이식편대숙주질환과 관련된 건성안 환자에서 사이클로스포린A과 제대혈청 병합치료의 효과

최정한,오한진,윤경철,Jung Han Choi,Han Jin Oh,Kyung Chul Yoon 대한안과학회 2013 대한안과학회지 Vol.54 No.4

Purpose: To investigate the efficacy of combined treatment with 0.05% cyclosporine A and 20% umbilical cord serum eye drops for severe dry eye associated with graft-versus-host disease (GVHD). Methods: Eighteen patients with severe dry eye associated with GVHD were treated with 0.05% cyclosporine A and 20% umbilical cord serum eye drops (group 1, n = 16), 0.05% cyclosporine A eye drops (group 2, n = 10) or artificial tears only (group 3, n = 10). Tear film break up time (BUT), Schirmer test, tear clearance rate (TCR), and keratoepithelio pathy score were measured before and 1, 3 and 6 months after treatment. Results: In group 1, significant improvement was observed in tear film BUT (from 3.25 ± 1.18 s to 6.63 ± 0.96 s, p < 0.01), TCR (from 2.38 ± 0.72 to 3.13 ± 0.72, p < 0.01) and keratoepithelio pathy score (from 6.31 ± 2.15 to 0.88 ± 0.89, p < 0.01) 6 months after treatment. Compared with group 2 and group 3, group 1 showed significant improvement in BUT (3 and 6 months after treatment) and keratoepitheliopathy score (1, 3 and 6 months after treatment). Conclusions: Combined treatment with 0.05% cyclosporine A and 20% umbilical cord serum eye drops is effective for severe dry eye associated with GVHD.

임플랜트 지지 상부구조물에서 나사조임순서와 조임방법이 풀림토크값에 미치는 영향

최정한,김창회,임영준,김명주,이석형,Choi, Jung-Han,Kim, Chang-Whe,Lim, Young-Jun,Kim, Myung-Joo,Lee, Seok-Hyung 대한치과보철학회 2007 대한치과보철학회지 Vol.45 No.5

Statement of problem: The screw detorque value is a measure of the preload remaining in the screw just before detorquing. Purpose: This study evaluated the effect of different screw tightening sequences and tightening methods on detorque values for a well-fitting implant superstructure. Material and method: An implant superstructure that connected directly to four implants (Astra Tech) was fabricated on a fully edentulous mandibular acrylic resin model. Six well-fitting dental stone casts were made with a pickup impression of the superstructure from the acrylic resin model. To evaluate the effect of three screw tightening sequences (1-2-3-4, 2-4-3-1, and 2-3-1-4) and two tightening methods (2-step and 1-step) on the stability of screw joint, the detorque values for a well-fitting implant superstructure were measured twice after screw tightening using 20 Ncm. Detorque values were analyzed using multi-way analysis of variance and two-way analysis of variance at a .05 level of significance. Results: 1. The mean detorque values for three screw tightening sequences were 12.3 Ncm, 12.6 Ncm, and 12.0 Ncm, respectively. 2. The mean detorque values for two screw tightening methods were 12.0 Ncm, and 12.2 Ncm, respectively. 3. The mean of mimimum detorque values for three screw tightening sequences and for two tightening methods were 10.6 Ncm, 11.1 Ncm, 10.5 Ncm, and 9.8 Ncm, respectively. 4. No statistically significant differences among the variables of screw tightening sequence and tightening method were found (p>.05) for detorque values and for mimimum detorque values. Conclusion: Within the limitations of this study, the screw tightening sequence and tightening method did not have a significant effect on the detorque values for a well-fitting implant superstructure.

내부연결 임플란트 상부구조물에서 나사조임술식이 풀림토크값에 미치는 영향

최정한,Choi, Jung-Han 대한치과보철학회 2010 대한치과보철학회지 Vol.48 No.4

연구 목적: 본 연구는 잘 맞는 임플란트 상부구조물에서 서로 다른 나사조임순서와 조임방법이 나사의 풀림토크값에 미치는 영향을 평가하였다. 연구 재료 및 방법: 서로 수동적 적합 관계를 갖는 완전 무치악 하악 주모형과 네 개의 평행한 임플란트 (Astra Tech)에 직접 연결되는 금속구조물을 제작하였다. 금속구조물과 잘 맞는 실험모형을 위해 주모형에서 연결인상법을 이용하여 여섯 개의 경석고 모형을 얻었다. 20 Ncm로 조인 후 나사의 풀림토크값을 두 번 측정하였다. 세 가지 나사조임순서 (1-2-3-4, 2-4-3-1, 그리고 2-3-1-4)와 두 가지 나사조임방법 (two-step과 one-step)에 대한 나사의 풀림토크값과 최소풀림토크값을 유의수준 .05에서 각각 다원분산분석법 (multi-way ANOVA)과 이원분산분석법 (two-way ANOVA)을 이용하여 통계분석 하였다. 결과: 나사조임순서에 대한 나사의 평균 풀림토크값은 12.8 Ncm (2-4-3-1)에서 13.1 Ncm (2-3-1-4)의 값을 보였고, 나사조임방법에 대한 값은 13.1 Ncm (two-step)와 11.8 Ncm (one-step)였다. 나사조임순서에 대한 나사의 평균 최소풀림토크값은 11.1 Ncm (1-2-3-4)와 11.2 Ncm (2-4-3-1과 2-3-1-4)였고, 나사조임방법에 대한 값은 11.2 Ncm (two-step)와 9.9 Ncm (one-step)였다. 나사의 풀림토크값과 최소풀림토크값은 세 가지 나사조임순서 간에 통계학적으로 유의성 있는 차이가 없었다. 그러나 두 가지 나사조임방법 간에는 두 값 모두 통계학적으로 유의성 있는 차이가 있었다. 나사를 두 단계로 나누어 조이는 방법이 한 번에 조이는 방법보다 더 큰 풀림토크값 (P = .0003)과 더 큰 최소풀림토크 값 (P = .0035)을 보였다. 결론: 본 연구와 같은 조건하에서, 연결인상법으로 얻은 잘 맞는 임플란트 상부구조물에 있어서 나사조임순서는 나사의 풀림토크값에 영향을 미치는 중요한 요소는 아니었다. 그러나 나사를 두 단계로 나누어 조이는 방법은 한 번에 조이는 방법보다 더 큰 풀림토크값을 보였다. Purpose: This study evaluated the effect of different screw tightening sequences and methods on detorque values in a well-fitting implant superstructure. Materials and methods: A fully edentulous mandibular master model and a metal framework directly connected to four parallel implants (Astra Tech) with a passive fit to each other were fabricated. Six stone casts were made with a splinted impression technique to represent a 'well-fitting' situation with the metal framework. Detorque values were measured twice after screw tightening using 20 Ncm. Detorque values and minimum detorque values for three screw tightening sequences (1-2-3-4, 2-4-3-1, and 2-3-1-4) and for two tightening methods (two-step and one-step) were analyzed using multi-way analysis of variance and two-way analysis of variance, respectively, at a .05 level of significance. Results: The mean detorque values for screw tightening sequences ranged from 12.8 Ncm (2-4-3-1) to 13.1 Ncm (2-3-1-4), and for screw tightening methods were 13.1 Ncm (two-step) and 11.8 Ncm (one-step). The mean of mimimum detorque values for screw tightening sequences were 11.1 Ncm (1-2-3-4) and 11.2 Ncm (2-4-3-1 and 2-3-1-4), and for screw tightening methods were 11.2 Ncm (two-step) and 9.9 Ncm (one-step). No statistically significant differences among three screw tightening sequences were found for detorque values and for mimimum detorque values. But, statistically significant differences between two screw tightening methods were found for two values. Two-step screw tightening method showed higher detorque value (P = .0003) and higher minimum detorque value (P = .0035) than one-step method. Conclusion: Within the limitations of this study, the screw tightening sequence was not a critical factor for the detorque values in a well-fitting implant superstructure by the splinted impression technique. But, two-step screw tightening method showed greater detorque values than one-step method.

임상적 방법을 이용한 내부연결 임플랜트에서 고정체수준 인상법의 정확도 평가

최정한,Choi Jung-Han 대한치과보철학회 2006 대한치과보철학회지 Vol.44 No.4

Statement of problem : Accurate impression is essential to success of implant prostheses. But there have been few studies about the accuracy of fixture-level impression technique in internal connection implant system. Purpose: This study evaluated the accuracy of splinted fixture-level impression technique using clinical methods and the effect of internal hex on fit of superstructure in internal connection implant system (Astra Tech). Material and method : Two metal master frameworks made from two abutments (Cast-to Abutment ST) each for parallel and divergent conditions and a corresponding. passively fitting, dental stone master cast with four future replicas (Fixture Replica ST) were fabricated. Ten dental stone casts were made with vinyl polysiloxane impressions from the master cast by acrylic resin splinted fixture-level impression technique. To evaluate the accuracy of impression technique, the fit of master frameworks for test models was evaluated using screw resistance test (SRT) and one-screw test. The results of SRT were recorded as SRT values from grade 1 to grade 5 by 1/4 turn. And to evaluate the effect of hex on fit of superstructure, the same tests were performed after removing hexes of master frameworks. Results: 1. There was only one case (2.5%) showing SRT value of test model below ade 2 in total before and after removing hexes of master frameworks. And, by removing hexes. SRT values decreased in only one test model (5%) and did not change in 17 test models (85%). 2. SRT values of the 1$^{st}$ screws were grade 2 in 80% of cases before, and grade 1 in 80% of cases after removing hexes. And, by removing hexes, SRT values decreased in 72.5% of cases. 3. SRT values of the 2$^{nd}$ screws were grade 3 in 85% of cases before, and grade 3 in 95% of cases after removing hexes. And, by removing hexes, SRT values did not change in 85% of cases. 4. There were only 2 cases regarded as acceptable fit by one-screw test, and SRT values of 2$^{nd}$ screws of both cases were grade 2. Conclusion. Within the limitations of this study, future-level impression of internal connection implant system is considered to obtain inaccurate working cast, even using acrylic resin splinted impression technique. And, it is considered to be unable improve the fit to remove the hexes of implant restoration.

저밀도 내피세포 환자의 백내장 수술 후 장기 임상결과

최정한,오한진,윤경철,Jung Han Choi,Han Jin Oh,Kyung Chul Yoon 대한안과학회 2013 대한안과학회지 Vol.54 No.4

Purpose: To investigate the long-term results after cataract surgery in eyes with low endothelial cell density (ECD). Methods: A retrospective medical record review was performed of 19 patients with low ECD (lower than 1000 cells/mm2) who 31 patients with a normal ECD (higher than 1600 cells/mm2) underwent cataract surgery. Clinical parameters including visual acuity, intraocular pressure (IOP), spherical equivalent refraction, anterior chamber depth, axial length and central corneal thickness (CCT) were measured and specular microscopy was performed to analyze the ECD and its morphology. The follow-up periods were 1 week, and 1, 3, 6 and 12 months postoperatively. Results: Clinical parameters except ECD and CCT had no significant difference between the 2 groups until 12 months postoperatively. The decreasing rate of ECD and increase of CCT were significantly different between the 2 groups at 1 week and 1 month postoperatively. However, no significant difference was found after 3 months postoperatively. Only 1 eye in the low ECD group with 367 cells/mm2 developed bullous keratopathy. Conclusions: In the low ECD group, a significant decrease of ECD and increase of CCT were observed at 1 month after cataract surgery. However there were no significant differences compared with the control group after 3 months postoperatively. The results suggest that cataract surgery is safe postoperatively for a long-term for a patient with low ECD.

녹내장 치료 시 점안약 치료 후 안부작용에 관한 연구

최정한,박정원,박상우,Jung Han Choi,Jung Won Park,Sang Woo Park 대한안과학회 2013 대한안과학회지 Vol.54 No.5

Purpose: To investigate the influence of number and type of side effects as well as treatment period after the use of anti- glaucoma eye drops in patients with glaucoma. Methods: A survey was conducted regarding the severity of ocular side effects after the use of anti-glaucoma eye drops in 528 patients with glaucoma. Side effects after using the eye drops included irritability, blurred vision, foreign body sensation, hyperemia, pinpricking sensation, itching, discomfort, pain, tearing, dry eye, and pigmentation. We analyzed the results to investigate the influence of number and type of side effects as well as treatment period. Results: The side effects after the use of anti-glaucoma eye drops were more severe and frequent in the patient groups using more than 1 eye drop (p < 0.01) and in the patients with longer treatment period (p < 0.01). Among patients using 1 eye drops, side effects developed frequently in patients using Ocucarpine<sup>®. Conclusions: In patients with glaucoma, using more than 1 anti-glaucoma eye drop or having a longer treatment period resulted in more side effects. Similaryly, patients using only 1 eye drop of Ocu-carpine<sup>® induced more side effects.

음악 스트리밍 사이트의 라우드니스 노멀라이제이션 연구

최정한(Jung Han Choi) 한국정보기술학회 2019 Proceedings of KIIT Conference Vol.2019 No.6

연마 방법과 칫솔질이 아크릴릭 레진의 표면 거칠기에 미치는 영향

이주리,정철호,최정한,황재웅,이동환,Lee, Ju-Ri,Jeong, Cheol-Ho,Choi, Jung-Han,Hwang, Jae-Woong,Lee, Dong-Hwan 대한치과보철학회 2010 대한치과보철학회지 Vol.48 No.4

연구 목적: 본 연구는 연마 술식에 따른 polymethyl methacrylate (PMMA)의 표면 거칠기의 차이를 비교하고, 광중합 광택제가 PMMA의 표면 거칠기에 주는 영향과 이후 칫솔질에 의한 거칠기의 변화를 알아보는데 그 목적이 있다. 연구 재료 및 방법: 총 60개의 $10{\times}10{\times}5\;mm$ 크기의PMMA 시편을 만들었다. 중합 방법 (압력 하 중합과 대기압 하 중합)과 표면 연마 방법 (기계적 연마와 화학적 연마)에 따라 대조군을 포함하여 각 10개씩 총 6군으로 나누었다. 기계적 연마는 카바이드 덴처버로 표면 마무리 한 후, 러버 포인트와 퍼미스를 이용하여 하였으며, 화학적 연마는 표면 마무리 후 광중합 광택제 ($Plaquit^{(R)}$; Dreve-Dentamid GMBH)를 도포하여 실시 하였다. 연마가 완료된 후 비 접촉식 3차원적 표면 형상 분석장치인 Accura $2000^{(R)}$으로 표면거칠기를 측정하였으며, 그 3차원적 영상을 얻었다. 그 후 칫솔질에 의한 마모의 영향을 평가하기 위해 초음파 전동 칫솔을 이용하여 각 시편당 칫솔질을 행하고 다시 Accura $2000^{(R)}$에 의한 표면 분석을 시행하였으며, 거칠기의 정도는 Ra 값으로 표시하였다. 연마 후와 칫솔질 후의 표면 거칠기를 비교하기 위한 통계적 분석은 Mann-Whitney test와 t-test를 이용하여 95% 유의수준에서 실시하였다. 결과: 화학적 연마군은 기계적 연마군에 비해 통계적으로 유의한 작은 평균 표면 거칠기 값을 보였으며 (P = .0045), 일반 대기압 하에서 중합시킨 군에서 그 차이가 더 크게 나타났다 (P = .0138). 초음파 전동 칫솔에 의한 모의 칫솔질 후 표면 거칠기는 기계적 연마군을 제외한 모든 군에서 크게 증가하였으며, 칫솔질 후의 표면 거칠기는 각 군에서 통계적으로 유의한 차이를 보이지 않았다. 결론: 비록 칫솔질에 의한 마모의 영향으로 표면 거칠기가 증가하기는 하지만, 화학적 연마가 기계적 연마에 비해 우수한 표면 거칠기를 보인다고 할 수 있다. Purpose: This study evaluated the effect of polishing techniques on surface roughness of polymethyl methacrylate (PMMA), as well as the influence of light-cured surface glaze and subsequent brushing on surface roughness. Materials and methods: A total of 60 PMMA specimens ($10{\times}10{\times}5\;mm$) were made and then divided into 6 groups of 10 each according to the polymerization methods (under pressure or atmosphere) and the surface polishing methods (mechanical or chemical polishing) including 2 control groups. The mechanical polishing was performed with the carbide denture bur, rubber points and then pumice and lathe wheel. The chemical polishing was performed by applying a light-cured surface glaze ($Plaquit^{(R)}$; Dreve-Dentamid GmbH). Accura $2000^{(R)}$, a non-contact, non-destructive, optical 3-dimensional surface analysis system, was used to measure the surface roughness (Ra) and 3-dimensional images were acquired. The surface roughness was again measured after ultrasonic tooth brushing in order to evaluate the influence of brushing on the surface roughness. The statistical analysis was performed with Mann-Whitney test and t-test using a 95% level of confidence. Results: The chemically polished group showed a statistically lower mean surface roughness in comparison to the mechanically polished group (P = .0045) and the specimens polymerized under the atmospheric pressure presented a more significant difference (P = .0138). After brushing, all of the groups, except the mechanically polished group, presented rougher surfaces and showed no statistically significant differences between groups. Conclusion: Although the surface roughness increased after brushing, the chemical polishing technique presented an improved surface condition in comparison to the mechanical polishing technique.

다수 임플란트 지지 보철물에서 지대주 나사의 풀림 토크값에 대한 연구

이주리,이동환,황재웅,최정한,Lee, Ju-Ri,Lee, Dong-Hwan,Hwang, Jae-Woong,Choi, Jung-Han 대한치과보철학회 2010 대한치과보철학회지 Vol.48 No.4

연구 목적: 본 연구는 다수의 임플란트에 의해 지지되는 보철물을, 두 가지 인상법에 의해 얻은 모형들에 연결한 후, 나사의 풀림 토크값을 측정하여 나사 결합부 안정성에 차이가 있는지를 알아보는데 그 목적이 있다. 연구 재료 및 방법: 네 개의 외부 육각 임플란트 (Br${\aa}$nemark $System^{(R)}$; Nobel Biocare AB)에 직접 연결되는 임플란트 상부 구조물과, 이와 수동적 적합을 갖는 완전 무치악 하악주모형을 만들었다. 이 주모형에서 비연결 인상법으로 6회 인상을 채득하여 6개의 모형 (1군)을 제작하고, 아크릴릭 레진을 이용한 연결 인상법으로 6회 인상을 채득하여 6개의 모형 (2군)을 제작하여, 총 12개의 실험모형을 제작하였다. 각 실험모형에 상부 구조물을 지대주 나사 ($TorqTite^{(R)}$ GoldAdapt Abutment Screw; Nobel Biocare AB)로 20 Ncm의 힘으로 조인 후 각 나사의 풀림 토크값을 총 2회 측정하였다. 두 군 간 나사의 풀림 토크값의 비교를 위한 통계분석은 반복측정을 고려하고 나사와 reading을 고정효과로, 모형을 랜덤효과로 포함하는 혼합모형 (mixed model)을 이용하여 유의수준 .05에서 실시하였다. 결과: 나사의 풀림 토크값의 평균은 7.9 Ncm (1군)과 8.1 Ncm (2군)이었으며, 4개 나사의 풀림 토크값 중 최소값인 최소 풀림 토크값의 평균은 6.1 Ncm (1군)과 6.5 Ncm (2군)이었다. 나사의 풀림 토크값은 두 군 간에 통계적으로 유의할 만한 차이가 없었고, 조인 순서와 위치가 서로 다른 4개의 나사 간의 풀림 토크값도 통계적으로 유의한 차이가 없었다. 최소 풀림 토크값도 두 군 간에 통계적으로 유의할 만한 차이가 없었다. 결론: 다수의 외부 육각 임플란트에 의해 지지되는 보철물에서, 나사의 풀림 토크값과 최소 풀림 토크값은 비연결 인상법과 연결 인상법에 의해 얻어진 모형 간에 차이가 없어, 나사 결합부 안정성에 차이가 없는 것으로 판단된다. Purpose: This study evaluated the detorque values of screws in a multiple implant-supported superstructure using stone casts made with 2 different impression techniques. Material and methods: A fully edentulous mandibular master model and a metal framework directly connected to four implants (Br${\aa}$nemark $System^{(R)}$; Nobel Biocare AB) with a passive fit to each other were fabricated. Six experimental stone casts (Group 1) were made with 6 non-splinted impressions on a master cast and another 6 experimental casts (Group 2) were made with 6 acrylic resin splinted impressions. The detorque values of screws ($TorqTite^{(R)}$ GoldAdapt Abutment Screw; Nobel Biocare AB) were measured twice after the metal framework was fastened onto each experimental stone cast with 20 Ncm torque. Detorque values were analyzed using the mixed model with the fixed effect of screw and reading and the random effect of model for the repeated measured data at a .05 level of ignificance. Results: The mean detorque values were 7.9 Ncm (Group 1) and 8.1 Ncm (Group 2), and the mean of minimum detorque values were 6.1 Ncm (Group 1) and 6.5 Ncm (Group 2). No statistically significant differences between 2 groups were found and no statistically significant differences among 4 screws were found for detorque values. No statistically significant differences between 2 groups were also found for minimum detorque values. Conclusion: In a multiple external hexagon implant-supported prosthesis, no significant differences between 2 groups were found for detorque values and for minimum detorque values. There seems to be no significant differences in screw joint stability between 2 stone cast groups made with 2 different impression techniques.

히알룬산젤이 구강 창상 치유에 미치는 영향

김형진(Hyung-Jin Kim),신창훈(Chang-Hoon Shin),홍종락(Jongrak Hong),최정한(Jung-Han Choi) 대한구강악안면외과학회 2007 대한구강악안면외과학회지 Vol.33 No.4

Purpose: In spite of various advantages of hyaluronic acid in wound healing, there are few research about wound healing process and period in oral and maxillofacial surgery. So, We evaluated the effects of local application of hyaluronic acid gel on wound healing of the oral mucosa using this animal model. Materials and methods: Young adult New Zealand White rabbits, weighting between 2.5 and 3.0kg, were used. Almost uniform round ulcers could be created on the gingival of the rabbits by chemical injury with acetic acid. In experimental group, hyaluronic acid gel was applied daily until the wounds healed and in control group, ulcer lesion was not any treatment. The lengths of ulcers were measured the longest and shortest axes of the ulcers and calculated the areas of ulcer. For histological examination, specimens were made, and observed under a light microscope. Results: The results showed that the number of fibroblasts, new blood vessels and the epithelial thickness from experimental group was higher than from control group. Hyaluronic acid promoted proliferation of the fibroblast, keratinocytes isolated from gingival tissue of rabbits in vitro. Topical application of hyaluronic acid accelerated healing of ulcers created in rabbits. Conclusion: The hyaluronic acid may be effective for wound healing of oral mucosal lesions.