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장학원,박관수,김창환,남동석,박효상,박노부,김종배,Chang, Hak-Weon,Park, Kwan-Su,Kim, Chang-Whan,Nam, Dong-Seok,Park, Hyo-Sang,Park, No-Boo,Kim, Jong-Bae 대한악안면성형재건외과학회 1997 Maxillofacial Plastic Reconstructive Surgery Vol.19 No.1
Malignant hyperthermia is a hypermetabolic, fatal syndrome triggered by anesthetic drugs that occurs frequently in genetically susceptible persons. It is characterized by tachycardia, rapidly increasing temperature, skeletal muscle rigidity, respiratory and metabolic acidosis, cyanosis etc. It has been noted that the majority of cases of malignant hyperthermia are fatal unless early diagnosis and treatment are performed. Thus, the accurate prediction of preanesthetic susceptibility and early diagnosis of malignant hyperthermia is necessary to appropriate treatment. Dantrolene sodium has been shown to be effective in the prevention and treatment of malignant hyperthermia. We experienced a case of malignant hyperthermia, which is presented of a 32-year-old healthy male patient in whom a orthognatic surgery was performed under $O_2-N_2O$-enfl-rane anesthesia with induction by pentobarbital and succinylcholine. We discuss this case with reviewing the history, incidence, etiology, pathophysiology, clinical signs & biochemical changes, prevention & treatment. 악성고열증은 마취중 혹은 마취 후에 나타나는 마취 합병증으로 발병률은 매우 희귀하나 높은 치사율 때문에 일단 발현하면 치명적인 결과를 초래하므로 예방 및 조기 발견에 의한 조기 치료가 매우 중요하다. 예방을 위해서는 보유자의 감별이 무엇보다 중요하고 이를 위해서는 철저한 개인력 및 가족력 조사와 술전 감수성 검사가 이루어져야 한다. 의심이 되는 환자는 마취 전후에 dantrolene sodium을 투여하여야 하고 마취시 유발 마취제 및 유발 인자를 피하며 emotional stress를 피하기 위해 충분한 sedation이 요구된다. 그러나 우리 나라에는 특수 치료제인 dantrolene sodium의 확보가 어려워 조기 발견을 하고도 효과적인 치료를 하지 못하는 경우가 흔히 있으므로 dantrolene sodium을 상비약으로 비치하는 것이 좋을 것으로 사료된다. 저자들은 32세의 건강한 젊은 남자 환자가 악성형수술도중 갑작스런 체온 상승과 빈맥근강직등이 발현하여 술 후 5일만에 급성 신부전증 및 파종성혈액내응고병증(DIC)으로 사망한 악성고열증 환자를 경험하였기에 문헌고찰과 함께 보고하는 바이다.
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김종배,박효상,김창환,이용규,최봉주,장학원 啓明大學校 醫科大學 1997 계명의대학술지 Vol.16 No.2
Cyclosporin is a relatively new immunosuppressive agent which has been used to prevent organ transplant rejection, to treat type-I diabetes mellitus and several other autoimmune disorders. It is anticipated that the therapeutic use of cyclosporin will increase progressively in the future to treat numerous other disorders. As its clinical use broadens, it will needed for health professionals to be familiar with the beneficial effects as well as some of the undesirable side effects of cyclosporin therapy. A side effect of this drug in dentistry appears to be pronounced gingival hyperplasia. Cyclosporin induced gingival hyperplasia is indistinguishable from gingival hyperplasia induced by phenytoin and nifedipine in clinical and histopathologic finding. We experienced two cases of gingival hyperplasia secondary to cyclosporin therapy in patients, 48-year old & 28-year old females who received a kidney allograft transplant. Clinical examinations revealed a severely overgrown and inflammed gingiva. Surgical excision of the excess tissue was accomplished under local anesthesia. On follow-up check, gingival hyperplasia in a 48-year old patient whose oral hygiene was very poor showed successive recurrence after three times surgical excision, another patient who could control oral hygiene thoroughly showed good healing. Conclusively, it seems to be very important to control oral hygiene thoroughly to decrease occurrence and recurrence of cyclosporin-induced gingival hyperplasia.
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Surface Characteristics and Osteoblast Cell Response on TiN- and TiAlN-coated Ti Implant
권태엽,이효진,김교한,장학원,하정윤 대한의용생체공학회 2011 Biomedical Engineering Letters (BMEL) Vol.1 No.2
Purpose The purpose of this study was to evaluate the surface characteristics and osteoblast cell response of TiN and TiAlN coated on Ti Surface. Methods TiN and TiAlN coatings were applied on Ti dental implant and surface characteristics of these coatings were evaluated. And osteogenic effect of TiN and TiAlN coating on MG63 osteoblast-like cell proliferation and differentiation was evaluated by cell viability assay (MTT assay), ALP activity assay and expressions of collagen gene. Results As observed by SEM, both the TiN and TiAlN coatings had thickness of about 1.7 μm. From the EDX analysis, Ti and N peaks and Ti, Al and N peaks are confirmed on the TiN and TiAlN coating surface, respectively. The wetting angles of TiN and TiAlN coatings were increased as compared to that of control Ti. As compared to Ti, a great number of attached cells on TiN and TiAlN coated surfaces were observed. The cell survival rate of the TiN and TiAlN were 125% and 117% as compared to that of the Ti (100%). Both the TiN and TiAlN coatings produced equivalent levels of protein. ALP activity of MG63 cells grown on Ti,TiN and TiAlN surface is indicated. Collagen gene was overexpressed in cells cultured on TiN and TiAlN in comparison with the Ti. Conclusions TiN and TiAlN coatings on Ti dental implant may have potential for use in dental implant in terms of their biocompatibility.
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