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      • KCI등재

        임플란트 고정체의 인위적 비틀림 후 시간 경과에 따른 골재유착 반응에 관한 연구

        황윤진,조진현,이청희,Hwang, Yun-Jin,Cho, Jin-Hyun,Lee, Cheong-Hee 대한치과보철학회 2010 대한치과보철학회지 Vol.48 No.4

        연구 목적: 본 연구의 목적은 골 유착된 임플란트에 인위적 비틀림을 가하여 골 유착을 파괴시킨 뒤 시간 경과에 따른 골 재유착력의 변화와 임플란트와 골과의 계면에서의 골 반응을 조직형태학적으로 분석하는 것이다. 연구 재료 및 방법: 표면처리 하지 않은 실험용 임플란트 (cp titanium, ${\phi}3.75\;mm{\times}4\;mm$)를 제작하였다. 3.5 kg이상의 뉴질랜드산 흰색 암컷 토끼 12마리의 좌우 경골에 제작한 임플란트를 2 - 3개씩 식립한 후, 6주의 골유착 유도한 기간을 부여한 후 비틀림 제거력을 측정하여 1차 측정치로 기록한 다음, 골 재유착을 얻기 위하여 다시 침하시켰다. 시간 경과에 따른 골유착의 변화를 살펴보기 위해 각각 4일 (I군), 1주 (II군), 2주 (III군), 3주 (IV군), 4주 (V군), 및 5주 (VI군)의 치유기간 후에 2차 비틀림 제거력을 측정하였다. 형광 조사 하에서 골 재형성여부를 검사하기 위해서 각군의 토끼에게 테트라사이클린 15 mg/kg을 근육 주사하였다. 2차 비틀림 제거력을 측정한 후 토끼를 희생시키고 각 실험군당 2 - 3개씩 총 16개를 제작하였다. 광학 현미경을 이용하여 형광 조사 하에서 골재형성여부를 관찰하였다. 측정된 각 실험군의 1차 비틀림 제거력과 2차 비틀림 제거력의 증감율의 평균을 구하였다. 그리고 각 실험군에서 그리고 실험군간에서 2차 비틀림 제거력이 1차 비틀림 제거력에 대하여 유의한 변화가 있는지 알아보기 위하여 paired t-test, one-way ANOVA, 그리고 DUNCAN 다중비교법으로 통계처리하였다. 결과: 실험 I군과 II군에서는 2차 비틀림 제거력이 감소하였으며 특히 실험 I군은 유의성 있게 감소하였다. 실험 III, IV, V, 그리고 VI군에서는 2차 비틀림 제거력이 유의성있게 증가하였다. 실험군 간 차이 비교에서, 실험 I, II군과 실험 III, IV, V, VI군 사이에 유의성있는 차이를 보였다. 형광 조사 검사에서 1주째 시편부터는 임플란트와 골과의 계면 부위에서 형광띠로 나타나는 광물화가 시작되는 부분이 관찰되었으며, 2주째 시편 이후부터는 더욱 분명하게 골생성이 이루어짐을 볼 수 있었다. 결론: 임플란트에 의원성 동요가 발생된 후 힘을 가하지 않은 상태로 일정시간 유지하게 되면 임플란트와 골 사이 계면에 다시 골유착이 발생되며 토끼의 경골에서는 높은 골유착력을 2주 만에 얻을 수 있었다는 것을 알 수 있었다. Purpose: The purpose of this study is to analyze the change in re-osseointegration over time and bone reaction at the interface between implant fixture and the surface of the bone, after destroying re-osseointegration by distorting the bone-implant interface artificially. Materials and methods: Experimental implant fixtures (cp titanium, ${\phi}3.75\;mm{\times}4\;mm$) which didn't have surface treatment were produced. Two or three fixtures were implanted on both tibias of twelve female rabbits (New Zealand white, more than 3.5 kg). Then after six weeks, removal torque (RT) was measured and the results were recorded as the first measurement values. The fixtures were submerged again to get reosseointegration between the bone and fixture. To identify the change in re-osseointegration of submerged fixtures over time, six groups had the healing time for four days (group I), one week (group II), two weeks (group III), three weeks (group IV), four weeks (group V) and five weeks (group VI), and then the secondary removal torque was measured for each group. To identify the bone formation under fluorescent light, tetracycline (15 mg/kg, IM) were treated on the rabbits of each group. After the second measurement, the rabbits were sacrificed, and 16 slides were made, two or three for each group. The slides were observed under the fluorescent light with light microscope. To find out the change in the secondary removal torque over the primary removal torque in progress of time, the averages of the increase rate of the primary and secondary torque removal force were calculated. Then, to find out if there were any critical differences between the primary removal torque and the secondary removal torque in each group and among the groups, the results were analyzed statistically by paired t- test, one-way ANOVA, and Duncan's Multiple Range Test. Results: In group I and II, secondary removal torque decreased, especially in group I. In group III, IV, V, and VI, secondary removal torque increased critically. Comparing the differences among the groups, the critical difference was shown between group I, II and group III, IV, V, VI. Mineralization at the interface between the bone and implant fixture was identified from the first week, and bone formation was shown more clearly from the second week. Conclusion: If the implant fixture remains unforced for a certain period of time after the fixture has had iatrogenic mobility, re-osseointegration occurs at the surface of the fixture, and for tibias of rabbits, higher re-osseointegration was obtained within two weeks.

      • KCI등재

        장석남 시에 나타난 삶의 인식 양상

        황윤진 ( Hwang Yun-jin ) 청람어문교육학회(구 청람어문학회) 2021 청람어문교육 Vol.0 No.79

        이 글에서는 장석남 시의 변모에 따른 삶의 인식 양상에 대해 살펴보았다. 전체 시집을 3기로 구분하여 삶에 대한 시인의 발전적 인식을 이해 하고자 하였다. 장석남의 1기시는 시인의 삶 속 비애를 인정하는 것에서 출발하였다. 가족과 가난, 삶의 목표 상실 등으로 인해 현실은 만족스럽지 못하였다. 삶에 비애의 분위기 만연하여 음울한 시적 전개가 나타난 시가 많았다. 2기시는 이전의 삶의 비애에 좌절하지 않고 자신만의 방법으로 극복하려고 노력하였다. 삶의 긍정성을 인식한 시인은 지속적인 자기반성을 통한 자기 성찰을 지향하였다. 개인의 삶에서 더 발전하여 시의 정치를 통해 사회 현실을 인식하기 시작하였다. 화자의 시선이 개인에서 사회로 범위를 넓힌 시기이기도 하다. 3기시에 이르면 가장 발전된 삶에 대한 시인의 인식이 드러난다. 『장자』제1편 「소요유」의 개념으로 장석남의 삶의 인식이 어떻게 변화하였는지 알 수 있다. 시인은 절대 자유의 경지에 이른 지인至人으로서의 삶을 살기 위해 노력한다. 세속적 가치에 얽매이지 않고 자연에 순응하며 궁극의 자유를 맛보고자 하였다. 또 한 진정한 타자와의 만남을 통해 현대의 독자들에게 의미 있는 삶의 모습 중 한 면모를 보여주었다. In this article, I examined the aspects of perception of life according to the transformation of Seoknam Jang's poem. The entire collection of poetry was divided into three periods to understand the poet's developmental perception of life. Jang Seok-nam's first poem started from acknowledging the sadness in the life of a poet. The reality was unsatisfactory due to family, poverty, and loss of life goals. There were many poems in which an atmosphere of sorrow prevailed in life and showed gloomy poetic development. The second period was not frustrated by the sorrows of his previous life, but tried to overcome it in his own way. The poet, who recognized the positivity of life, aimed for self-reflection through continuous self-reflection. He further developed in his personal life and began to recognize social reality through poetry politics. It is also a time when the speaker's gaze expanded the range from individual to society. In the third stage, the poet's perception of the most developed life emerges. With the concept of “Soyoyu” in the first part of 『Jangja』, you can see how Jang Seoknam's perception of life has changed. The poet strives to live his life as an acquaintance who has reached the level of absolute freedom. Without being bound by worldly values, he tried to comply with nature and taste the ultimate freedom. In addition, it showed one aspect of life that is meaningful to modern readers through encounters with real others.

      • SCOPUSKCI등재
      • KCI등재후보

        개복 수술로 확인된 외상성 췌장 손상 환자에 대한 임상적 고찰

        황보선미 ( Seon Mi Hwang Bo ),권영봉 ( Young Bong Kwon ),윤경진 ( Kyung Jin Yun ),권형준 ( Hyung Jun Kwon ),천재민 ( Jae Min Chun ),김상걸 ( Sang Geol Kim ),박진영 ( Jin Young Park ),황윤진 ( Yun Jin Hwang ),윤영국 ( Young Gook 대한외상학회 2011 大韓外傷學會誌 Vol.24 No.2

        Purpose: Althoughpancreas injury is rare in abdominal trauma,it posesa challengeto the surgeon because its clinicalfeaturesare not prominentand the presence of main duct injurycannot be easily identified by imaging studies. Furthermore, severe pancreas injuries require a distal pancreatectomy or a pancreaticoduodnectomy which are associated considerable morbidity and mortality. We reviewed the clinical features of and outcomes for patients with pancreas injury. Methods: For 10 years from Jan. 2001 to Dec. 2010, thirty-four patients were diagnosedas having pancreas injury by using an explo-laparotomy. Patients successfully treated bynon-operative management were excluded. Patients were divided into early (n=18) and delayed surgery groups (n=11) based on an interval of 24hours between injury and surgery. The clinical features of and the outcomes for the patients in both groups were compared. Results: Males were more commonly injured (82.4% vs.17.6%). The mean age was 37.2 years. The injury mechanisms included vehicle accidents (62.9%, 22/34), assaults (20%, 7/34), and falls (11.4%, 3/34)). The head and neck of the pancreas was most commonly injured, followed by the body and the tail (16, 12, and 6 cases). Of the 34 patients, 26 (76.5%) patients had accompanying injuries. Grade 1 and 2 occurred in 14 (5 and 9) patients, and grade 3, 4, and 5 occurred in 20 (16, 3, and 1) patients. The early and delayed surgery groups showed no difference in surgical outcomes. Two patients with grade 3 in the early surgery group died after surgery,one due tomassive hemorrhage and the other due to septic shock. Of the five patients initially managed non-operatively,three developed peripancreatic necrosis and two developed pseudocyst. All five patients were successfully cured by surgery. Conclusion: All cases of pancreas injury in this study involved blunt injury, and accompanying injury to major vessels or the bowel was the major cause of mortality. Surgery delayed for longer than 24 hours after was not associated with adverseoutcomes.

      • KCI등재

        80세 이상 고령 환자에서의 복강경담낭절제술

        조자윤(Ja Yun Cho),김종열(Jong Yeol Kim),장수근(Su Kurn Chang),김상걸(Sang Geol Kim),황윤진(Yoon Jin Hwang),윤영국(Young Kook Yun) 대한외과학회 2009 Annals of Surgical Treatment and Research(ASRT) Vol.76 No.4

        Purpose: Biliary tract disease is one of the most common causes of acute abdominal pain in elderly patients, but there is still some debate over treatment. The aim of this study is to determine the safety and surgical outcomes of laparoscopic cholecystectomy (LC) for benign gallbladder disease in octogenarian patients. Methods: We selected 42 patients of 80 years or older who underwent LC or open-converted cholecystectomy(OC) from February 1992 to November 2006. We evaluated clinicopathological features, treatment modalities, and surgical outcomes retrospectively. Results: The patients included 17 males and 25 females. The mean age of the patients was 83.3 and 83.7, respectively. Right upper quadrant pain was the most common symptom, present in 85.7% of the patients. Gallstones were present in 85.7%. ASA class Ⅱ and Ⅲ comprised 92.9% of the patients. Comorbidities included hypertension, cardiac disease, pulmonary disease, and diabetes mellitus. Preoperatively biliary drainage was performed in 12 cases (endoscopic drainage in 8, percutaneous drainage in 4 cases). Preoperative cholecystostomy was performed in 5 cases. Emergency operations were more frequent than elective surgery (25 vs. 17). Mean hospital stay of LC patients was 5 days, whereas that of OC patients was 13 days. Open conversion rate was 16.7%. No surgical mortality was present and postoperative morbidity included acute myocardial infarction in one patient and wound infection in one patient. Conclusion: LC in octogenarian patients was safe. However, since the incidence of comorbidities is high in these patients, great care should be taken to evaluate and manage the comorbidities before surgery.

      • KCI등재

        5 ㎝ 이하의 간세포암에 대한 제한적 간절제술과 대량간절제술후 결과 및 장기 생존율 비교

        김혜진(Hye Jin Kim),황윤진(Yoon Jin Hwang),김종렬(Jong Yeol Kim),권형준(Hyung Jun Kwon),김규성(Gyu Sung Kim),천재민(Jae Min Chun),김상걸(Sang Geol Kim),윤영국(Young Kook Yun) 대한외과학회 2010 Annals of Surgical Treatment and Research(ASRT) Vol.78 No.1

        Purpose: Though major hepatic resections including hemihepatectomy, trisectionectomy, and central bisectionectomy are most commonly employed for small (<5 ㎝) hepatocellular carcinoma (HCC), limited hepatic resection is indicated in some HCC patients with impaired liver function, poor physical condition, or tumors peripherally located. We compared the clinicopathological features and long-term survival between the patients who underwent major resection and limited resection. Methods: From January 1998 to May 2007, 223 patients who underwent hepatic resection for small HCC were enrolled. 123 patients underwent limited resection and 100 patients underwent major resection. Clinocopathologic features, overall, and disease-free survival were compared between both groups. Results: The limited resection group had lower mean serum albumin levels (3.86±0.41 vs. 4.11±3.61, P<0.0001) and higher mean ICG R15 (12.66±0.87 vs. 7.51±4.33, P<0.0001). Patients with esophageal varix and liver cirrhosis were more common in the limited resection group (34.1% and 73.1% versus 9% and 45% respectively). Morbidity and mortality were not different in both groups. Overall 1-, 3-, 5-year survivals in both limited resection and major resection groups were 89.4%, 77.3%, 43.8% and 87.8%, 76.5%, 62.1% respectively (P=0.161) and 1-, 3-, 5-year disease free survivals were 80.2%, 50.2%, 38.6% and 79.9%, 63.2%, 50.4% respectively (P=0.10). Conclusion: Despite indifference of overall and disease-free 5-year survival rates between limited and major resection groups, careful follow up is essential to detect late recurrence in the limited resection group, since limited resection tends to have more frequent recurrence, especially 2 years after surgery.

      • KCI등재
      • KCI등재
      • KCI등재

        간세포암 환자의 수술 후 간내 조기 재발에 대한 위험 인자

        전은성(Eun Seong Jeon),황윤진(Yun Jin Hwang),김종열(Jong Yeol Kim),천재민(Jae Min Chun),김상걸(Sang Geol Kim),윤영국(Young Kook Yun) 대한외과학회 2008 Annals of Surgical Treatment and Research(ASRT) Vol.75 No.1

        Purpose: The purpose of this study is to comprehend the prognosis and risk factors for the early recurrence after resection for hepatocellular carcinoma (HCC). Methods: Between 1997 and 2005, 237 patients underwent curative resection for HCC at Kyungpook National University Hospital. The patients were followed up regularly to detect any recurrences of HCC by performing imaging studies and AFP. Early recurrence was defined as recurrence that occurred within one year after resection. The patients were divided into the early recurrence group and the others, which included both patients without recurrence and with recurrence that occurred later than 1 year after resection. The clinicopathologic factors of both group were compared to identify the prognosis and the risk factors by performing univariate and multivariate analyses. Results: Seventy three patients (30.8%, 73/238) had early recurrence after resection and 164 patients (69.2%, 164/238) didn`t have recurrence in the first year. The survival rate was significantly better in the without early recurrence group than that in the early recurrence group (96.3% vs 60.3% and 85.1% vs 23.4%, 62.8% vs 7.3% 1, 3, 5 years). The risk factors for early recurrence in the HCC patients were a tumor size greater than 5 ㎝ (P=0.011; odds ratio=2.304) and vascular invasion (P=<0.001; odds ratio=6.342). Conclusion: Since a large tumor size and vascular invasion are the risk factors for early recurrence, the patients who have these risk factors should be followed up with caution and possible postoperative adjuvant therapeutic trials should be considered.

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