarthritis is a noninflammatory degenerative disease affecting the articular surfaces and is accompanied by remodeling of the underlying bone. The sympotms of osteoarthritis of the temporomandibular joint are pain in the joint and muscles of mastication, limitation. Osteoarthritis is generally accepted that several factors can contribute to the trauma, aging process, internal derangement and MPDS. Radiographic features of the osteoarthritis are seen flattening of joint, sclerosis on flattened area and osteophyte or anterior lipping. In the past, osteoarthritis was considered to self-limiting disease. Currently, synovial chondro-membrane is part of the process of osteoarthritis secondary to trauma. Synovial chondromatosis is an uncommon disease of cartilaginous transformation of synovial membrane with formation of loose bodies within the joint space. The pathogenesis in more an active metaplastic than a neoplastic process. The cause of synovial chondromatosis is unknown. Although trauma and inflammation have all been cited as possible factors in tis pathogenesis. The clinical sign and symptoms are unilateral swelling of the joint region, pain in the joint area and crepitus seem to be the most reliable signs and symptoms. Radiographic evidence of loose bodies may or may not be present. This is a case report of 66 year old female with synovial chondromatosis, that is advanced disease of the osteoarthrits. We treated patient with surgical excision of lose bodies, diskectomy and synovectomy. The defected articular fossa area was reconstructed with temporalis fascia flap. The result was satisfactory.

스트렙토조토신으로 유도된 당뇨 백서에 티타늄 임프란트 매식 후 주위 골형성에 관한 연구

신상훈,김종렬,박봉수 대한악안면성형재건외과학회 2000 Maxillofacial Plastic Reconstructive Surgery Vol.22 No.5

Use of osseointegrated implants for missing teeth has been widely utilized in clinical dentistry. Allthough the procedure has been highly successful, there have also been unavoidable failures. The success of osseointegration depends in part on the host bone and its healing capacity, and concerns have been raised about various conditions affecting its quality and quantity. Diabetes mellitus, which is a major health problem for the elderly, represents a reduction in collagen synthesis, delayed wound healing and osteoporosis. The underlying clinical problem is a deficiency of bone mass. Because age and gender are reported to be an important risk factor for diabetes mellitus, the rate of implant loss caused by failure of osseointegration may also be expected to increase correspondingly. Thus, a large population of the target population for dental implants may have a high risk for implant failure. There are, however, few histologic reports regarding tissue reaction to implants in diabetes patients. Streptozotocin is the current diabetogenic agent of choice for producing experimental diabetes mellitus. The toxic acts specifically on the β- cells of the pancreas and the metabolic conditions which result from the use of streptozotocin are reported to resemble those observed in humans. The purposes of this study were to histologically examine the tissue reaction to titanium implants inserted into the tibiae of streptozotocin induced diabetic rats using light microscopy and to assess over time the quantitative differences between the newly formed bone of diabetes-induced rats and controls using image processing systems and immunohistochemistry with fibronectin and CD44 antibody. Seventy adult rats of both sexes were used in this study. In thirty-five rats, streptozotocin was injected intraperitoneally to induce diabetes and the serum glucose concentration was checked to ensure the induction of diabetes prior to implant placement and at the time of sacrifice. The titanium screw implants (diameter, 2.0mm; height, 3.5mm) were inserted into left tibiae of 70 rats, 35 in the control group and 35 in the DM group. The experimental rats were sacrificed at different time interval(1st, 2nd, 3rd, 4th, 6th, 8th and 12th week) for histologic examination, histomorphomeric analysis and immunohistochemistry with fibronectin and CD44 antibody. The results obtained from this study were as follows : 1.A rapid bone formation was observed in control group compared with DM group based on histological examination. However the pattern of bone formation in both groups was similar. 2.According to the histomorphometric analysis, the control group showed significantly higher in marrow bone density, marrow bone-implant contact ratio, and total bone-implant contact ratio compared with DM group. 3.The level of fibronectin expression was the most abundant at 3 and 6 weeks, which maintained to 6 and 12 weeks in control and DM group, respectively. From 8 weeks, the level of fibronectin expression decreased gradually in control but not in DM group. 4.The level of CD44 expression was the most abundant at 4 weeks, which decreased gradually to 12 weeks in control group while high level of CD44 expression was observed with no significant change to 12 weeks in DM group. From these results, it could be stated that although the rate of bone formation was delayed in DM group, dental implant procedure was not a contraindication and longer healing period was necessary in diabetes mellitus.

인슐린 비의존형 당뇨병 환자에서 혈장 Endothelin-1농도의 변화

신양수,조희충,김원식,국기용,김용화,정종훈,문철웅,배학연,양성훈 朝鮮大學校 附設 醫學硏究所 1992 The Medical Journal of Chosun University Vol.17 No.2

Endothelin(ET) is a 21-residue peptide originally isolated from the cultured porcine endothelial cells. There are at least three genes for endothelin:endothelin-1(ET-1), endothelin-2(ET-2), and endothelin-3(ET-3). Endothelins are present in various human biological fluids including plasma, urine, breast milk, and saliva and have been found elevated plasma ET concentrations in patients with diabetes mellitus, Patients undergoing maintenance hemodialysis due to chronic renal failure, patients with acute myocardial infarction, and patients with subarachnoid hemorrhage. Endothelial cell damage is suspected to occur in diabetic patients and may be one important cause of angiopathy, a major complication in diabetes mellitus. The elevation of ET in diabetic patients may be a marker of, and further exacerbate, their vascular disease. We measured the levels of ET-1 in plasma of 50 patients with non-insulin dependent diabetes mellitus(NIDDM) and 25 normal subjects by radioimmunoassay. The plasma ET-1 concentration (mean±S.D.) in NIDDM was 6.461 A2.510 f㏖/ ㎖, and was significantly higher than in normal subjects (4.567±1.155f㏖/㎖) (P<0.05). The plasma ET-1 concentration (mean±S.D.) in diabetic retinopathy group( 7.15±2.454 f㏖/ml) was significantly elevated than those in otherwise uncomplicated groups (5.348±2.390 f㏖/㎖)(P<0.01). The correlation between any clinical parameters and plasma ET-1 levels in NIDDM was not significant, In conclusion, this study suggest that the elevated levels of ET-1 in diabetic patients may be play a important role in the pathogenesis of diabetic complications.

성인 급성 백혈병의 치료에 관한 연구

김종완,장준,신승훈,윤일국,박철신,김삼용 충남대학교 의과대학 지역사회의학연구소 1989 충남의대잡지 Vol.16 No.2

19 adult ALL patients were treated with follwing regimens; VP regimen to 5 patients, VPA regimen to 4 patients, multi-drug combined intensive therapy of Hoelzer regimen to 10 patients. The results of therapy are as follows: 1. Complete remission occured in 3 patients on VP regimen(60%), 4 patients on VPA regimen (100%), 8 patients on Hoelzer regimen (80%), respectively, and overall complete remission rate was 78.9%. 2. Mean survival time of total patients was 13.8 months, and in complete remission group, it was 16.2 month, but in non-complete remission group, it was 1.8 month. 3. Factors favorable for complete remission were absence of organomegaly(P<0.05) and initial leukocyte count under 30,000/㎟(P<0.01), factors favorable for the survival duration were initial leukocyte count under 30,000/㎟(P<0.05) and remission within 4 weeks of treatment.(P<0.01). 4. Recurrence rate were 40% in VP regimen, 50% in VPA regimen, and 20% in Hoelzer regimen. 5. During the remission induction period, common side effects of chemotherapy were alopecia, nausea, vomiting, mucositis, and general weakness and it was severe in VPA regimen and Hoelzer reimen than in VP regimen. But no significant difference was noted between VPA regimen and Hoelzer regimen. From the above results, we could confirm the importance of multiple drug combined intensive chemotherapy of remission regimen and periodic reinduction chemotherapy.

소아 시신경로 교종에서 보조적 치료의 역할

장종호,나영신,김정훈,이정교,강신광,김태형 The Korean Neurosurgical Society 2004 Journal of Korean neurosurgical society Vol.35 No.2

콜레스테롤 생합성 저해제 검색법의 개발

임종철,이남훈,김한균,염형렬,이대호,강현석,류형선,명재일,김완,신부안 全南大醫大 2001 전남의대학술지 Vol.37 No.2

뇌실외 배액술 시행과 관련된 뇌실염 : 원인균주와 경험적 치료약제의 적절성

도병훈,김신우,오종택,손종원,하상우,이응갑,장현하,이종명,김능수 대한감염학회 2005 감염과 화학요법 Vol.37 No.2

목적 : 본 연구는 뇌실외 배액술을 시행한 신경외과 환자들에서 뇌실염 발생 빈도, 원인균주와 감수성 추이 및 경험적 치료로 사용되는 항생제인 ceftazidime과 vancomycin의 적절성 여부에 대하여 조사하였다. 재료 및 방법 : 2000년 12월부터 2003년 10월까지 EVD를 시행한 경북대학교병원 신경외과 입원환자 340명 중 뇌실염이 발생한 39명을 대상으로 후향적으로 조사하였다. 결과 : 340명 중 39예 (11.5%)에서 뇌실염이 발생하였고 이들 가운데 4명이 뇌실염과 연관하여 사망하였다(10.3%). EVD 시행일로부터 뇌실염 발생까지는 평균 8.4일이었다. 원인균은 33예(87.1%)에서 확인되었으며 Aci-netobacter (19예, 45%), methicillin-resistant coagulase negative Staphylococcus (9예, 22%), methicillin-resistant Staphylococcus aureus (9예, 22%) 등의 순이었다. 가장 많이 동정된 Acinetobacter 19예 중에서 8예(42.1%)가 ceftriaxone에 내성을 보였으며 현재 경험적으로 널리 사용되는 ceftazidime에 대해서는 11예중 3예(27%)가 내성을 보였다. 결론 : 최근 EVD 시행과 관련된 뇌실염 뇌실염 최근 그람음성 non-fermenter 특히 Acinetobacter에 의한 경우가 증가하고 있으며, 이들 그람음성 non-fermenter는 현재까지 경험적으로 사용되는 ceftazidime에 점차 내성을 보이고 있다. 경험적 치료제에 대한 성공률을 높이기 위해서는 각 병원별 내실염의 원인균주의 감수성에 대한 검사가 필요하겠다. Purpose : To investigate the etiologic microorganisms of external ventricular drain (EVD)-related ventriculitis and the appropriateness of using ceftazidime and vancomycin as an empiric therapy in neurosurgical patients with EVD-related ventriculitis. Materials and Methods : Retrospective analysis of 39 patients with EVD-related ventriculitis among 340 neurosurgical patients to whom EVD had been placed during December 2000 and October 2003 at Kyungpook National University Hospital. Results : Thirty-nine EVD-related infections (39/340, 11.5%) occurred and the attributable mortality rate was 10.3% (4/39). The average duration from the ventricular catheter placement to the development of ventriculitis was 8.4 days. All patients with EVD infection had fever and 89.7% (35/39) of the patients showed nuchal rigidity. The positive culture rate in CSF was 87.1% (34/39) and the frequency of individual organism is as follows : Acinetobacter 45% (19 cases), methicillin-resistant coagulase negative Staphylococcus 22% (9 cases), methicillin-resistant Staphylococcus aureus 22% (9 cases), Enterococcus 5% (2 cases), Streptococcus pneumoniae 3% (1 case), non-fermenting gram-negative bacilli 3% (1 case). The polymicrobial infection rate was 15.4% (6/39). Among 19 cases of Acinetobacter infection, 42.1% (8/19) of the strains showed resistance to ceftriaxone and 15.7% (3/11) to ceftazidime. However, all cases were sensitive to meropenem. Conclusion : These findings show that the major etiologic organisms causing EVD-related ventriculitis have recently changed to Gram-negative non-fermenters, especially Acinetobacter. Because Gram-negative non-fermenting rods resistant to ceftazidime are increasing, an immediate change from ceftazidime plus vancomycin, the widely accepted empiric antibiotic therapy, to meropenem plus vancomycin should be considered when clinical symptoms and signs show no improvement or even deterioration.

하지강화 훈련후 슬관절 테이핑 적용이 근육발현에 미치는 영향

이용식,신철호,이종훈 한국학교체육학회 2002 한국학교 체육학회지 Vol.12 No.2

본 연구는 슬관절 테이핑 적용이 지구성 운동 후 근육발현에 어떠한 영향을 미치는지 그 효과를 과학적으로 분석하는데 목적을 두고 있다. 연구 목적을 달성하기 위하여 비 테이핑 그룹8명, 테이핑 그룹8명을 cybex Orthotron Ⅱ을 이용하여 하지강하 운동을 실행한 후 t-test 검증을 통하여 두 그룹간의 차이를 비교 분석하였으며, 분석 결과 다음과 같은 결론을 얻었다. 첫째, 60˚ /sec굴곡 운동 시 최대근력(p<.05), 평균파워(p<.01), 총 일량(p<.001)에 의미 있는 효과를 보였다. 둘째, 60˚ /sec신전 운동 시 최대근력, 평균파워, 총 일량 에서는 효과를 보이지 않았다. 셋째, 180˚ /sec 굴곡 운동 시 최대근력, 평균파워, 총일량 에서는 효과를 보이지 않았다. 넷째, 180˚ /sec 신전운동 시 최대근력, 평균파워, 총 일량 에서는 효과를 보이지 않았다. The following research is to analyze scientif4cally the efficient effects to the muscle revelation when taping is applied to the the joint after persistent exercise. To reach the purpose of the reseach, two groups of 8 people taped and untaped were formed using the cybex Orthothron Ⅱ to exercise and strengthen the leg. After the exercise, by verifying the t-test the difference between the two groups were compared and analyzed. The following conclusion is the result of the analysis. First, in the 60˚/sec curvature movement exercise it showed an effective meaning to the maximum muscular strength(p<.05), average power(p<.01), and total working quantity(p<.001). Second, in the extension exercise, there was an effective meaning to the maximum muscular strength(p<.05), but no effect shown in the maximum average power, and total working quantity. Third, in the 180˚/sec curvature movement exercise, there was no effects shown in the maximum muscular strength, average power, and total working quantity. Forth, in the 180˚/sec extension exercise there was no effects shown in the maximum muscular strength, average power, and total working quantity.

무증상의 현미경적 혈뇨를 동반한 성인 환자에서 신조직 검 사의 유용성

김형종,최훈영,김동기,김현진,장제현,김현욱,최규헌,이호영,한대석,강신욱 대한신장학회 2003 대한신장학회잡지 Vol.22 No.6