디지털방사선영상에서 추출한 해면질골의 강도와 미세구조의 형태계측학적 분석에 대한 연구

한승윤,이선복,오성욱,허민석,이삼선,최순철,박태원,김종대,Han Seung-Yun,Lee Sun-Bok,Oh Sung-Ook,Heo Min-Suk,Lee Sam-Sun,Choi Soon-Chul,Park Tae-Won,Kim Jong-Dae 대한영상치의학회 2003 Imaging Science in Dentistry Vol.33 No.2

Purpose : To evaluate the relationship between morphometric analysis of bone microstructure from digital radiographic image and trabecular bone strength. Materials and Methods : One hundred eleven bone specimens with 5 mm thickness were obtained from the mandibles of 5 pigs. Digital images of specimens were taken using a direct digital intraoral radiographic system. After selection of ROI (100 × 100 pixel) within the trabecular bone, mean gray level and standard deviation were obtained. Fractal dimension and the variants of morphometric analysis (trabecular area, periphery, length of skeletonized trabeculae, number of terminal point, number of branch point) were obtained from ROI. Punch sheer strength analysis was performed using Instron (model 4465, Instron Corp., USA). The loading force (loading speed 1 mm/min) was applied to ROI of bone specimen by a 2 mm diameter punch. Stress-deformation curve was obtained from the punch sheer strength analysis and maximum stress, yield stress, Young's modulus were measured. Results: Maximum stress had a negative linear correlation with mean gray level and fractal dimension significantly (p<0.05). Yield stress had a negative linear correlation with mean gray level, periphery, fractal dimension and the length of skeletonized trabeculae significantly (p < 0.05). Young's modulus had a negative linear correlation with mean gray level and fractal dimension significantly (p < 0.05). Conclusions : The strength of cancellous bone exhibited a significantly linear relationship between mean gray level, fractal dimension and morphometric analysis. The methods described above can be easily used to evaluate bone quality clinically.

최근 국내에서 진행된 약선 연구 동향 고찰

한승윤(Seung Yoon Han),김성혜(Sung Hye Kim),한상윤(Sang Yun Han),한유리(Yoo Ri Han),이한별(Han Byul Lee),권영규(Young Kyu Kwon),채한(Han Chae) 한의병리학회 2015 동의생리병리학회지 Vol.29 No.4

Open reduction and internal fixation of condylar fracture through intraoral approach-technique and clinical results

김재승(Jae Seung, Kim),장현호(Hyun Ho Chang),김만진(Man Jin Kim),한승윤(Seung Yun Han) 대한구강악안면외과학회 1995 대한구강악안면외과학회지 Vol.21 No.4

하악과두골절에 대한 처치방법은 수십년 전부터 연구되어지고 발전되어오고 있지만 아직 논란의 여지가 많은 것이 사실이다. 현재까지 쓰이고 있는 방법은 크게 두가지로 대별되는데, 첫째는 수술없이 하악골의 운동을 통해 정상적인 기능을 찾아주고자 하는 보존적인 방법이 되겠고 두번째는 수술, 즉 구강의 접근법을 통한 정복 고정술이 되는데 진이개 접근법이나 Risdon 접근법을 통한 직접 정복 고정술, 남씨 방법, 또 최근의 Lag screw를 이용한 방법 등이 여기에 속한다. 성장기 아동이나 골절부위가 capsule 내부 등 과두부의 상부에 위치하여 오히려 수술 후 합병증이 예상되는 경우에는 보존적인 방법을 택하나, 성인의 경우에서는 특히 원래의 해부학적 형태를 회복하지 못하는 데서 오는 과두부 운동 제한 및 하악골 운동 상태의 변회 등을 볼 수 있다. 따라서 골절선이 과두경부 및 그 하방인 경우 많은 외과의사들은 아직 관혈적 정복 고정술로 하악골을 원래의 해부학적 형태로 회복시키고자 한다. 하지만 접근경로에 따른 외부반흔, 안면 신경 손상, 과도한 골막 박리 등에 의한 골절편 흡수 및 괴사 등이 문제로 되고 있다. 따라서 저자 등은 구강내 접근법을 통하여 보존적 방법과 구강외 접근법에 의한 수술의 단점을 보완하면서 골절 부위를 원래의 해부학적 형태로 복원하고자 하였다. 이에 본 논문에서는 구강내 접근법원을 통한 하악과두 정복 고정술의 방법 및 임상적 결과를 소개하고자 한다. 본 연구는 1993년 5울 부터 1995년 2원 까지 경험한 19명의 과두부 골절 호나자 중 구강내 접근법으로 수술하고 3개월에서 1년 까지 관찰한 5명을 대상으로 하였다. 연구 결과는 다음과 같다. 1. 구강내 접근법은 구강외 접근법에 비해 안변 산경 손상, 반흔, 골조직 괴사 등의 기능성을 없앨 수 있었다. 2. 구장내 접근법을 통하여 수술한 환자 5명 모두에서 안정된 교합과 함께 개구 및 전, 측방운동을 포함한 하악골 운동 장애는 없었으며 개구 및 전방 운동시 편측으로의 변위도 관찰되지 않았다. 3. 구강내 접근법은 경우에 따라 골절선의 시야 확보가 어려울 수 있으므로 골절선이 과두경부 하방으로 위치할 때 시행하는 것이 좋겠다. The methods of management ofr condylar fractures have been investigated and improved for several decades. The methods which have been used up to date are classified broadly into conservative and surgical treatment. Conservative treatment is planned to restore normal function through intermaxillary fixation and early exercises of mandibular movement. It is chosen in the cases of children s or growing adolescent s fractures and adult s intracapsular or high condylar fracture. Although long term results proved conservative treatment to be satisfactory, it is impossible to restore the preexisting anatomic relation and it may cause dysfunction or limitation of mandibular movement. So surgical intervention has been advocated for various types of condylar fracture. Until now, most surgical treatments have been undertaken by the following methods such as preauricular or Risdon approach, Nam s method, and lag screw fixation method. All of them are through an extraoral approach, which can cause complications such as facial nerve injury, external scar, and resorption or necrosis of bone fragments. In order to overcome these complications, we attempted an intraoral approach. In this article, the technique and the clinical results of an intraoral approach are presented. We treated 5 patients having subcondylar (4) and low condylar neck (1) fractures with the use of an intraoral approach from May, 1993 to February, 1995. After 3 to 12 months follow-up, we could draw the following conclusions. 1. An intraoral approach has advantages over an extraoral approach ; No facial nerve damage, no facial scar, and the decrease of possibility of necrotic bone change. 2. The 5 patients treated in this technique had a stable occlusion state and all of them had no functional disturbance such as limitation of opening, protrusive and laterotrusive movements. Protrusive and opening deviation was not also noted. 3. Because the intraoral approach has some limitation in gaining enough visibility, it is better to use this method in cases of which fracture line is present below the condylar neck.

유년기 중이염에 의해 야기된 측두하악관절 강직증 - 치험례

김재승(Jae Seung Kim),김만진(Man Jin Kim),서호균(Ho Kyun Seo),한승윤(Seung Yun Han),장현호(Hyun Ho Chang) 대한구강악안면외과학회 1998 대한구강악안면외과학회지 Vol.24 No.1

본 증례에서의 악관절 강직증은 유년기의 홍역 및 이에 따른 중이염으로 이차적으로 발생된 것으로 사려되었다. 이에 대한 치료로서 구내 및 구외 접근법(전이개 절개, Risdon 절개)으로 1) 이환측의 과두돌기 및 오훼돌기 절제술, 2) 반대측 오훼돌기 절제술, 3) 이환측 측두와의 재형성, 4) Titanium 과두 및 금속고정판을 이용한 악관절 재건을 시행하였다. 수술 6일 후 악간고정을 제거하였을때 안정된 교합 상태와 25mm의 최대 개구량을 확인할 수 있었으며, 지속적인 물리치료를 시행하여 술후 3개월 후에는 43mm의 최대개구량을 얻었다. 술후 2년 이상이 지난 지금 개구 장애 등의 하악 운동의 기능적 장애는 보이지 않고 있다. 그러나 본 증례에서는 악관절의 재건을 의하여 금속 인공 과두를 사용하였으므로 차후 이식체에 의한 관절와의 흡수등이 발생할 가능성과 술후 관절 주위 조직의 섬유화에 의한 섬유성 악관절강직증의 발생 등을 고려해 앞으로 계속적이고 충분한 물리치료 및 세심한 관찰이 필요할 것으로 사려된다. The causes of temporomandibular joint(TMJ) ankylosis are classified into trauma, systemic or local infection, and systemic diseases. Recent reports have implicated taruma as the main cause, with infection being a distant one. Local infections of surrounding structures(eg, mastoiditis and otits media) can spread to TMJ by a direct extension or a hematogenous spread. In childhood, dense barrier of bone between the middle ear and the joint cavity may not be developed to prevent the spead of the infection. Otitis media is known to be a common complication of measles in children. Therefore children are more susceptible to TMJ ankylosis secondary to otitis media caused by measles. In the present case, the patient was 21 years old. At the age of 5 years, he had been caught by measles and accompanying otitis media. Since then, he had suffered from trismus for over 15 years. He was diagnosed as bony ankylosis of the left TMJ. We reconstructed his TMJ with 1) the resection of the condylar mass, 2) ipsilateral coronoidectemy, 3) contralateral coronoidectomy, 4) recontouring of glenoid fossa, and 5) replacement with a metal prosthesis (titanium condyle). In the choice of the graft material, we preferred metal prosthesis to autogenous costochnodral rib bone because the patient was still in the state of chronic otitis media and mastoditis. His mandibular function was improved significantly postoperatively. Until now he gets along without any postoperative complication.

측두하악관절에 발생한 연골아세포종의 치험례

장현호(Hyun Ho Chang),한승윤(Seung Yun Han),안형모(Hyung Mo Ahn),최원종(Won Jong Choi),김재승(Jae Seung Kim) 대한구강악안면외과학회 1997 대한구강악안면외과학회지 Vol.23 No.4

Chondroblastoma is a rare primary bone tumor which originates from cartilage, and represents approximate 1% af all bone tumor. The chondroblastoma arises most frequently from the epiphysis of the long bones with the humerus being the commonest site. It afflicts usually the young under 25 years with greater incidence in male. As there is no cartilage cell on craniofacial bone which is mainly fromed by intramembranous ossification, the chondroblastoma on the craniofacial bone is extremely rare. But the chondroblastoma recurred frequently in craniofacial bone when the mass is excised incompletely or curretted and, as the tumor has the outstanding ability of local invasiveness, it destructs the adjacent bone. In addition, it is difficult to diagnose differentially from sarcoma or giant cell tumor histopathologically. Due to the entities described above, it is necessary to remove the entire tumor mass as complete as possible, to treat with radiation pre or postoperatively for preventing from recurrence, and to observe for a long time. The chondroblastoma on temporal bone is rare and is difficult to diagnose and treat successfully. So we d like to present a case of chondroblastoma which was originated from temporal side of TMJ with literatural review.

배터리의 충전상태에 따른 복합진동 시험 기반 전기적 특성 비교 및 분석

김재호(Jae-ho Kim),이평연(Pyeong-Yeon Lee),한승윤(Seung-Yun Han),임철우(Cheol-Woo Lim),장민호(Min-Ho Jang),김종훈(Jong-Hoon Kim) 전력전자학회 2019 전력전자학술대회 논문집 Vol.2019 No.7