Callus distraction method를 이용한 하악골 신장술 : 계단골절단술식의 적용

김명진,윤필영,신동준,김수경,김종원,김규식 대한악안면성형재건외과학회 2000 Maxillofacial Plastic Reconstructive Surgery Vol.22 No.2

Since callus distraction technique was applied clinically for the correction of dentofacial deformity to the patients with hemifacial dysplasia by McCarthy in 1992, many surgeons have tried to apply this method to the maxillofacial region. But this technique has some drawbacks. One of the disadvantages of this technique is extensive scar formation in the facial area, which is a sequelae of extraoral approach for supraperiosteal dissection of the periosteum overlying the mandible. Recently, we have made an effort to perform this technique through intraoral approaches to prevent scar formation on the submandibular area and modified the design of the osteotomy, that is step osteotomy technique, to increase the raw bone surface on both osteotomized segments. The rationale for the application of this step osteotomy technique is to increase the amount of regeneracted bone and the length of distraction, to avoid damage of inferior alveolar neurovascular bundle, and to increase initial stability of the splitted segments. Step osteotomy procedure can be done with fine micro-osteotomy saw through subperiosteal tunneling. Extraoral pins should be inserted before making the osteotomy. Since 1974 we have applied this technique at 8 sites In 5 patients with mandibular deficiencies: 2 cases of hemifacial microsomia, 1 case of developmental facial asymmetry and 2 cases of mandibular bony defect. Mandibular elongation have been achieved from 12 to 20mm in length. 1 out of 8 site, we experienced non-union in the case of mandibular body defect. Some skeletal relapse and growth retardation phenomenon have been observed in some cases with the longest follow-up of 48 months.

부산지역 수돗물과 지하수의 중금속 농도

김준연,손지언,김형수,김두희,원미숙,김인식,이혜령 동아대학교 산업의학연구소 2000 산업의학연구소 논총 Vol.- No.5

This study investigated mean airborne CO concention of 15 workplaces, suspected of CO exposure and conducted self-reported questionnaire completion and indirect COHb concentration measure using Micro II Smokerlyzer to healthy 702 adult subjects from 1999 May to 1999 September in order to find a relation of CO exposure and occupational factors, socioeconomic factors, and health related behaviors and confirm the related conditions in the screening test for CO exposure. The results of this study were summarized as follows : 1. In the CO exposed and non exposed group, COHb concentrations of the smokers were 2.55±0.96% and 2.21±0.97% and that got a statistically significant difference, There were not statistically significant differences in the age and total smoking index. Passed times after the last smoking, Working time/day, and working duration were statistically significant difference (p〈0.05). 2. In the CO exposed and non exposed group, COHb concentrations of non-smoking group were 0.94±0.35% and 0.68±0.47% and that got a statistically significant difference. There were not statistically significant differences in the age and working duration but Working time/day was a statistically significant difference(p〈0.05). 3. In the CO exposed group, r-square of multiple regression of the smokers was 38.5 % and passed time after the last smoking, working time/day, and job category were statistically significant differences (p〈0.05). And r-square in the CO non-exposed group was 38.3 % and age, passed time after the last smoking, and total smoking index were statistically significant difference. 4. In the CO exposed group, r-square of multiple repression of the non-smokers was 66.3% and job category and airborne CO concentration were statistically significant differences(p〈0.05). But r-square of non-smokers in the CO non-exposed group was 1.0% and there was not a statistically significant difference(p〈0.05). 5. In the smokers of CO exposed and non exposed groups, relation of COHb concentration and passed time after the last smoking was expressed as exponential function, Y = 2.9182e-0.0083x and r-square of this function was 37.4%. Therefore it was more than 150 minutes that passed time after the last smoking was when COHb concentrations were measured as less than 1%. In conclusion, variable, that was statistically significant to COHb concentraion in the both CO exposed and non-exposed smokers, was a passed time after the last smoking. We suggest that you have to restrict the smoking of smokers at least 150 minutes in the exposed and non exposed group before COHb concentration measure in order to exclude smoking effects

TEOS 솔 침전공정에서 SiO2 과포화 농도 및 입자 크기에 미치는 반응조건 영향

김경수,김선근,김우식,김성수,김준경 한국화학공학회 2000 Korean Chemical Engineering Research(HWAHAK KONGHA Vol.38 No.6

본 연구에서는 솔 침전공정에서 TEOS(Tetraethylorthosilicate) 반응물을 이용하여 실리카 분말 합성시에 TEOS 농도, 물농도, 반응물 주입속도, 교반속도 등의 반응조건이 실리카 과포화 농도 및 입자크기에 미치는 영향에 대해 연구하였다. TEOS 반응물과 물 농도가 증가할수록 입자유도시간은 짧아졌으며 입자유도시점에서의 과포화 농도는 감소하였다. 그러나, 반응물 주입속도가 입자유도시간과 입자유도시점에서의 과포화 농도에 미치는 영향은 서로 상반되었다. 즉, 반응물 주입속도의 증가에 따라 입자유도시간은 감소하였으나 입자유도시점에서의 과포화 농도는 증가하였다. 반응조건에 따라 서로 다른 과포화 농도에서 입자가 유도되는 것은 입자의 형성에 있어서 과포화도 이외의 용액의 조건에도 영향을 준다는 것을 의미하는 것이다. 한편, 교반속도는 입자유도시간과 유도시점에서의 과포화 농도는 거의 영향을 주지 않았다. 이것은 솔 침전공정에서 반응물 혼합시간이 충분히 짧아 실리카 생성에 있어서 반응속도가 입자유도 및 과포화 농도 결정에 가장 크게 영향을 미쳤기 때문이다. 반응조건에 따른 가수분해 및 축합 반응속도를 Kim등[15]이 제시한 식을 이용하여 예측하였으며 이 결과는 본 실험에서 측정한 입자유도시간의 함수로도 매우 잘 묘사될 수 있었다. 또한, 반응조건에 따라 합성된 최종입자의 크기 변화도 입자유도시간의 함수로 훌륭히 묘사될 수 있음을 보여 주었다. In a single feed semi batch reactor effects of reaction conditions, such as TEOS and water concentrations, react feed flow rate and agitation speed, on the silica supersaturation and particle size synthesized in sol precipitation were investigated. As the TEOS and water concentrations increased, the particle induction time and the supersaturation at the particle induction point were reduced. However, the dependencies of the particle induction time and supersaturation at the particle induction point on the reactant flow rate were opposite to each other. That was, the particle induction tune decreased with increase in the reactant flow rate but the supersaturation at the particle induction point increased. The fact that the supersaturation level to induce the particle was varied with the reaction condition implied that the solution condition determined by the reaction condition as well as the supersaturation level was important to the particle induction. Meanwhile, the particle induction time and supersaturation at the particle induction point were little influenced by the agitation speed in the reactor. This result was due to the micromixing time being short enough in comparison to the reaction time of TEOS. Thus, the particle induction time and supersaturation at the particle induction point was predominantly determined by the reaction time rather than the micromixing time of TEOS. The reaction rate constants of TEOS hydroysis and condensation, which was predicted with Kim et al.'s equations [15] at the reaction conditions was described as a function of the particle induction time. In addition, the particle size synthesized at the reaction conditions was able to be well fitted as a function of the particle induction time.

정형물리치료의 적정 의료보험수가에 관한 연구

김명준,황성수,김호봉,김수형 대한정형물리치료학회 2000 대한정형도수물리치료학회지 Vol.6 No.2

농산물 소독과정에서 브롬화메틸에 노출된 근로자에게 발생한 신경병 2례

박태혁,김정일,손지언,김종국,김형수,정갑열,김준연 大韓産業醫學會 2000 대한직업환경의학회지 Vol.12 No.4

목적 : 농산물 소독과정에서 브롬화메틸에 노출된 근로자에게 발생한 신경병 2례 보고. 방법 : 피로감, 전신무력감, 어지럼증, 보행장애 등의 증상을 주소로 내원한 브롬화메틸을 사용하여 방역작업에 종사하는 건강한 20세와 18세의 근로자를 대상으로 혈액검사, 신경정도 및 근전도검사, 뇌자기공명영상 등의 임상검사와 작업력조사를 시행하였다. 결과 : 1례에서 뇌자기공명영상에서 연수와 소뇌의 양측 측충부의 고신호강도가 관찰되었고 11일 후의 추적조사에서 동일 부위의 고신호강토가 감소된 소견이 관찰되었으며 뇌병증으로 최종 진단되었다. 다른 1례는 신경전도검사에서 다발성 신경병 소견과 뇌유발전위검사에서 우측 하부 뇌간부위 병소가 관찰되었고 뇌병증 및 말초신경 병으로 최종 진단되었다. 결론 : 근로자들의 증상은 소독과정에서 브롬화메틸 노출로 인한 신경 병으로 판단되며 훈증소독과방역작업에 종사하는 근로자들의 실태조사와 안전에 대한 대책이 시급하다고 하겠다. Objectives : To report two cases of neuropathy due to methyl bromide intoxication. Methods : Workers, engaged in the fumigating process, complained fatigue, general weakness, ataxia, and hypersomnia. We evaluated them with blood tests, neurophysiologic studies and MRI and investigated their occupational history. Results : Increased signal intensities were found in the medulla oblongata and paraver mian of cerebellum in MRI and after 11 days, high signal intensities were reduced in the following MRI. In the other case, polyneuropathy and rlght lower brainstem lesion were observed In the NCV and BAEP studies. Conclusions : We confirmed that worker's symptoms were related to methyl bromide exposure in the fumigation. It is necessary that we should evaluate present condition of fumigating process and prepare appropriate methods to protect workers engaged in the fumigation.

수산화세륨(Ⅲ)으로부터 질산암모늄세륨(Ⅳ)의 제조

윤호성,김철주,이진영,김성돈,김준수,유승준 한국화학공학회 2003 Korean Chemical Engineering Research(HWAHAK KONGHA Vol.41 No.3

본 연구에서는 수산화세륨으로부터 질산세륨 용액 제조 후 질산암모늄 첨가에 의한 질산암모늄세륨 제조시, 출발용액의 산도와 농도 그리고 질산암모늄 첨가량, 반응온도 및 반응시간이 질산암모늄세륨 합성에 미치는 영향을 고찰하였으며, XRD, SEM 그리고 TGA 분석을 통하여 결정의 형태 및 구조에 대한 고찰을 수행하였다. 4가의 수산화세륨을 질산에 용해한 질산세륨(Ⅳ)수용액으로부터 질산암모늄 첨가에 의한 질산암모늄세륨 제조시 회수율을 고려한 최적 합성조건은 출발물질의 세륨 농도 70-100g/l, 출발용액의 산도 7 mol/l, 질산암모늄 첨가량 2.5당량, 감압·가열온도 65℃ 및 반응시간 15-30min.이었으며, 제조된 질산암모늄세륨의 결정 화학식은 (NH_4)_2[Ce(NO_3)_6) · ×H_2O(x=6-8)인 것을 알 수 있었다. Synthetic process of ammonium cerium nitrate from cerium hydroxide was presented and influences of concentration and acidity of starting solution, addition quantity of ammonium nitrate, reaction temperature, reaction time on the yield of ammonium cerium nitrate are discussed. The shape and composition of crystal were determined by SEM, thermogravimetry differential thermal, x-ray diffraction and chemical analysis. The optimum synthesizing conditions of ammonium cerium nitrate were discribed as follows; rare earth concentration of starting solution 70-100 g/l. acidity of starting solution 7 mol/l, addition quantity of ammonium nitrate 2-3 equivalent, the condition of rotary evaporation 65℃ and reaction time 15-30 min. It was also known that the chemical formulae of ammonium cerium nitrate was (NH_4)_2[Ce(NO_3)_6] ·×H_2O(x=6-8) from TGA.

151종 생약제 추출물이 B형 간염 바이러스 표면 항원(HBsAg)과 항체(HBsAb)의 결합반응 그리고 HBV DNA polymerase 활성에 미치는 효과 : 한국산 각종 생약제를 이용한 B형 간염치료제의 개발

정태호,김정철,김문규,이인선,채성철,김승래,정준모,이인수,김승호,함경수 慶北大學校 醫科大學 1992 慶北醫大誌 Vol.33 No.3

세계인구 43억명 중 B형 간염 바이러스 보균자는 2억 1천 5백만명이며 이중 78%인 1억 6천만명 이상이 아시아 대륙에 집중되어 있다. 한국도 B형 바이러스 간염의 침윤지대이다. 본 연구는 B형 바이러스 보균자 혹은 만성간염을 치료할 수 있는 생약제를 탐색할 목적의 일환으로 한국에서 시판하는 생약제 151종을 구입하여 증류수로 추출하고 여과한 후 냉동건조하여 HBs 항원에 대한 결합능, HBV DNA polymerase억제능, tumor necrosis factor(TNF) 유리에 미치는 영향, 그리고 galactosamine 유발 간염에 대한간장보호 작용을 조사하였다. 151종의 생약제중 0.16㎍/㎖ 농도에서 간염 vaccine 내에 함유된 HBs 항원과 결합하는 생약제는 지유, 가자, 복분자, 대황, 정향, 빈량, 산수유, 소목, 마황, 쇄양, 후박, 목과, 양강, 오약, 산사, 목단피 등 16종이었다. 이들 생약제중 대황(Rheum palmatum L. 大黃), 가자(Terminalia chebula R. 訶子), 지유(Sanguisorba officinalis L. 地楡), 복분자(Rubus coreanus M. 覆盆子)는 HBV DNA polymerase 활성도를 비교적 강하게 억제하였으며 빈량(Areca catechu L. 빈랑), 정향(Eugenia caryophyllata T. 丁香), 목과(Chaenomeles japonica L. 木瓜), 산수유(Cornus officinalis S. 山茱萸)는 약하게나마 HBV DNA polymerase 활성을 억제하였다. 또한 HBV DNA polymerase를 억제한 대황, 가자, 지유, 복분자, 빈량, 정향, 마황, 소목, 산수유를 대상으로 TNF 유리에 미치는 영향을 조사한 결과 소목을 제외한 8종의 생약제 모두가 대식세포를 자극하여 TNF를 유리시켰다. 그리고 장차 임상에 사용함을 전제로 HBV DNA polymerase를 억제한 대황, 가자, 지유, 복분자, 빈량, 정향, 마황, 소목, 산수유를 galactosamine 유발 간염(백서)에 투여하여 간기능 검사에 미치는 효과를 조사하였으나 간기능 검사상으로는 특별한 보호작용을 나타내지 못하였으며 생약제 단독 투여로서는 간기능에 대하여 나쁜 영향을 주지 않았다. Hepatitis B virus infection is major cause of acute and chrome hepatitis, cirrhosis of liver, and hepatocellular carcinoma. There are over 200 million carriers of hepatitis B virus in the world, nearly 80 % of whom live in the South East Asia, Korea is also highly endemic area of hepatitis B virus infection. This study was performed to evaluate the effect of extracts of traditional Korean herbal medicines on hepatitis B virus. 151 traditional herbs were extracted, filtered and lyophilized. Using 151 herbal extracts we tested binding capability to the HBs Ag, inhibition of HBV DNA polymerase, release of tumor necrosis factor (TNF), and protection against galactosamine induced liver damage. Among 151 herbs, 16 herbs (Sanguisorba officinalis L., Terminalia chebula R., rubus coreanus M., Rheum palmatum L., Eugenia caryophyllata T., Areca catechu L., Cornus officinalis S., Caesalpinia sappan L, Ephedra sinica S., Cynomorium songaricum R., Machilus thunbergii S., Chaenomeles japonica L., Alpinia officinarum H., Lindera strychnifolia V., Crataegus pinnatifida B., Paeonia suffruticasa A. ) had binding capability to HBs Ag which contained in the commercial hepatitis vaccine, at 16 ug/㎖ of concentratioa Among the above 16 herbs, Rheum palmatum L., Terminalia chebula R., Sanguisorba officinalis L., Rubus coreanus M. significantly inhibited the HBV DNA polymerase activity, and Areca catechu L., Eugenia caryophyllata T., Ephedra sinica S., Caesalpinia sappan L., Chaenomeles Japonica L., Cornus officinalis S. also inibited the HBV DNA polymerase activity but less effective. All of the herbs, except Caesalpinia sappan L., which inhibited the HBV DNA polymerase activity, actively stimulated the mononuclear cells to release tumor necrosis factor(TNF) in whole blood culture system. The herbs which inhibited the HBV DNA polymerase activity, did not show any protective effect in galactosamine-induced hepatitis in rats, but there was no direct toxic effect when herbs were administered alone.

소아 확장성 심근증의 임상적 고찰

이성환,김준식,박근수,김명성,권태찬,김천수,이상락 啓明大學校 醫科大學 1996 계명의대학술지 Vol.15 No.1

A Clinical assessment of the 25 patients with dilated cardiomyopathy who were admitted to the Department of Pediatrics, Keimyung University Dong San Hospital from January, 1982 to June, 1993 was performed. The result were as follows: 1) Among 25 patients with dilated cardiomyopathy. 8(32%) were younger than 1 year of age at the time of admission. 2) Adriamycin toxicity was the only encountered etiologic factor in 1 patient. 3) On admission, hepatomegaly and tachycardia were noted in almost all patients. 4) The Chest X-rays showed cardiomegalies in all 25 patients, pulmonary vein congestions in 15(60%) and pleural effusion in 2(8%). 5) The electrocardiography showed left ventricular hypertrophy in 72% and supraventricular tachycardia in 32%. 6) The echocardiographic examination showed left ventricular dilatations in all patients and left atrial dilatations in 20(80%). 7) Of 18 patients who had followed mean period of 2.9 years, 10 patients died within 9 months after the diagnosis.

Rat의 복강에 삽입한 Fluorouracil-Polyglycolic acid 제형의 Fluorouracil 용출에 관한 연구

노승무,정경수,오정연,김진향,양준묵,강대영,송규상,최정목,최선웅,이진호,조준식,민병무,김용백,김창식,박근성,김승영,김학용,인현빈 忠南大學校 癌共同硏究所 1998 癌共同硏究所 硏究誌 Vol.2 No.1

A common form of relapse in adenocarcinoma of the stomach is intraperitoneal dissemination, in fact, among gastric adenocarcinoma patients who have undergone surgery intended to cure, approximately 50% of the patients develope initial recurrence in the peritoneal cavity regardless of the anatomic site of the primary tumor within the stomach. The efficacy of systemic postoperative chemotherapy to prevent peritoneal recurrence of gastrric adcnocarcinoma is not satisfactory. There is still a great need for improved therapeutic strategies on the disseminated microscopic disease and small miliary nodules remaining on the peritoneal surface or lymphatics after operation. The authers have made fluorouracil-polyglycolic acid composite disks(Fu-PGA disks) with fluorouracil and biodegradable polymer: polyglycolic acid for more effective intraperitoneal chemotherapy. We inserted the Fu-PGA disk(s) in the peritoneal cavity of rat and pharmacokinetic study was performed to measure fluorouracil concentration in the peritoneal fluid, plasma, liver, kidney and heart tissue at 24 hour, 72 hour and 168 hour after insertion of Fu-PGA disk(s). Myelosuppressive action of this composite also was determined following its administration. The data of this study suggested that Fu-PGA composite will be a new device releasing drugs in a controlled manner and having targetability to peritoneum, and this device will be improving the efficacy of intraperitoneal chemotherapy for gastric adenocarcinoma.

Rat의 복강에 삽입한 Filorouracil-Polyglycolic acid제형의 Fluorouracil용출에 관한 연구

노승무,정경수,오정연,김진향,양준묵,강대영,송규상,최정목,최선웅,이진호,조준식,민병무,김용백,김창식,박근성,김승영,김학용,인현빈 충남대학교 의과대학 지역사회의학연구소 1998 충남의대잡지 Vol.25 No.1

A common form of relapse in adenocarcinoma of the stomach is intraperitioneal dissemination, in fact, among gastric adenocarcinoma patients who have undergone surgery intended to cure, approximately 50% of the patients develope initial recurrence in the peritoneal cavity regardless of the anatomic site of the primary tumor within the stomach. The efficacy of systemic postoperative chemotherapy to prevent peritoneal recurrence of gastrric adenocarcinoma is not satisfactory. There is still a great need for improved therapeutic strategies on the disseminated microscopic disease and small miliary nodules remaining on the peritoneal surface or lymphatics after operation. The authers have made fluorouracil-polyglycolic acid composite disks(Fu-PGA disks) with fluorouracil and biodegradable polymer: polyglycolic acid for more effective intraperitoneal chemotherapy. We inserted the Fu-PGA disk(s) in the peritoneal cavity of rat and pharmacokinetic study was performed to measure fluorouracil concentration in the peritoneal fluid, plasma, liver, kidney and heart tissue at 24 hour, 72 hour and 168 hour after insertion of Fu-PGA disk(s). Myelosuppressive action of this composite also was determined following its administration. The data of this study suggested that Fu-PGA composite will be a new device releasing drugs in a controlled manner and having targetability to peritoneum, and this device will be improving the efficacy of intraperitoneal chemotherapy for gastric adenocarcinoma.