Interleukin-1B(1L-1B) polymorphisms and gastric mucosal levels of IL-Iβ cytokine in Korean patients with gastric cancer

Chang, Young-Woon,Jang, Jae-Young,Kim, Nam-Hoon,Lee, Jae Won,Lee, Hyo Jung,Jung, Woon Won,Dong, Seok-Ho,Kim, Hyo-Jong,Kim, Byung-Ho,Lee, Joung-Il,Rin Chang KYUNG HEE UNIVERSITY MEDICAL CENTER 2006 고황의학상 수상논문집 Vol.21-22 No.-

Interleukin-1B and IL-1 receptor antagonist gene polymorphisms are associated with an increased risk of gastric cancer (GC) in Caucasian populations. However, recent studies could not find any association between IL-1B-511T polymorphism and the risk of GC in Asians. We tested for an association between IL-1 loci polymorphisms with increased gastric mucosal levels of IL-1β and an increased risk of developing GC in a Korean population. Polymorphisms of IL-1A-889, IL-1B-31, IL-1B-511 and IL-1RN were genotyped in 434 controls and 234 patients with GC. Mucosal IL-1β cytokine was measured using an ELISA. The frequencies of IL-1A, IL-1B-511, IL-1B-31 and IL-1RN were not statistically different between controls and all patients with GC. After subclassification of GC, only patients with intestinal-type GC showed a higher frequency of IL-1B-31T homozygotes (OR = 2.2; 95% CI = 1.1-4.3) compared with controls. Risk was also significantly increased in these patients for IL-1B-31T homozygotes compared with patients with diffuse-type GC (OR = 3.4; 95% CI = 1.5-7.7). As in Caucasian populations, linkage disequilibrium between IL-1B-31 and IL-1B-511 was nearly complete, but the pattern of haplotype related to the risk of GC (IL-1B-31T/IL-1B-511C) was opposite (IL-1B-511T/IL-1B-31C). Mucosal IL-1β levels in H. pylori-infected GC patients were higher in patients homozygous for IL-1B-31T compared with IL-1B-31C/T and IL-1B-31C/C. Thus, the combined effects of H. pylori infection and IL-1B-31T/IL-1B-511C polymorphisms with enhanced mucosal IL-1β production contributed to the development of intestinal-type GC in this Korean population.

1990년대 간경변증의 원인, 합병증, 사망원인의 변화에 관한 고찰

김병호,김경진,김효종,장린,이정일,동석호,이동근,한요셉,장영운,백일현 대한간학회 2000 Clinical and Molecular Hepatology(대한간학회지) Vol.6 No.3

$quot;목적: 우리나라에서 간경변증의 가장 중요한 원인은 B형 간염이지만 최근 C형 간염에 의한 경우가 늘고 있으며, 알코올성 간경변증은 드문 것으로 알려져 있으나 음주 인구 및 음주량의 증가로 빈도가 증가되었을 것으로 추측된다. 또한 진단 기술의 발달, 정맥류 출혈 치료의 발전, 간세포암의 조기진단 및 치료법의 발달로 간경변의 진단 시기 및 사망원인 등에도 변화가 있을 것으로 생각된다. 이에 연자 등은 C형 간염 진단이 가능하게 된 1991년 이후의 환자를 대상으로 간경변증의 원인, 진단 시기, 합병증 및 사망원인의 변화 등을 조사하여 비교, 분석하였다. 대상과 방법: 1991년부터 1998년까지 경희대학교 병원에 입원하여 간경변증으로 진단된 1157명의 환자를 대상으로 원인, 합병증의 발생빈도, 사망원인에 대하여 병력기록을 후향적으로 분석하였으며, 이들 결과를 전ㆍ후반기로 나누어 비교하였다. 결과: 간경변증 환자 1157명 중 남자가 848명(73.3%)으로 많았으며, 전ㆍ후반기의 차이는 없었다. 환자의 연령은 전반기 51.4±11.1세, 후반기 51.2±11.2세로 차이가 없었으며, B형 간염이나 알코올에 의한 경우도 유사한 양상이었다. 그러나 C형 간염에 의한 경우는 약 10세 높은 연령), 알코올(12.7%, 20.0%), C형 간염(8.5%, 17.5%) 순으로 후반기에 알코올이나 C형 간염에 의한 경우가 증가하였으나 통계학적 차이는 없었다. 사망환자 249명의 원인 분석에서 전ㆍ후반기 모두 간부전(38.7%, 40.2%)이 가장 많았고, 그 이외 전반기는 정맥류 출혈(20.0%), 간암(18.7%), 간신증후군 순(11.3%)이었고 후반기는 간신증후군(19.2%), 정맥류 출혈(16.2%), 간암(11.2%) 순으로 간신증후군은 증가하고 정맥류출혈은 감소하는 경향이었으나 통계학적 차이는 없었다. 결론: 1990년대 간경변증의 원인은 과거와 마찬가지로 B형 바이러스 감염이 가장 많았지만, 알코올성 간경변증의 빈도가 약 30%로 과거에 비하여 증가한 것으로 생각되었다. C형 간염바이러스 감염에 의한 경우는 빈도의 변화 없이 약 10세 높은 연령에서 진단되었다. 간경변증의 진단은 점차 간경변 초기에 진단되는 경우가 증가하였다. 간경변증의 사망원인 중 정맥류 출혈은 점차 감소한 반면 간경변증 말기에 나타나는 간신증후군에 의한 경우가 증가하는 경향을 보였다$quot;. $quot;Background: Alcoholic liver disease has increased. The causes of death in liver cirrhosis have changed. The author tried to categorize the etiology and complications of liver cirrhosis and analyze the causes of death in the 1990s. Method: The author retrospectively reviewed medical records of 1,175 patients diagnosed as having liver cirrhosis at Kyung Hee University Hospital from January 1991 through December 1998. The etiology, complications and the cause of death were compared between the early (1991-1994) and the late (1995-1998) periods. Results: The proportion of male patients (73.3%) was still about 3 times that of female patients. There was no difference in age at the time of diagnosis between early and late periods (51.4 11.1 and 51.2 11.2 years respectively). Hepatitis B virus (HBV) infection was still the most common cause of liver cirrhosis (57.0%) and alcohol was the next (31.1%). The complications of liver cirrhosis at the time of diagnosis were, in order: esophageal varices, ascites, and variceal bleeding. But there was no significant difference between the periods. The proportion of Child grade B was the most common at the time of diagnosis in both periods, but Child grade A increased in the late period. The most common cause of death was liver failure and the next cause was variceal bleeding in the early period. Hepatorenal syndrome was the second most common cause in the late period. Conclusion: There was no change in the etiology between early and late periods. HBV infection was still the most common etiology but the incidence of alcoholic liver cirrhosis might have increased in the 1990s. The proportion of the Child B at initial diagnosis was the highest (around 50%) but that of Child A increased in the late period. Among the causes of death, liver failure and hepatorenal syndrome had a tendency to increase in the late period$quot;.

급성 췌장염의 시대적 변화

김배영(Bai Young Kim),김효종(Hyo Jong Kim),정형근(Hyung Keun Chung),김영관(Young Kwan Kim),동석호(Seok Ho Dong),김병호(Byung Ho Kim),이정일(Jung Il Lee),장영운(Young Woon Chang),장린(Rin Chang) 대한내과학회 1993 대한내과학회지 Vol.45 No.5

N/A Background: According to the rapid changes in social environment such as increasing alcohol consumption and the marked improvement in diagnostic technique, we expect that there have been major changes in various aspects of acute pancreatitis during the recent 12 years in Korea. Methods: The medical records of 317 patients with acute pancreatitis diagnosed from 1980 through 1992 were reviewed about clinical, laboratory and radiological findings in the three different time period. Results: 1) There has been an increasing incidence in male sex about three folds. 2) There has been an increasing trends in the duration of hospitalization. 3) A significant increase was observed in the proportion of patients with alcoholic pancreatitis in the three different time period; 26.9%, 45.7%, 50.7% respectively. 4) The complication rates have been slightly increased in the three different time period; 46.3%, 47.1%, 59.1% respectively. But, the type of complications has not been changed. 5) There is increasing severity in non-gallstone group, but no significant differences in gallstone group. There is a declining trends in the number of patients with muld severity index, but increasing trend in the number of patients with moderate severity index in non-gallstone group. 6) There was no significant differences in mortality rate. Conclusions: There has been major changes in the etiology ans severity of acute pancreatitis from 1980 through 1992. Especially, significant increase in the proportion of patients with alcoholic pancreatitis was observed in the three differnt time period. These results might be due to socioeconomic changes.

흰쥐에서 사염화 탄소(CCl4)에 의한 간섬유화의 유도

김병호,이정일,김효종,김영관,장린,동석호,장영운,송일한 대한소화기학회 1992 대한소화기학회지 Vol.24 No.6

Experimental model of hepatic fibrosis is importent contributions to the understanding of cellular and molecular mechanisms underlying excessive accumulation of extracellular matrix in the liver. Carbon tetrachloride (CCl₄) is one of the oldest and most widely used toxin for experimental induction of hepatic fibrosis in laboratory animals. In this study, We intended to induce the hepatic fibrosis in the rat by the intragastric CCl₄/ phenobarbtal treatment once a week for 12 weeks and the administration dosage of CCl₄ in each week was determined by the daily body weight change. Liver function and histologic change were examined just after 12-week treatment in group Ia (9 rats, Phenobarbital treatment only) and II (18 rats, CCl₄/phenobarbital treatment), and liver function and the irreversibility o histologic change were examined 12 weeks after 12-week treatment in group Ib (9 rats, phenobarbital treatment only) and III (18 rats, CCl₄/phenobarbital treatment). 1) Death rate after 12-week treatment was 11% in group Ⅰ, 56% in group Ⅱ and 50% in group Ⅲ. and the highest rate was at 1 week. that is 33 o each in group Ⅱ and Ⅲ. 2) Tatal protein, alkaline phosphatase, alanine aminotransferase and portal venous pressure were significantly increased in group Ⅱ compared with that in group Ⅰa, but it was only portal venous pressure that was increased in group Ⅲ than in group Ⅰb, 3) The gross finding of micronodular change was shown in 88% of group Ⅱ, 71% of group Ⅲ, but none of group Ⅰ. The microscopic finding of hepatic fibrosis was found in all of group Ⅱ and Ⅲ, but none of group Ⅰ. The severe form of hepatic fibrosis suggesting cirrhosis was found in group Ⅱ and Ⅲ, 12% and 29% respectively. In our study, mortality rate was high within 1 week after CCl₄ treatment, which resulted in half survival rate after 12-week treatment. We also experienced the loin rate of severe fibrotic changes in surviving rats. In the future, in order to produce a severe irreversible fibrotic change with low mortality in inducing hepatic fibrosis with CCl₄/phenobarbital treatment in the rat, adequate detemination of the initial dose of CCl₄ and appropriate choice of administration route of CCl₄ were thought to be needed.

Chlorhexidine varnish 처치 후 고정식 교정장치 장착 환자의 치태내 균주 변화 양상에 대한 장기간 관찰 연구

장영일,양원식,남동석,김태우,백승학 대한치과교정학회 2000 대한치과교정학회지 Vol.30 No.3

본 연구의 목적은 chlorhexidine varnish를 고정식 교정장치 장착 환자의 치면에 도포한 후 나타나는 치태내 균주의 변화 양상을 장기간 관찰하는 것이다. 서울대학교병원 치과진료부 교정과에서 고정식 교정장치로 치료하기로 하였던 환자 100명중에서 32주까지 장기간 추적 (follow-up) 되었던 21명을 최종 연구대상으로 선정 하였다. 실험군(12명)은 chlorhexidine varnish를 1주일 간격으로 4회 도포한 후 고정식 교정장치를 부착하였고, 대조군(9명)은 chlorhexidine varnish처치를 하지 않고 고정식 교정장치를 부착하였다. 그리고 실험군에서는 20주 째에 chlorhexidine varnish를 1회 처치하였다. 두 군에서 고정식 교정장치 부착 직전과 부착 후 4, 8, 20, 32주의 치태내 균주의 변화 양상을 간접면역 형광 현미경법으로 분석하고 SAS 통계프로그램을 사용하여 다음과 같은 결과를 얻었다. 1.Streptococcus mutans는 실험군에서 전 실험기간동안 통계학적으로 유의성 있게 억제되었고 (p〈0.01), 대조군에서 전 실험기간동안 통계학적으로 유의성 있게 증가하였다 (p〈0.05). 2.Streptococcus sanguis, Streptococcus mitis, Actinomyces viscosus, Actinomyces naeslundii는 실험군과 대조군에서 통계학적으로 유의성 있는 변화를 보이지 않았다. 따라서 고정식 교정장치를 사용할 환자에서 chlorhexidine varnish를 처치할 경우 치아 우식의 주 원인균인 Streptococcus mutants를 장기간 선택적으로 억제할 수 있을 것으로 생각된다. The authors observed the long term effects of chlorhexidine vanish treatment on microbial change of dental plaque in orthodontic patients with fixed appliances. The initial sample was 100 patients who were arranged to be treated with fixed orthodontic appliances. The final sample consisted of 21 patients who could be traced for 32 weeks after application of fixed orthodontic appliances. They were classified into the experimental group (12 patients) and the control group (9 patients). The experimental group was treated with chlorhexidine vanish once a week for 4 weeks before application of fixed orthodontic appliance. The control group was not treated with chlorhexidine varnish before application of fixed orthodontic appliance. The experimental group was treated once more after 20 weeks. The microbial changes of dental plaque were analysed by indirect immunofluorescence technique at pre-treatment, post-treatment 4, 8, 20, and 32 weeks. The results were as follows. 1.In the experimental group, streptococus mutans was significantly suppressed during experimental period.(p〈0.01) But, in the control group, streptococcus mutants was significantly increased after placement of fixed orthodontic appliances during experiment period.(p〈0.05) 2.Streptococcus sanglus, Streptococcus mitis, Actinomyces viscosus, and Actinomyces naeslundii did not show significant change between the experimental and the control group during experiment period. So, if we treat the orthodontic patients with chlorhexidine varnish before application of fixed appliances, we may suppress the major cariogenic bacteria, Streptococcus mutans, selectively for long period.

Antihypertensive Activity of Korean Medicinal Plants Against Okamoto-SHR (Ⅰ)

Il-Moo Chang(장일무),Young-Choon Park(박영춘),Jae-Hoon Kim(김제훈),Koo-Dong Han(한구동),Jong-Heun Lee(이종흔),Joong-Soo Kim(김중수) 한국생약학회 1981 생약학회지 Vol.12 No.1

Six medicinal plants described in Dong-Ee-Bo-Gam as to be useful for hypertension treatment were evaluated their antihypertensive activity against Okamoto-SHR, an animal model of spontaneous hypertension. Ethanol extracts of plant samples were prepared and were p.o. administered once daily for 20 days. Average blood pressures of rats were measured during two weeks periods before drug administration. Then blood pressure of each rat was measured every three days during drug administration period. As a positive control, propranolol, β-blocker was used and the blood pressures of test group rats were compared with those of negative and positive control group rats. Among 6 plant extracts, Acanthopanax sessiliflorum and Atractylodes japonica(alba) extracts appeared to exhibit antihypertensive activity.

Fluoxetine과 Haloperidol의 병합투여시 정신병리 및 추체외로 증상의 변화

이민수,한창수,김제원,원경식,곽동일,Lee, Min-Soo,Han, Chang-Su,Kim, Jae-Won,Won, Kyung-Sik,Kwak, Dong-Il 대한생물정신의학회 1997 생물정신의학 Vol.4 No.1

본 연구는 정신분열증 환자 38명을 대상으로 하여 haloperidol과 fluoxetine을 8주간 병합투여 하였고, PANSS, CGI, Simpson-Angus 척도를 투여전과 투여후 2, 4, 6, 8주에 시행하여 임상증상 및 추체외로 부작용을 평가하였다. 결과는 다음과 같다. 1) 8주간의 연구기간동안 양성, 음성증상의 유의한 변화가 없었다. 2) 8주의 연구기간동안 추체외로 부작용의 증가가 나타나지 않았다. 이는 기존 연구에서 fluoxetine에 의해 haloperidol의 혈중농도가 증가하여 효과 및 부작용이 증가한다는 연구보고와는 다르며, 이 결과는 haloperidol과 fluoxetine의 병합사용을 안전하게 할 수 있다는 것을 의미한다고 하겠다. Objectives : The authors have intended to know the drug interaction of fluoxetine and haloperidol when coadministering two drugs to the chronic schizophrenics by assessing the changes of positive, negative symptoms and extrapyramidal symptoms. Method : We selected 38 patients, the chronic schizophrenics with no physical problems. they are randomly assigned to placebo group and drug group. And then, placebo or fluoxetine 20mg were administered to the subjects of each group during 8 week period. We have assessed their psychopatholgy and extrapyramidal symptoms using Positive and Negative Syndrome Scale(PANSS), Clinical Global Impression(CGI), Simpson-Angus Scale at 0, 2, 4, 6, 8 week during the period. Results : 38 patients have completed the study during 8 weeks. 1) PANSS, CGI : no significant difference between groups and no significant change according to the times. 2) Simpson-Angus Scale : no significant changes. Conclusion : When co-administering fluoxetine and haloperidol, there were no significant changes of psychopathology and extrapyramidal symptoms. These results suggest that it is safe to coadminister fluoxetine to schizophrenic patients with haloperidol treatmemt.

유년기 Ⅲ급 부정교합자에서 이모장치의 치료 효과에 관한 연구

남동석,서정훈,양원식,장영일 대한치과교정학회 1998 대한치과교정학회지 Vol.28 No.4

본 연구는 유년기의 하악 전돌성 III급 부정교합자에게 이모장치를 착용하여 치료하였을 때 나타나는 변화를, 보다 적절한 대조군을 이용하여 알아보고자 시행하였다. 이모장치를 이용하여 치료한 하악전돌의 골격성 III급 부정교합자중에서 치료 시작 시기가 약 7세경인 29명(남자 14명, 여자 15명)을 실험군으로 하였고, 비슷한 연령으로 골격적 상태가 유사하며 어떤 형태의 교정치료도 받지 않은 III급 부정교합자 21명(남자10명, 여자11명)을 대조군으로 하였다. 2년의 관찰 기간을 거쳐, 초기 및 2년 후의 두부방사선사진을 계측 분석하여 그 변화량을 비교한 결과 (t-test, p<0.05) 다음과 같은 결론을 얻었다. 1. 이모장치를 착용하지 않은 대조군에서는 악골의 부조화가 개선되지 않고, 심화되는 방향으로 성장하였다. 즉, 치료하지 않은 하악 전돌성 III급 부정교합자는 성장에 의해 개선이 일어나지 않음을 나타내었다. 이모장치를 착용한 실험군에서는 전후방 골격 부조화가 감소하였으며, 하악 전돌감이 개선되었다. 2. 두개저와 상악골의 성장은 이모장치에 의해 유의한 변화를 보이지 않았다. 3. 이모장치의 하악골 성장억제 효과를 인정할 수 없었으나, 하악골의 성장 방향의 변화 및 성장 형태의 변화가 관찰되었다. 4. 이모장치 착용시 수직적 성장 경향이 증가하였다. 5. 연구 성적을 종합적으로 검토한 결과, 이모장치의 주된 치료 기전은 하악골의 후하방 회전과 변위이며, 성장 방향과 형태의 변화가 부분적으로 기여한다고 볼 수 있었다. 위의 결과를 종합해 보면 이모장치의 치료효과는 하악 골격 성장의 억제효과라기 보다는 하악골의 후방 회전과 변위에 의한 것이며 성장기 하악 전돌성 III급 부정교합자에서 골격 부조화의 개선 및 전돌감 해소에 유용한 장치라고 생각된다. The purpose of this study was to investigate the changes in the craniofacial skeleton subsequent to chincap therapy in the juvenile skeletal Class III malocclusion with more appropriate control samples. The experimental group consisted of 29 Korean children(14 males, 15 females) who had skeletal Class III malocclusion with prognathic mandible and were undergone chincap therapy from the beginning of treatment. The control group was composed of 21 Korean children(10 males,11 females) who had no orthodontic treatment, but with similar skeletal discrepancies to experimental group. Lateral cephalometric radiographs at the age of 7, and 2 years later were analyized and compared with student`s t-test(p<0.05). The results of this study were as follows; 1. The control group without chincap therapy had not shown any improvement of the skeletal discrepancies, but had grown to be much severe. This means that the untreated Class III patient with prognathic mandible would not be corrected by growth. For the experimental group with chincap therapy, the anterior-posterior skeletal discrepanices and mandibular prognathism were both improved. 2. Neither significant restraint nor acceleration of growth was found in the cranial base and maxilla by chincap treatment. 3. The inhibition of mandibular growth could not be accepted, but the changes of the direction of growth and morphological changes were found. 4. Vertical growth tendency was increased with chincap therapy. 5. When putting together the results of the analyses, it seems to be the rotation and displacement of the mandible that the major treatment effects of chincap are. The changes of the direction of growth and the morphological changes also seems to contibute to the treatment effect partly. In summary, the chincap doesn`t restrain the mandibular growth. But, it is considered as a useful treatment modality for correction of skeletal discrepancies and reduction of mandibular prognathism in growing Class III patients with madibular prognathism.

악교정 수술후 골격성 Ⅲ급 부정교합 환자의 하악운동 변화에 관한 연구

남동석,양원식,서정훈,장영일 대한치과교정학회 1997 대한치과교정학회지 Vol.27 No.2

본 연구는 골격성 III급 부정교합 환자에서 악교정 수술 전후의 하악운동 양상을 관찰하여 수술에 의한 하악운동의 변화를 평가하기 위하여 시행되었다. 서울대학교병원 교정과에서 골격성 III급 부정교합으로 진단받고 수술 전 교정치료를 받은 후, 동 병원 악안면구강외과에서 악교정 수술을 시행한 20명(남;9명, 여;11명)을 대상으로 수술 직전과 수술 2-7개월 후에 Sirognathograph와 BioPak EGN을 이용하여 최대 개폐구 운동과 시상면, 전두면, 수평면에서의 하악한계운동을 기록하고 21개의 항목을 계측하여 다음과 같은 결과를 얻었다. 1. 수술 후에 가장 큰 변화를 보인 항목은 시상면상 전방 운동각도로서, 수술 전 17.4°에서 수술 후 38.8°로 증가하였다. 또한 전치 유도가 형성됨에 따라 전방운동 궤적도 일직선에서 상악 절치의 형태에 따른 곡선으로 변하였다. 2. 수술 전후를 비교할 때 p<0.01 수준에서 유의성을 보인 항목들은 최대 개폐구 운동시 최대 개구량과 최대 전후방 운동량, 시상면상 최대 개구량, 전두면상 좌측방 운동각도의 4항목이었다. 3. 수술 전후를 비교할 때 p<0.05 수준에서 유의성을 보인 항목들은 전두면상 최대 좌우 운동폭, 수평면상 최대 우측방 운동거리, 최대 좌측방 운동각의 3항목이었다. 4. 최대 개폐구 운동시 최대 개구량과 최대 전후방 운동량은 수술 후 측정시간에 따른 차이를 보였다(p<0.05). 즉 2, 3개월군에서보다 5, 6, 7개월군에서 더 많은 운동량 회복을 나타내었다. 5. 수술 전 불규칙하던 개폐구시 운동 궤적은 수술 후 개구로와 폐구로가 일치하며 부드러운 곡선을 이루었는데, 이는 악교정 수술에 의해 교합장애가 제거되었기 때문인 것으로 생각된다. The purpose of this study was to evaluate changes in mandibular movement patterns after orthognathic surgery in skeletal Class III patients. The sample consisted of 20 Class III malocclusion patients(9 males, 11 females). Just before and after(2-7months) surgery, maximum opening & closing movement, mandibular border movement on sagittal, frontal and horizontal planes were recorded using Sirognathograph & BioPak EGN. On each record, 21 items were measured and statistically analyzed. The results were as follows: 1. Angle of protrusive movement on sagittal plane showed greatest change after surgery. Also, as the incisal guidance was established by surgery, straight path of protrusive movement became curved line. 2. Maximum opening distance and maximum antero-posterior distance on maximum opening & closing movement, maximum opening distance on sagittal plane, angle of left lateral excursion on frontal plane were statistically significant after surgery(p<0.01). 3. Maximum width of lateral excursion on frontal plane, distane of right lateral excursion and angle of maximum left lateral excursion on horizontal plane were statistically significant after surgery(p<0.05). 4. Maximum opening distance and maximum antero-posterior distance on maximum opening % closing movement showed significant differences according to post-surgical time(p<0.05). More recovery of range of movement occured in 5-7month group than in 2-3month group. 5. As the occlusal interferences were removed by orthognathic surgery, irregular opening & closing path became smooth curve.

서울대학교 치과병원 교정과에 내원한 부정교합 환자의 최근 경향

임동혁,김태우,남동석,장영일 대한치과교정학회 2003 대한치과교정학회지 Vol.33 No.1

최근 치의학이 눈부시게 발전하고, 소득이 증가하면서 이에 따라 일반인의 의식이 점차 변하면서 외모에 대한 관심도도 점차 높아지고 있다. 본 연구는 내원환자의 부정교합의 유형, 치료방법의 변화를 파악하여 내원환자와 보다 적절한 의사소통을 위한 정보를 제공하고, 교정치료 요구의 특성을 파악하여 부정교합의 역학적 자료를 제공하고자 본 연구를 시행하였다. 이를 위해 2002년 상반기와 1992년 상반기에 서울대학교 치과병원 교정과에 내원한 환자중 진료기록부가 잘 보존된 676명을 대상으로 하여 부정교합의 유형과 내원 환자의 지역분포 및 주소의 변화, 치료방법의 변화를 조사 연구한 결과 다음과 같은 결론을 얻었다. 1. 내원 환자의 남녀 비율은 1992년 1:2.1에서 2002년 1:1.5로 남자환자가 많이 증가했음을 알 수 있다. 2. 연령별 내원 환자의 분포에서 2002년에는 7세에서 12세군이 32.0%로 가장 높게 나타났으며, 그 다음으로는 19세에서 24세군이 24.0%, 13세에서 18세군이 21.6%, 25세 이상군이 14.2%, 4세에서 6세군이 5.8%, 0세에서 3세군이 2.4%로 가장 낮았다. 1992년도 내원 환자의 연령 분포와 비교시 성인 환자의 비중이 증가하였다. 3. Angle 분류법에 의한 내원환자의 분포에서 2002년에는 Ⅲ급 부정교합이 48.1%로 가장 높게 나타났으며, Ⅰ급 부정교합이 25.0%, Ⅱ급 1류 부정교합이 20.9%, Ⅱ급 2류 부정교합이 3.4%로 나타났다. 4. 내원환자의 지역별 분포에서 서울 북동지역의 환자가 37.0%, 서울 남동지역이 13.2%, 서울 남서지역이 12.3%, 서울북서지역의 환자가 6.5%로 나타났다. 1992년도와 비교시 서울 북동지역환자의 내원 비율이 증가하고 그 외 지역내원 환자의 비율은 감소한 것으로 나타났다. 5. 주소(chief complaint)별 내원 환자의 분포는 2002년에 하악 전돌이 17.5%로 가장 높게 나타났으며, 크라우딩이 14.2%, 안면 비대칭이 11.8%로 나타났다. 1992년의 주소별 내원 비율과 비교시 안면 비대칭을 주소로 내원한 환자의 비율이 유의하게 증가하였고, 내원 동기가 매우 다양해졌다. 6. 2002년도 내원 환자의 치료방법은 고정식 장치가 38.0%, 악교정 수술이 25.0%, 성장 관찰이 13.0%로 나타났다. 1992년도와 비교시 chin cap의 사용이 줄었으며, 상대적으로 악교정 수술과 성장관찰을 요하는 환자의 비중이 유의할 만하게 증가하였다. Over the past decades, the number of patients seeking orthodontic treatment has increased markedly with socioeconomic development and change of recognition on appearance. The purpose of this study was to provide an epidemiologic data base related to the orthodontic treatment need. We could take an adequate information regarding the characteristics of orthodontic patients, and the changing trends about treatment mordality. Distrubution and treands were investigated in 676 patients who had been examined and diagnosed at Departnent of orthodontics, Dental Hospital, Seoul National University from January to June in 1992 and 2002. 1. Sex distribution of patients changed from 1:2.1 to 1:1.5(male:female). 2. In 2002, age distribution had shown 7∼12 vear-old group being the largest (32.0%) and percentage of 19∼24, 13∼18, over 25, 4∼6, 0∼3 year-old group were 24.0%, 21.6%, 14.2%, 5.8%, 2.4% respctively. Compared with data in 1992, the number of adult patients highly increased. 3. With regard to angle classification, each percentage of ClassⅠ, Class Ⅱ div 1, Class Ⅱdiv 2, and Class Ⅲ malocclusion were 25.0%, 20.9%, 3.4%, and 48.1% respectively in 2002. 4. Geographic distribution showed that most of the patients visited (37.0%) lived in northeast of Seoul in 2002. 5. Mandibular prognathism showed the highest percentage in chief complaints. The percentages of crowding and facial asymmetry were 14.2% and 11.8% in 2002. Patients with facial asymmetry increased significantly. 6. Percentages of patients treated with fixed appliance and orthognathic surgery were 38.0% and 25.0% in 2002. Patients needed to observe the growth pattern comprised 13.0% with increasing trends. The use of chin cap reduced and the percentage of orthognathic surgery and growth observation increased significantly.