한의계의 관점에서 본 보건의료 환경 변화와 건강보험심사평가원의 역할

홍주의 건강보험심사평가원 2021 HIRA RESEARCH Vol.1 No.1

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악관절 수술후 안면신경 손상에 대한 임상적 연구

주재동,이의웅,김준배,박광호,김형곤 大韓顎顔面成形再建外科學會 1994 Maxillofacial Plastic Reconstructive Surgery Vol.16 No.4

Authors have studied retrospectively the facial nerve injury after TMJ surgery through the preauricular approach routine. The study material used was 4 patients of all 113 patients who were diagnosed as internal derangement and have been operated from March 1989 to February 1991 in Youngdong severance hospital, and were induced postoperatived facial nerve injury. The patient group who had the postoperative injured facial nerve was recognized degree of injury using the diagnostic method, Electromyography(EMG) and Nerve conduction test(NCT) which are used widely at present and was treated as conservative care and we identified the recovery time as the same method. The results as follows : 1. The meticulous care and precious surgical technique are needed in both operation and postoperation. During the TMJ surgery, the excessive retraction of the flap and frequent use of nerve stimulator and electric surgical knife should be avoided as possible and postoperative hematoma and swelling should be minimized. 2. The 4 patients were experienced with the postoperative facial nerve injury of all 133 patients who had been operated the TMJ surgery through the routine preauricular approach on our hospital. And the incidence of postoperative facial nerve injury happened was about 0.3% and its incidence was relatively low comparing with any other previous reports. 3. EMG and NCT were considered as useful methods which can diagnose the nerve injury objectively and identified the effect of treatment and recovery time. 4. The faical nerve-injured patients who were induced postoperatively after TMJ surgery, were diagnosed as second-degree nere injury through the EMG and NCT. And the patient group was treated well as conservative physical therapy for about 2 to 4 months.

삼백초(Saururus Chinensis (Lour.) Bail) 열수추출물의 암세포 저해 효과 및 항산화효소 활성에 미치는 영향

양의주,한정,김현정,이인선 충북대학교 첨단원예기술개발연구센터 1999 연구보고서 Vol.4 No.-

삼백초(Saururus Chinensis (Lour.) Bail)열수추출물의 항암활성 검색을 위하여 여러 암세포에 대한 저해효과와 항산화효과를 측정하고 발암물질인 MNNG를 투여한 동물조직내의 항산화 효소 활성변화에 미치는 영향 등을 살펴보았다. 그 결과 삼백초 열수추출물은 특히 혈액암 세포인 U937에 대해 가장 높은 저해 활성을 나타내었고, 또한 Chinese hamster V79 cell을 이용한 H2O2로 유도된 세포독성에 대한 억제효과도 나타내었다. 그리고 삼백초 열수추출물은 MNNG를 투여한 다음 감소된 glutathione S-transferase와 superoxide dismutase의 활성과 glutathion의 함량을 높여주었다. 이상의 결과로 삼백초 열수추출물은 항산화에 관련하여 발암을 예방하리라 사료된다. Chemoprevetion effects of Saururus Chinensis (Lour.) Bail water extracts on several tumor cells, Chinese hamster V79 cells and antioxidant enzymes in Wistar male rats were investigated. The water extracts of Saururus Chinensis (Lour.) Bail showed a higher cytotoxicity effect on the human histiocytic leukemia cells(U937) and protective effects against the cytotoxicity of H2O2. The glutathione content was decreased by MNNG treatment but was increased by adding Saururus Chinensis (Lour.) Bail water extracts. Also the activities of glutathione S-transferase and superoxide dismutase were increased by the treatment of Saururus Chinensis (Lour.) Bail water extracts more than with MNNG alone. These results suggest that the water extracts of Saururus Chinensis (Lour.) Bail inhibit the growth on U937 and has a protective effect on liver and stomach damage by the activities of free radical generating enzymes.

週齡에 따른 생쥐 Leydig세포의 전자현미경적 구조

서의수,박매자,김덕훈,주강 慶北大學校 醫科大學 1990 慶北醫大誌 Vol.31 No.3

주령(週齡)의 증가에 따른 생쥐 Leydig세포의 광학현미경형태와 초미세구조에 관한 변화는 다음과 같다. 1. 생후 1주군에서 미분화된 Leydig세포는 정세관 주위에서 관찰할 수 있었고, 핵은 방추형이며, 핵질과 핵막에는 이염색질이 많이 분포하고, 세포질에는 소포체와 사립체가 조금 분포하나 그 이외의 세포소기관은 거의 없었다. 2. 3주군에서의 Leydig세포는 아직 완전히 분화되지는 않았으나 정세관 주위에서 관찰되었다. 핵은 난형이며, 핵막의 일부 함입과 이염색질의 부착이 있고 세포질에는 잘 발달된 무과립성 내형질망과 membrane whorl이 있으나 그 이외 세포소기관의 발달은 미약하였다. 3. 5주군에서는 완전히 분화한 Leydig세포들의 군집이 정세관 주위에서 관찰되었다. 핵은 거의 원형이며, 핵에는 진염색질이 분포하며, 세포질에는 사립체의 발달이 현저하고, 그 이외의 세포소기관은 약간 증가하였다. 4. 7주군에서는 잘 발달된 정세관의 구조와 잘 분화된 Leydig세포들의 군집을 tubule의 각 공간에서 관찰할 수 있었다. 세포는 핵이 원형으로, 핵막은 뚜렷하고 세포질에는 무과립성 내형질망, 지방소적, 용해소체, 사립체, 당원입자 등이 아주 잘 발달되어 있었다. This study was performed to investigate the ultrastructure of the Leydig cell on aging of the mouse. The results obtained were as follows. One week after birth: The undifferentiated Leydig cells are found around seminiferous tubules. The nucleus showed the fusiform shape. The heterochromatin was found to be adherent to the nuclear membrane and to be dispersed in the nucleoplasm. The smooth endoplasmic reticulum and mitochondria were poorly developed, and the other cell organelles did not appear at this stage. The cytoplasmic vacuolations began to appear. After 3 weeks: Not fully differentiated Leydig cells are present around tubules. The nucleus had oval shape, and some nuclear membrane was caved and adhered to the heterochromatin. The smooth endoplasmic reticulum and membrane was caved and adhered to the heterochromatin. The smooth endoplasmic reticulum and membrane whorl were well developed. But the other cell organelles were poorly developed. After 5 weeks: Clusters of fully differentiated Leydig cells are found around the tubules. The nucleus had round shape, and the nucleoplasm included an euchromatin. Numerous mitochondria were ovserbed at this stage. After 7 weeks: Clusters of fully differentiated Leydig cells are located in the interspace of each tubules. The shape of nucleus was round, and nuclear membrane was prominent. The smooth endoplasmic reticulum, lipid droplets, lysosomal dense body, mitochondria, ribosome and glycogen were increased markedly in number.

혈액에서 분리된 세균의 항생제감수성 : Vitek System을 이용한 최소억제농도측정 Minimal Inhibitory Concentration Determined by Vitek System

김의종,김선주,신보문,박명희,조한익,김상인 대한화학요법학회 1988 대한화학요법학회지 Vol.6 No.1

Minimal inhibitory concentrations of total 148 strains isolated from blood culture at Seoul National University Hospital were determined by Vitek System. 90% MIC of gram-negative bacteria against amikacin was 2-16㎍/㎖, and those against beta-lactams was > 16㎍/㎖ in general, Except Salmonella spp,. 90% MIC against chloramphenicol and tetracycline was >8㎍/㎖. Range of 90% MIC against vancomycin was ≤.5-4㎍/㎖ in case of garm-positive bacteria, except Enterococcus spp. which showed 90% MIC as >16㎍/㎖. Against ampicillin, 90% MIC of Staphylococcus spp. was >16㎍/㎖, but those of Streptococcus spp. was ≤.25-2㎍/㎖. Streptococcus viridans group showed 90%MIC against penicillin as ≤.03㎍/㎖. Susceptibility of gram-negative bacteria was generally 98% against amikacin, and those of gram-positive bacteria was 80% against vancomycin. 34% of Staphylococcus spp. was resistant of oxacillin. These results may be useful for the primary selection and the dosage determination of antibiotics in the treatment of patients with bacteremia.

Cone beam형 전산화단층영상을 이용한 하악과두 위치의 연구

황형주,김규태,최용석,황의환 대한구강악안면방사선학회 2006 Imaging Science in Dentistry Vol.36 No.2

Purpose : To evaluate position of the mandibular condyle within articular fossa in an asymptomatic population radiographically by a cone beam computed tomography. Materials and Methods : Cone beam computed tomography of 60 temporomandibular joints was performed on 15 males and 15 females with no history of any temporomandibular disorders, or any other orthodontic or prosthodontic treatments. Position of mandibular condyle within articular fossa at centric occlusion was evaluated. A statistical evaluation was done using a SPSS. Results : In the sagittal views, mandibular condyle within articular fossa was posteriorly located at medial and central sections. In the coronal views, mandibular condyle within articular fossa was laterally located at central section. Mandibular condyles in the right and left sides were showed asymmetric positional relationship at medial, central, and lateral sections. Conclusion : Mandibular condyle within articular fossa in an asymptomatic population was observed nonconcentric position in the sagittal and coronal views.

원자로압력용기장 용접열영향부의 미세조직 변화가 Magnetic Barkhausen Noise 거동에 미치는 영향

김주학,윤의박,문종걸,박덕근,홍준화 韓國非破壞檢査學會 1998 한국비파괴검사학회지 Vol.18 No.4

최근 자기적 특성의 변화가 재료의 미세조직적 상태에 민감하다는 보고가 있다. 재료의 미세조직은 상(phase), 결정립의 크기, 석출물 등의 다양한 인자로 구성되며, 본 연구에서는 이러한 인자들을 이용하여 재료의 특성과 Barkhausen noise(BN)의 관계를 연관시키기 위한 시도를 하였다. ASTM A 508 Gr.3 원자로압력용기강을 대상으로 용접열영향부의 미세조직적인 변화를 일곱가지 대표적인 영역으로 구분하였고, 각 영역에서의 미세조직과 기계적특성의 변화를 파악한 후, 각 조건별로 BN을 측정하였다. 통상의 보자력이나 잔류자화 같은 자기적 성질은 큰 변화가 없었지만, BN은 미세조직의 상태에 따라 현격한 변화를 보였다. 결정립과 석출물의 크기가 증가함에 따라 BN은 증가하였고, tempered martensite 보다는 tempered bainite 조직에서 높은 BN을 나타냈다. Recent study has demonstrated that some magnetic properties are sensitive to the microstructural state of material. The ASTM A 508 Gr. 3 reactor pressure vessel steel has various microstructural changes including martensitic and bainitic phases, and various sizes of grain and precipitates in the weld heat-affected zone (HAZ). To correlate the microstructural state with Barkhausen noise (BN), specimens were prepared through simulating various weld thermal cycles using a thermal simulator. The conventional magnetic properties, i.e. coercive force, remanence and maximum induction, did not change significantly. whereas the BN amplitude and energy during a magnetization cycle changed markedly with microstructural state. The BN increased with increasing grain and carbide sizes, and the tempered bainite structure showed higher BN parameter than tempered martensite.

유방암에서 Peanut lectin과 Cystol Estrogen Receptor 의 분포에 관한 비교연구

박희주,김의한,강상균 순천향대학교 1991 논문집 Vol.14 No.2

To understand interrelationship between localization of Peanut lectin and Cytosol Estrogen Recepter, the authors collected 25 cases female breast carcinoma obtained by the biopsy and mastectomy, We performed H & E stain and immunohistochemical stains by Avidin-Biotion-Complex method then analyzed their reactions. Results obtained are as following : 1. Of 25 patients with breast cancer, 15 were presented with PNA-positive cells in their tumor tissue, However, there were variation in incidence for PNA in the tumor cells depending on the degree of differentiation ; while PNA-positive cells were observed in all patients with well differentiated tumor(N=3/3), they were displayed in 50% of patients with poorly differentiated tumor(N=5/ 10). In patients with tumor with moderate differentiation. PNA-positive cells were present in 55.6%(N=5/ 9). It appears that the better the differentiation, not only the higher the incidence for PNA at the free border of cell membrance. 2. Of 25 brest cancer, 14 were presented with CER-positive cells. CER-positive cells were exhibited in 33.3%, 66.7% and 70.0% in well differentiated(N=1/ 3), moderate differentiated(N=6/9), and poorly differentiated(7/10), respectively. On view of the degree of differentiation of the tumor cells. CER-positive and PNA-positive cells reveals opposite pattern. 3. There was a some relationship between age and incidence for PNA or CER in tumor cells. In patients at age less than 40, between 40 and 50 and over 50, CER positivity in tumor cells were 13.3%, 33.3% and 53%, and PNA positivity in tumor cells were 7.1%, 36% and 57%, respectively. 4. 8 cases of PNA positivity(57.1%) was detected among 14 cases of CER positive cases, while 7 cases(63.6%) of PNA positivity was noted among 11 cases of CER negative. There the expression pattern of PNA and CER were different and unrelated each other. 5. Although stronger or more extensive staining for CER tended to be associated weaker or more restricted staining for PNA, the tendency for reciprocal correlation could not quite achieve the statistial significance.

상악동의 실험병소에 관한 X선학적 연구

이주현,황의환,이상래 慶熙大學校 齒科大學 1994 慶熙齒大論文集 Vol.16 No.1

Cell differentiation is a very important process in morphogenesis, and epithelial-mesenchymal interaction may play an important role in cell differentiation. Therefore, during development of root dentin, arcllular cementum and periodontal ligament, the changes of the morphology of dental mesenchymal cells and of the distribution of extracellular matrix proteins - type I collagen, type ID[ collagen, and fibronectin(FN) - are investigated using 14-day-old Sprague-Dawley rats. 1. In the zone of Hertwig's epithelial root sheath, intact epithelial root sheath which is formed with two layers of epithelial a -Rs and covered with basement membranes is observed. Cells of dental follicle and of dental papilla adjacent to the epithelial root sheath are not differentiated yet. In the zone of differentiation, odontoblasts and cementoblasts are differentiated. Cells in the middle of the dental follicle are differentiated into fibroblasts. In the zone of formation, dentin and acellular cementum are observed. The fibroblasts in the forming periodontal ligament are oriented obliquely ard synthesize the collagen fibrils parallel to their direction. 2. In the zone of HERS, immunoreactivity of FN is very strong at the inner basement membrane of the HERS. In this zone, immunoreactivity of type Ill collagen in the extracellular matrix is stronger than in other zones. 3. In the zone of differentiation, cell body of odontoblast shows little of immunoreactivity to FN and collagens. But cell membrane of proximal surfaces of odontoblasts shows very strong immunoreactivity to FN. Along the cementoblasts attached root dentin, strong immunoreactivity to FN is shown. 4. In the zone of formation, acellular cementum matrix is stained strongly to FN. Periodontal ligament shows strong immunoreactivity to FN, type I collagen, and type III collagen with their fibrils' direction. Predentin is stained moderately with FN, type I and type III collagen, but immunoreactivity of mineralized dentin is weaker. 5. Hertwig' s epithelial root sheath ;plays an important role in cell differentiation by the epithelial-mesenchymal interaction. Extracellular matrix of the mesenchymal cells seems to affect the cell differentiation directly and/or indirectly.

구치부 복합레진 수복을 위한 와동 이장용 재료의 방사선불투과성에 관한 연구

문주훈,최의환 大韓口腔顎顔面 放射線學會 2000 Imaging Science in Dentistry Vol.30 No.4

Purpose : The aim of this study was to determine the relative radiopacities of cavity lining materials (Resin-modified Glass Ionomer cement, Composer and plowable resin) for posterior composite resin restoration. Material & Methods : Resin-modified glass ionomer cement (Fuji II LC, VitrebondTM), Compomers (Dyract□, Compoglass, F2,000, Dyract□ flow Compoglass Flow) find Flowable resins (Tetric□ flow, AelitefloTM RevolutionTM) were used. Five specimens of 5 mm in diameter and 2 mm thick were fabricated with each material. Human molars were horizontally sectioned 2 mm thick to include both enamel and dentin. The radiopacities of enamel, dentin, cavity lining materials, aluminum step wedge were obtainded from conventional radiograph and NIH image program. Results : All the tested lining materials showed levels of radiopacity the same as or greater than that of dentin. All compomer tested (Dyract□, Compoglass, F2,000, Dyract□ flow, Compoglass Flow) and VitrebondTM, Tetric□ flow were more radiopaque than enamel. The radiopacities of Fuji II LC and RevolutionTM were between enamel and dentin and resin-modified glass ionomer cement, Compomer and Tetric□ flow were greater than those of RevolutionTM, AelitefloTM or dentin. The level of radiopacity of the tested materials was variable; those with low radiopacity should be avoided in class II restorations, where a clear determination of recurrent caries by the examining clinician could be compromised. Conclusion : Clinician should be able to distinguish these cavity lining materials radiographically from recurrent decay, voids, gaps, or other defects that lead to clinical failure. Utilization of materials ranked more radiopaque than enamel would enable clinicians to distinguish the lining material from tooth structure. (Korean J Oral Maxillofac Radiol 2000; 30:243-248)