하악골에 발생한 골막 골육종

김태우,김승범,권혁찬,문선재,윤정훈,김형준,차인호,육종인,김진 대한악안면성형재건외과학회 2002 Maxillofacial Plastic Reconstructive Surgery Vol.24 No.1

Periosteal osteosarcoma is a distinct entity of malignant bone tumor with characteristic clinical, morphological, and histological features within the group of juxtacortical osteosarcoma. Periosteal osteosarcoma is predominantly located in the tubular long bones, and extremely rarely involving the jaws. A case of periosteal osteosarcoma of the right mandible is presented. A 27-year-old woman complained of the gingival swelling and bleeding tendency of the right posterior mandible. Clinical examination revealed a reddish brown strawberry-like swelling on the affected mucosa, which measured 1.5㎝×1.5㎝. The tumor was located on the lingual cortex of the mandible and extended into the surrounding soft tissues. Microscopically, the tumor consisted exclusively of atypical chondroblastic cells with a small osteoblastic area. A minimal bone marrow involvement was noted and the adjacent cortex was free of tumor. These findings suggested that the tumor originated from the periosteal cambium layer, which lies between the periosteal fibrous layer and the cortex of mandible.

서울의 Penicillinase Producing Neisseria Gonorrhoeae 발생빈도(1994)

김재홍,안진균,정성재,김영태,김중환,김시영,이석종,이홍렬,서호석,김경훈,권혁진,정우권,고우석,이용석,안필수,오준규,오용섭 대한화학요법학회 1996 대한화학요법학회지 Vol.14 No.1

Background : In recent years gonorrhoea has been panendemic and remains one of the most common Sexually Transmitted Diseases in the world, especially in developing countries. Objective & Method : For the detection of a more effective therapeutic regimen and assessing the prevalence of Penicillinase Producing Neisseria Gonorrhoeae(PPNG), Ive have been trying to study the patients who have visited the VD Clinic of Choong-Ku Public Health Center in Seoul since 1980 by means of the chromogenic cephalosporin method. Results : In 1994, 168 strains of N. gonorrhoeae were isolated, among which 109 (64,9% ) were PPNG. Conclustion : Our results suggests that the prevalence of PPNG in Seoul is still increasing.

Rifampicin에 의한 것으로 추정되는 위막성 대장염1예

김수현,이은우,정종혁,문승현,김동한,양혁승,오영상,김호동,김도현,박혁,박정환,박경옥,이영직 朝鮮大學校 附設 醫學硏究所 2006 The Medical Journal of Chosun University Vol.31 No.2

Pseudomembranous colitis, caused by altering the normal colonic flora and allowing the multiplication of Clostridium difficile, is an deleterious adverse effect of antibiotics. But it is rarely reported by rifampicin. Rifampicin is one of the first line drug in the treatment of tuberculosis and many patients are exposed to its potential adverse effects. We experienced a patient that had abdominal discomfort and hematochezia due to pseudomembranous colitis after receiving antituberculous medication, and which was probably caused by rifampicin. A 82 years old man was admitted with abdominal discomfort and hematochezia for one week. On the past history he had been diagnosed as endobronchial tuberculosis about 4 months ago. Colonoscopy revealed multiple discrete whitish mucosal lesion on rectosigmoid colon, and histologic findings were consistent with pseudomembranous colitis. The antituberculous agents were discontinued and vancomycin was administered. The patient's symptoms were resolved within several days. There was no recurrence after reinstitution of the antituberculous agents excluding rifampicin. We report here on a case of pseudomembranous colitis probably due to rifampicin.

Lif(Mg, Cu, Na, Si) 열형광선량계를 사용한 60 Cr- 선의 수중흡수선량 측정

김현자,정운혁,이우교,도시홍 대한방사선 방어학회 1990 방사선방어학회지 Vol.15 No.2

새로 개발한 LiF(Mg, Cu, Na, Si)열형광선량계를 사용하여 60Co원격조사장치에 의한 수중흡수 선량을 측정하였다. 공기중 조사선량으로부터 TLD공동의 흡수선량 교정인자(DTLD/TL)를 결정하였고, 수중흡수선량은 TLD공동의 흡수선량을 측정하여 공동이론에 의해 해석하였다. 10×10cm 2 및 5×10cm 2의 빔 크기에서 팬텀내 여러지점에 대하여 LiF(Mg, Cu, Na, Si) TLD로 수중흡수선량을 결정하고 동일한 위치에서 NE 2561전리함을 사용하여 측정한 값과 비교한 결과, LiF(Mg, Cu, Na, Si)TLD의 측정오차(±3%)범위내에서 잘 일치 하였다. 빔의 크기가 5×5cm 2, 10×10cm 2 및 30×30cm 2인 경우에 깊이-선량 백분율과 팬텀-공기 선량비를 측정하였으며 이 값들은 British Journal of Radiology(1983)의 데이터와 잘 일치하였다. Newly developed LiF(Mg, Cu, Na. Si) thermoluminescence phosphors sealed in a plastic capsules(3.2mm dia., 0.9mm wall thickness) were used for in-phantom dosimetry of 60Co r-irradiation. The absorbed doses in water were determined by applying the general cavity theory to the absorbed dose in TLD cavity, which was computed from exposure. The absorbed doses at various sites in the water-phantom were measured by LiF(Mg, Cu, Na, Si) TLD and compared with doses obtained by the ionization method. Both results were consistent within the experimental fluctuation(±3%). Central axis percentage depth doses and phantom-air ratios measured by LiF(Mg, Cu. Na, Si) TLD showed good agreement with the published values [Br. J. Radiology. Suppl. 17(1983)].

한약과 양약의 약물상호작용에 관한 연구(제1보) : Nicardipine과 청혈단의 상호작용 Effects of CHUNGHYULDAN on the Pharmacokinetics and Pharmacodydnamics of Nicardipine in Rats

김남재,진성민,최혁재,주수만,송보완,김종우 한국병원약사회 2002 병원약사회지 Vol.19 No.4

The influence of single and repeated oral pretreatment of CHUNG-HYUL-DAN(CHD). a widely used Korean traditional herbal medicines prescribed for hypertension and hyperlipidemia, on the pharmacokinetics and pharmacodynamics of a calcium channel blocker, nicardipine after oral administration of nicardipine was investigated in rats. The single pretreatment of CHD significantly increased area under the plasma concentration-time curve(AUC_(0-8h), but did not influence the time to reach the maximum peak plasma concentration(T_(max)), the maximum peak plasma concentration(C_(max)), terminal elimination half-life(t_(1/2) or the elimination rate constant(λ) for nicardipine. And, C_(max) and AUC_(0-8h) for nicardipine were significantly increased by with 1-week repeated pretreatment with CHD, but the other parameters were not significantly different from those of control. Also, the extent of the lowering effect of nicardipine on blood pressure in rats was significantly increased after oral administration of nicardipine with single and repeated oral pretreatment with CHD. These results indicated that single and 1-week repeated oral pretreatment with CHD should inhibit the metabolism of nicardipine in rats.

전두엽 상내측 신경교종의 수술 수 발생하는 운동보조영역 증후군

김재현,고영초,이채혁,권오기,최우진,박효일 인제대학교 백병원 2002 仁濟醫學 Vol.23 No.2

Objective : This retrospective study was aimed to correlate characteristic neurologic deficits of transient contralateral motor weakness with or without speech disturbance(Supplementary Motor Area, SMA syndrome) after the resection of the gliomas in the superior frontal gyrus, especially with the extent of resection of the tumors. Method : Ten patients with medial superior frontal glioma, who underwent gross total or subtotal resection of the tumor, as well as, partial or complete resection of the spolementary motor area were studied. The following parameters were evaluate 1) tumor location 2) extent of resection 3) degree and duration of postoperative deficits. Result : Postoperative neurologic deficits were transient contralateral motor weakness with or without motor dysphasia. As a whole, postsurgical SMA syndrome occurred in 3 patients out of 10 patients with medial superior frontal gliomas(30%), who underwent gross total or subtotal resection of the tumors. Motor deficits were present in 3 out of 10 patients and speech disturbances in 2 out of 3 left frontal gliomas. Recovery of neurological dysfunction was rapid occurring between the 5th 14th POD and their neurological function returned almost normal in two patients. In the remaining one patient, who had preoperative mild motor weakness showed incomplete recovery of the worsened motor weakness and newly developed speech disturbance till 1yr postoperatively. Conclusion : The postsurgical SMA syndrome in patients with glioma in the medial superior frontal gyrus was not so uncommon phenomenon and well correlated with the extent of surgical resection of the supplementary motor area. Thus, preoperative awareness and warning about the possibility of the development of this charicteristic SMA syndrome is necessary.

Retinoic acid에 의해 유발된 흰쥐의 구개열에서 Transforming Growth Factor-beta 1, 2, 3의 발현의 변화

김종환,박진혁,신선호,윤혜경,김우형,이희철 인제대학교 백병원 2002 仁濟醫學 Vol.23 No.4

Objective : Craniofacial malformations are among the most frequent congenital birth defects in humans : cleft palate, that is inadequate fusion of the palatal shelves. Retinoic acid is teratogenic in many species, producing multiple malformations, including cleft palate. Also it plays an important role in embryogenesis, by regulating morphogenesis, cell proliferation, differentiation, and deposition of the extracellular matrix. The effects of retinoic acid which leads to cleft palate vary depending on the stage of development exposed. After exposure of embryonic mice to retinoic acid on gestational day(GD) 10, abnormally small palatal shelves form. And the elevation of palatal shelves is delayed. The growth and differentiation factor, transforming growth factor-beta(TGFβ) family is thought to play important roles in multiple developmental processes, especially, the development of the embryonic palate. The expression of the TGFβ family in embryonic palate suggests a functional role for these molecules. In this study, author has determined the tissue distributions of TGFβ family in murine embryonic palate, and compared them in terms of developmental stage and locations in normal and retinoic acid-induced cleft palate. Methods and Material : Retinoic acid was administered orally at gestational day(GD) 10 to ICR mice. The pregnant mice were sacrifeced on GD 12, 13. 14, 15 to obtain the fetuses and immunohistochemistry was performed. And using the scanning electron microscope, morphology of normal palate and cleft palate was studied. Results : In the retinoic acid-treated fetuses, palatal shelves did not elevate and cleft palate was induced. On GD 13 in the palates of the retinoic acid-treated fetuses, expression of the TGFβ1, 3 decreased dramatically, but that of TGFβ2, did not change. The expression of the TGFβ1, 3 in the palates of the retinoic acid-treated fetuses, increased on GD 14, 15, Significant differences in TGFβ family expression were observed with areas of the palate. Conclusion : These results suggest that retinoic acid inhibits the expression of TGFβ 1, 3, which is critical in the developing palate, and elevation of palatal shelves is delayed and impaired, therefore cleft palate is induced. These data demonstrate a role for retinoic acid and retinoic aicd-induced TGFβ family in the regulation of palatal development and suggest a role for TGFβ in retinoic acid-induced cleft palate.

하악지시상분할절단술에서 자가수혈의 이용시 혈액학적변화에 관한 연구

김신헌,윤형기,박진혁,김우형,이희철,Park, Jin-Bae 인제대학교 백병원 2002 仁濟醫學 Vol.23 No.4

Objective : s we has known risk of acquired immunodeficiency disease due to trans-fusion, we recognize the importance of autologous blood transfusion. Since 1990, the use of autologous blood transfusion was increased in Korea. The use of autologous blood transfusion in orthognathic surgery is common. The purpose of this research is to determine, in patients undergoing sagittal split ramus osteotomy, clinical predictive cri??eria for preoperative autologous blood donation and to propose guidelines to increase the efficiency of it. Methods and Material : This article reviewed one hundred two patient who had received bilateral sagittal split ramus osteotomy with autologous blood donation in oral and maxillofacial surgery, Paik hospital, Pusan, from January 1995 to December 1999. Hemoglobin & hematocrit change was evaluated pre- and postoperatively, and erythropoiesis, relationship between procedure time and blood loss was evaluated. Results : 1. Mean age of male patient was 23.1 years and that of female patient 22.5 years. Mean body weight was 73.7㎏ in male and 49.4㎏ in female. 2. Preoperative autologous blood donation unit was mean 1.9 unit(1unit=320㎖), and transfused unit was mean 1.3 unit. 3. Three of 102 patients had positive reaction for hapatitis B virus, but no complication were occurred. 4. The interval from initial donation of autologous blood to surgery was 19 days, and from last donation to surgery was 11 days. 5. Mean hemoglobin levels in predonation period were 15.1 g/㎗ in male and 12.7g/㎗ in female. Hemoglobin and hamatocrit levels decreased by 1.0g/㎗ and 3.2% in male and 1.1g/㎗ and 3.3% in female, respectively, after collection of 1 unit of autologous blood, and decreased by 1.8 g/㎗ and 6.4% in male and 1.9 g/㎗ and 6.9% in female after collection of 2 units. 6. Preoperative erythropoiesis from first donation to surgery showed no statistically significant difference between male and female patients. 7. Estimated blood volume(EBV) ranged from 4,100㎖ to 5,800㎖ in male and from 2,600㎖ to 3,600㎖ in female. Mean estimated blood loss(EBL) was 640㎖, and up to 32% of EBV. 8. All 25 patients with more than 20% loss of EBV were trnasfused intraoperatively, and 18 of 24 patient with 16-20% loss, 16 of 30 patient with l1~15% loss, 7 of 20 patient with less than 10% loss were transfused. Transfusion requirement was increased parallel to EBV. Conclusion : It seems that the proper unit of autologous blood donation is 1.3 unit, and autologous blood transfusion is a safe method in elective surgery that predicted large blood loss. In the future, if transfused blood was controlled based on hypotensive anesthesia, preoperative hemoglobin and hemotocrit level, the proper level of autologous blood transfusion will be accomplished.

狩獵人의 意識 및 行態에 關한 硏究

邊雨爀,金源明 高麗大學校 自然資源科學硏究所 1996 自然資源科學硏究 Vol.4 No.-

The purpose of this study is to investigate hunter's consciousness and the behavior of hunting activities, thereby proposing primary information of decision-making hunting polices and regulation which are based to manage wildlife resource. Data for this study were obtained from available 809 among 3,424 questionares delivered to hunters who have gone hunting to chungbuk hunting preserve in 1990. The results of study are as follow, most of the hunters who are good scholar and earn a large income and are the middle-aged, are influential members of the society as a whole. The 48.2% of hunters were unsatisfied with this hunting trip, because of coming home with poor bag and the fear of illegal traps. Hunters thought the density of wildlife population was very low, and the bag was dependent in hunter's hunting ability. Hunters thought that their ability of according to hunting laws and regulations and discrimination power of wildlife were more developing hunting preserve, hunter's education, hunting trust, revicement hunting law, and enforcement hunting agent are need to enrichment hunting culture and economics.

최근 8년간 K지방대학병원 응급실로 내원한 치과 응급환자에 관한 임상적 연구

유재하,김종배,김태우,문선재,권혁찬,김승범 大韓顎顔面成形再建外科學會 2001 Maxillofacial Plastic Reconstructive Surgery Vol.23 No.6

The delivery of the proper care to the emergency dental patients is more important in the aspdect of community dental service. To attain such a purpose requires the sacred duty to the training of oral and maxillofacial surgeons. This is a retrospective study on the characteristics of dental injuries and diseases in emergency patients. Ths study was based on a series of 2,649 patients treated as dental emergency patients at K country hospital of medical college, from Jan. 1, 1993, to Dec. 31, 2000. The obtained results were as follows. The trauma(71.6%) was the most frequent cause in dental emergency patients, odontogenic infection and oral hemorrhage were next in order of frequency. The primary interdental wiring and transpalatal wiring were frequent proper methods with rubber drainage for prevention of hemorrhage and infection in the primary care of jaw fracture. The peak incidence(45.0%) about the infection group was occurred in the pulpitis of advanced dental caries, and common treatments were the medication of antibiotics & anagesics and I&D. In the dentoalveolar hemorrhage group, a major cause was postoperative hemorrhage(57.9%) and hemostasis was obtained by pressure dressing, suture and drainage of infected wound. About TMJ disorder group, the peak incidence was showed in the post-traumatic myofascial pain dysfunction syndrome and its primary care was medications(anagesics & sedatives). In the other groups, various irritable specific pains were complained, such as trigeminal neuralgia-form pain, acute stomatitis, chemical burn, terminal stage neuritis of head & nech cancer and their primary care methods were various individually. For the rapid and correct care of the emergency dental disease above, well-trained education should be presented in the intern and resident curriculum of oral & maxillofacial surgery.