Original Article 1 - 합성골 이식재인 Osteon$^{(R)}$을 이용한 상악동 거상술-임상적, 방사선 계측학적 연구

차재국,정의원,김민수,엄유정,김창성,조규성,최성호,정성민,Cha, Jae-Kook,Jung, Ui-Won,Kim, Min-Soo,Um, Yoo-Jung,Kim, Chang-Sung,Cho, Kyoo-Sung,Choi, Seong-Ho,Chung, Sung-Min 대한치과의사협회 2010 대한치과의사협회지 Vol.48 No.1

Purpose: The aim of this study was to evaluate 1 year cumulative survival rate of implants placed on augmented sinus using Osteon$^{(R)}$, bone graft material and to assess height of the grafted material radiographically. Material and Methods: 10 maxillary sinuses were augmented in 10 patients and 25 implant fixtures were installed simultaneously or after 6 months healing period. The height of the sinus graft material was measured using panoramic images immediately after augmentation and up to 19 months subsequently. Changes in the height of the sinus graft material were calculated with respect to implant length and original sinus wall height. Results: The cumulative survival rate was 100% in all 25 implants. Additionally, normal healing process without any complication was observed in all patients. The mean crown/Implant ratio was 1.25. The mean marginal bone loss was 0.95mm and the mean resorption rate of Osteon$^{(R)}$ was 0.05mm/month. The fastest resorption site of Osteon$^{(R)}$ is the first molar area. The grafted material was well maintained in sinus and decreased slightly over 1 year. Conclusion: In conclusion, It can be suggested that Osteon$^{(R)}$ may have predictable result when it was used as a grafting material for sinus floor augmentation.

한국 호아 천식 환자의 삶의 질에 대한 설문 개발 및 유용성 평가를 위한 다기관 공동 연구

차재국(Jae Kook Cha),오재원(Jae Won Oh),홍수종(Soo Jong Hong),이혜란(Hae Ran Lee),이명익(Myung Ik Lee),김규언(Kyu Earn Kim),이준성(Joon Sung Lee),이하백(Ha Baik Lee),이상일(Sang Il Lee) 대한천식알레르기학회 2000 천식 및 알레르기 Vol.20 No.3

N/A Background:and object: Traditional asthma outcome measures such as symptoms, spirometry. And medication requirements usually provide valuable information about the asthmatic status but they rarely capture the functional impairments. Thus, many clinicians are increasingly recognizing the importance of an assessment of health-related quality of life(HRQL) as an outcome measure in asthma. We developed a questionnaire to measure asthma-specific quality of life in Korean children and evaluated the measurement properties. Materials and methods : The questionnaire for children with asthma included 14 items in three domains (symptoms-6 items, activity limitation-4 items, and emotional function-4 items) and the response options for each item were on a 5-point scale where 1 indicated maximum impairment and 5 indicated no impairment. Results were expressed as the mean score for overall quality of life as well as for each of the domains. At #follow-up clinic visit, patients completed global assessment of change related to their symptoms, activities and emotions. We recruited children (7-17 years of age) with asthma from thirty-three general hospitals. Results Data from 214 patients(144 boys and 70 girls) who completed the questionnaire were analyzed. The mean age was 10.0 years and the disease severity consisted of mild intermittent (26.6%), mild persistent(36.0%), moderate persistent(32.2%), and severe persistent (3.3%). The questionnaire for children with asthma showed a high index of responsiveness, reproducibility, and both longitudinal and cross-sectional correlations with the conventional asthma indices and with the questionnaire score. But there was no relationship between changes in questionnaire score of the domain of emotional function and changes in FEV1 or PEFR. Conclusion: The questionnaire of children is straight forword, and easy to apply.

한국 소아 천식 환자의 보호자 삶의 질에 대한 설문 개발 및 유용성 평가를 위한 다기관 공동 연구

차재국(Jae Kook Cha),오재원(Jae Won Oh),홍수종(Soo Jong Hong),이혜란(Hae Ran Lee),이명익(Myung Ik Lee),김규언(Kyu Earn Kim),이준성(Joon Sung Lee),이하백(Ha Baik Lee),이상일(Sang Il Lee) 대한천식알레르기학회 2000 천식 및 알레르기 Vol.20 No.3

N/A Background: and objective: Asthma is the most common chronic disease among children. Thus, when children have asthma, it can have a significant impact on health-related quality of life, not only for children, but also for parents and family. We developed to measure asthma- specific quality of life in caregivers of children with asthma age 7~17 years and evaluated the measurement properties of the questionnaire. Materials and method: The questionnaire of caregivers of children with asthma include 13 items in two areas(activity limitation-4 items, emotional function-9 items) and the response options for each item are on a 5-point scale where 1 indicates maximum impairement and 5 indicates no impairement. Results are expressed as the mean score for overall quality of life as well as for each of the domains. At follow-up visit, we asked caregivers whether they had experienced any change in their overall quality of life related to their children's asthma since the previous visit. They responded on a 11-point scale from -5(a very great deal worse) to 0(no change) to +5(a very great deal better). We recruited 195 caregivers of children with asthma from thirty-three general hospitals and evaluated the measurement properties of the questionnaire. Result: The questionnaire of caregivers of children with asthma showed excellent responsiveness in changed group, but the change in score of stable and changed group has no difference. It was reproducible in subjects who are stable. There was no longitudinal and cross- sectional correlations between caregiver's questionnaire score and the child's asthma status, while cross-sectional correlations were found between caregiver's questionnaire score and PEFR Conclusion The questionnaire of caregivers of children with asthma is simple and easy to use, and is applicable.

소아 천식의 근황과 치료 경향에 관한 조사

차재국(Jae Kook Cha),윤혜선(Hae Sun Yoon),이혜란(Hae Ran Lee) 대한소아알레르기호흡기학회(구 대한소아알레르기 및 호흡기학회) 1998 소아알레르기 및 호흡기학회지 Vol.8 No.2

목 적 : 지난 20년간 우리 나라에서도 소아천식이 증가해왔으며, 천식의 병태 생리가 밝혀지면서 치료방법에도 않은 변화가 왔고, 지난 1994년 소아천식의 치료지침이 발표된 바 있다. 따라서 실제 일상에서 시행되고 있는 천식 치료의 실태를 알아보고자 본 조사를 실시하였다. 방 법 : 소아과 전문의를 대상으로 소아천식의 실태와 진료에 관한 24개 문항의 설문지를 통해 조사하였다. 결 과: 1) 소아천식 환자의 연령적 분포는 3-5세 이하가 전 소아천식 환아 중 72-90%를 차지하였으며, 천식의 중증도에 관한 조사에서 경중 천식이 71-80%로 대부분이었다. 2) Cough variant asthma의 분포는 전 소아천식 아동 중 약 10%로 나타났으며, 운동 유발성 천식도 응답자의 1/3에서 전 천식소아 환아 중 10%이내라고 하였다. 3) 처음 천식 환자 진료시에 환자나 보호자에게 설명하는데 소요되는 시간은 5-9분간이 대부분이었고, 증상 일기를 쓰게 하는 경우와 최대호기유속(PEFR)을 측정하도록 하는 경우가 각각 약 20-10% 이내로 소수였다. 4) 급성 천식 치료에 있어 흡입제 또는 네뷰라이저로 치료하는 경우보다 아직도 경구용을 사용한다는 경우가 73%로 많았으며, 특히 개인의원에서 경구용을 선호하고 있었다. 5) 만성 천식 치료에 있어 대학병원에서는 항염증제의 네뷰라이저 혹은 흡입제 치료가 일차 선택 약제로 사용되는 분포가 높았으나, 개인 의원에서는 60-70%에서 경구용 베타2 자극제의 사용이 흔하였다. 예방적 치료로는 케토티펜(ketotifen)이 가장 널리 (91.5%) 사용되고 있었다. 6) 면역 치료는 전체 소아 천식 환아 중 약 10% 이내에서 흔히 실시되고 있었다. 결 론 : 소아천식은 5세 이하가 대부분이었으며 경증 천식이 않았다. 천식 치료는 소아 천식치료지침이 실제 임상에서 잘 적용되고 있지 못했으며 따라서 더욱 많은 교육과 이에 대한 홍보가 요구된다. Purpose : During the past two decades in Korea, the prevalence rate of childhood asthma has been increased, and also there has been a significant evolution in the management of asthma. In 1994, a guideline for the diagnosis and treatment of asthma was established. This study was designed to investigate a real picture of clinical practice in the management of childhood asthma. Methods : This survey was conducted with data on 24 items of questionnaires from pediatricians working in private clinics, general hospitals, and university hospitals. We investigated the age distributions, severity of asthma, educational levels, management of asthma, and current trends of medication. Results : 1) In age distribution, childhood asthma was most prevalent in 3-5 years old age group(30-40%), followed by 2 years old age group, and was least prevalent in 10-15 years old age group. 2) The number of patients with cough variant asthma was about 10% of all childhood asthma. 3) A period of 5-10 minutes was the most common period consumed for the explanation of child asthma during each medical practice. Cases recording symptom diary and cases monitoring PEFR(using peak flow meter) were less than 10% each. 4) With regard to the use of β2 agonist in the treatment of acute asthmatic attack, rate of using oral drugs and nebulizer or inhalers of β2 agonist are similar in the university hospitals, but the rate of using oral drugs was over 80% in private clinics. 5) With regard to the use of anti-inflammatory drugs in the management of chronic asthma, nebulizer or inhaler therapy was the first-line choice in the university hospitals(rate over 60-90%), oral drugs were main therapy in private clinics. The administration of anti-allergic medication as a preventive measures was recommended in about 40-50%, and ketotifen was used most frequently. 6) Immunotherapy was being performed in about 10% of childhood asthma patients. Conclusion : Childhood asthma was most prevalent in the age group under 5 years and severity was mostly mild. For the management of childhood asthma, the education and control for asthma are still insufficient and previously published guidelines have been inappropriately used in practical field.

합성골 이식재인 Osteon<SUP>®</SUP>을 이용한 상악동 거상술

차재국(Jae-Kook Cha),정의원(Ui-Won Jung),김민수(Min-Soo Kim),엄유정(Yoo-Jung Um),김창성(Chang-Sung Kim),조규성(Kyoo-Sung Cho),최성호(Seong-Ho Choi),정성민(Sung-Min Chung) 대한치과의사협회 2010 대한치과의사협회지 Vol.48 No.1

Purpose: The aim of this study was to evaluate 1 year cumulative survival rate of implants placed on augmented sinus using Osteon<SUP>®</SUP>, bone graft material and to assess height of the grafted material radiographically. Material and Methods: 10 maxillary sinuses were augmented in 10 patients and 25 implant fixtures were installed simultaneously or after 6 months healing period. The height of the sinus graft material was measured using panoramic images immediately after augmentation and up to 19 months subsequently. Changes in the height of the sinus graft material were calculated with respect to implant length and original sinus wall height. Results: The cumulative survival rate was 100% in all 25 implants. Additionally, normal healing process without any complication was observed in all patients. The mean crown/Implant ratio was 1.25. The mean marginal bone loss was 0.95 ㎜ and the mean resorption rate of Osteon<SUP>®</SUP> was 0.05 ㎜/month. The fastest resorption site of Osteon<SUP>®</SUP> is the first molar area. The grafted material was well maintained in sinus and decreased slightly over 1 year. Conclusion: In conclusion, It can be suggested that Osteon<SUP>®</SUP> may have predictable result when it was used as a grafting material for sinus floor augmentation.

측방변위판막술 후 재발된 하악 전치부 순면 치은퇴축의 유리치은이식술을 이용한 치근 피개

주명재(Myung-Jae Joo),차재국(Jae-Kook Cha),이중석(Jung-Seok Lee),정의원(Ui-Won Jung) 대한치과의사협회 2017 대한치과의사협회지 Vol.55 No.7

The purpose of this case report is to present a case of free gingival graft for treatment of mandibular incisor labial gingival recession relapsed after laterally positioned flap surgery. A 22 year-old female patient with discomfort and labial gingival recession on left mandibular central incisor was treated. The patient had been treated root coverage on same site by laterally positioned flap surgery, but treated site had relapsed in one month. Exposed root surface was covered by free gingiva from left palatal area. Although gingival color did not completely match with adjacent gingiva, more than 5mm keratinized gingiva was attained. The patient showed no further recurring pain and recession on gingiva after 5 months from the surgery. In conclusion, the root coverage with gain of keratinized gingiva could be achieved through free gingival graft from palate on relapsed gingival recession.

소아설사 환아에서의 Escherichia coli O157 분리

송원근,김현태,이규만,차재국,이건희,Song, Wonkeun,Kim, Hyoun Tae,Lee, Kyu Man,Cha, Jae Kook,Lee, Kon Hee 대한소아감염학회 1997 Pediatric Infection and Vaccine Vol.4 No.1

목 적 : Escherichia coli (E. coli) O157은 설사, 출혈성대장염 등을 일으키며, 드물게 용혈성 요독증후군까지 일으키는 세균이다. 미국이나 유럽에서는 세균성설사의 2~3번째로 흔한 원인균이다. 우리나라는 이 세균감염이 거의 없는것으로 알려져 왔으나, 우리나라도 점차 햄버거와 같은 간이음식의 섭취가 늘어나, 이 세균감염이 생겼을 가능성이 있을 것으로 사료되어, 향후 이 세균에 대한 통상적인 변배양 검사의 필요성 여부를 알아보고자 하였다. 방 법 : 1996년 3월부터 1997년 2월까지 6개월 이상된 소아설사 환아의 변배양 검체를 대상으로 하였다. Sorbitol-MacConkey 한천에 배양한 후 형성된 집락 중 무색 집락을 대상으로 E. coli로 동정된 것을 E. coli O157 라텍스 응집검사를 실시하여 응집이 되면 양성으로 판독하였다. 결 과 : 총 317 검체중 11월에 1 검체 (0.3%)에서 Shiga 독소를 생성하지 않는 E. coli O157:NM이 분리되었다. 7세 남아로 2일간의 복통과 1일간의 설사 및 구토를 주소로 입원 한 후 특별한 치료없이 2일후 증상이 호전되어 퇴원하였다. 결 론 : 검사된 모든 대변 검체중 한 검체 (0.3%)만이 E. coli O157이 분리되었으나 Shiga 독소를 생성하지 않는 군주였다. 따라서 이 세균의 분리를 위한 통상적인 변배양 검사는 아직 불필요한 것으로 사료되었다. Purpose : Escherichia coli O157 can produce diarrhea as well as hemorrhagic colitis and hemolytic uremic syndrome. In many parts of North America, E. coli O157 often is the second or third most commonly isolated enteric bacterial pathogens. Recently, intakes of fast food, including hamburgers have increased in Korea. Therefore, E. coli O157 infection in Korea are likely to be increased. Methods : Stool samples from 317 pediatric diarrheal patients were analyzed by culture on sorbitol-MacConkey agar. Sorbitol-negative colonies were teated by E. coli O157 latex agglutination test. Results : Of the 317 specimens, one (0.3%) were E. coli O157:NM that not produced Shiga toxin. The 7 year old male patient who had complained of abdominal pain, vomiting and non-bloody diarrhea for 2 days. The patient was improved for 2 days after admission. Conclusions 1 Only one (0.3%) of all fecal samples were isolated E. coli O157 that not produced Shiga toxin. Therefore, routine stool culture for the isolation of E. coli O157 was not likely to be neccessary so far.

Mycoplasma pneumoniae 폐렴에 동반된 Henoch-Sch nlein purpura 1례

김종진 ( Jong Jin Kim ),차재국 ( Jae Kook Cha ),이건희 ( Kon Hee Lee ),윤혜선 ( Hye Sun Yoon ) 대한소아감염학회 1997 Pediatric Infection and Vaccine Vol.4 No.2

Mycoplasma pneumoniae는 주로 소아연령에서 질병을 일으키며, 호흡기계를 침범하고 피 부, 중추 신경계, 혈액계, 심혈관계, 위장관계, 관절 등도 침범할 수 있다. Henoch-Sch nlein 자반증은 피부, 위장관, 관절, 신장 등을 침범하여 자반증, 관절통, 피부병변, 위장 증상, 사구체 신염 등을 나타내는 질환으로 기본적인 병리 소견은 소혈관염이며 혈관벽에 IgA의 침착이 특징이다. 원인은 잘 알려져있지 않고 알레르기, 약물과민, 감염 등이 발병에 관여하는 것으로 알려져 있으며 감염인자 중에서 연쇄상 구균, Yersinia, Legionella, 풍진, 독감, 홍역 바이러스, Mycoplasma 등이 관련된 보고가 있다. 저자들은 Mycoplasma 폐렴과 동시에 Henoch-Sch nlein 자반증이 나타난 환아를 경험하였기에 보고하는 바이다. We experienced a case of Henoch-Sch nlein purpura associated with Mycoplasma pneumoniae pneumonia in a 28 month old male who suffered from cough, abdominal pain and both leg swelling and pain. Physical examination showed varying sired purpura, characteristic of Henoch-Sch nlein purpura, below both knee. Laboratory test revealed Mycoplasma pneumoniae antibody titer >1:2,560 and cold agglutinins titer 1:64. Chest X-ray showed peribronchial blurring in both lung fields. The patient was treated with midecamycin and prednisolone for 7 days and responded to the treatment well. The authors report a case of Henoch-Sch nlein purpura with Mycoplasma pneumoniae pneumonia with brief review of related literatures.

초기 신생아 황달 발생 예측의 선별검사로서 경피적 빌리루빈 측정법이 유용성

최영환 ( Young Hwan Choi ),차재국 ( Jae Kook Cha ),김종완 ( Jong Wan Kim ),유기양 ( Ki Yang Ryoo ) 대한주산의학회 1999 Perinatology Vol.10 No.1

근단변위판막술과 함께 유리치은이식술을 사용하여 임플란트 주변 각화치은을 증대시킨 2건의 증례 보고

백원선(Won-Sun Baek),차재국(Jae Kook Cha),이재홍(Jae-Hong Lee),이중석(Jung-Seok Lee),정의원(Ui-Won Jung) 대한치과의사협회 2016 대한치과의사협회지 Vol.54 No.4

Narrow zone of attached gingiva and shallow vestibule around the implants might contribute to difficulty of cleasing, periimplant mucositis caused by incomplete cleansing and further peri-implantitis. The aim of this case report is to present modification of soft tissue biotype around the implants by free gingival grafts according to timing of surgical intervention and shape of free gingiva. A 44 year-old male patient had a missing area on lower right second molar area with 1 to 2 mm of narrow attached gingiva zone and wanted to be treated by implant placement. In radiographic analysis, there was enough alveolar bone to install an implant, free gingiva from hard palate was grafted following implant placement using double layer flap. The width of attached gingival was increased to 4 to 5mm and well maintained during 5 months of follow up. A 69 year-old female patient also had a missing area on lower right first and second molar area with 1 to 2 mm narrow attached gingiva. Since she had systematically angina pectoris and dental phobia, minimal invasive free gingival graft after implants placement was planned. After 2 months of implant surgery, free gingival graft surgery was performed with healing abutments connection. The grafted gingiva was composed of two strip shaped free gingiva, and they were immobilized by periodontal pack. The width of attached gingival was increased to 4 to 5mm and well maintained during 10 months of follow up. With prosthesis delivery, the patients recovered ideal periodontal environment around implants and masticatory function. In conclusion, periodontal health and masticatory function could be achieved through implant placement and free gingival graft.