• 멤브레인
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• 제15권3호
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• pp.213-223
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• 2005

본 연구에서는 히알루론산나트륨/카르복시메틸셀룰로오스나트륨(HA/CMC)으로 구성된 유착방지 막을 제조하였고, 쥐에서 유착방지용에 대한 효과를 평가하였다. 유착방지 막은 HA/CMC 용액을 동결건조한 후 1-에틸-3-(3-디메틸아미노프로필)카보디이미드 (EDAC)로 가교하여 제조하였다. Sprague-Dawley쥐의 맹장/복벽 찰과상 모델에서 복부 중앙선 절개 후 장막과 복벽을 bone burr로 $1\times2\;(cm^2)$ 크기로 찰과상을 만들고, 상처 면 주위의 3곳을 봉합사로 고정시켰다. 상처난 장을 실험군의 경우 HA/CMC 막으로 덮어주었으며, 대조군은 아무처치도 하지 않은 상태로 복벽을 마주보게 하였다. 대조군의 대부분은 수술 후 7, 14, 21, 28일에 유착정도 3 이상을 나타내었고, 반면 실험군의 $60\~70\%$는 수술 후 14, 21, 28일에 유착정도 2 이하를 나타내었다. 이는 유착세기에서도 유사하였다. 일반적으로 유착정도와 유착세기는 수술 후 14일까지 점차 증가하였고, 수술 후 21일에는 거의 동일하거나 약간 증가하였으며, 28일째에는 감소하였다. 대조군은 유착정도와 유착세기, 유착면적에서 높은 수치를 나타내었다. 이 유착방지막은 수술 후 유착방지에서 좋은 임상결과를 나타낼 수 있을 것으로 기대된다.

• 대한의용생체공학회:의공학회지
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• 제19권5호
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• pp.469-476
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• 1998

초음파, 내시경 등의 NTSC 영상을 PC를 통해 획득하고, 고해상도의 YGA 모니터에 표시할 경우 주사변환 과정을 거치면서 치명적인 영상의 왜곡(tear-drop)이 나타난다. 본 연구에서는 이러한 왜곡을 해소하는 여러 가찌 방법을 살펴보고 실시간으로 왜곡을 보정할 수 있는 하드웨어를 PC상에서 구현하였다. 하드웨어 시스템은 De-Interlace 전용의 소자와 PCI bridge 등을 이용함으로써 고화질의 영상표현과 실시간의 영상전송이 가능하다 구현된 시스템에서 영상의 질은 눈에 띄게 향상되었으며, PC 기반의 시스템으로 구성함으로써 영상의 저장, 전송 및 텍스트의 기록 등 다양한 기능을 쉽게 구현할 수 있었다.

• 대한치과보철학회지
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• 제31권3호
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• pp.394-410
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• 1993

This study was accomplished for appreciation of the mandibular moments according to antero- posterior movement of pivot placed on the lower natural dentition. For this study, 20 subjects(male, $21\sim30$ yrs., average age 24) in the category of normal occlusion were selected, and the intraoral Vitallium clutches were cast and fabricated for each subjects. A 2-dimension PSD(Position Sensitive Detector, Hamamatsu Photonics Co., Japan) was attached to maxillary clutch in a mode of three dimensional control and LED (Light Emit Diode, Hamamatsu Photonics Co., Japan) was set up on mandibular clutch. Both clutches were set into oral cavity of each subjects and adjusted. Then the subjects were allowed to intercuspated with maximal bite force while the pivoting ball in the mid-line moving from anterior toward posterior position. The displacement scales were recorded by CCD camera(Sony, CCD-TR-705) and VCR, The conclusions were as follows : 1. When the subject was allowed to bite the metal pivoting ball in the midline of lower dentition with maximal bite force voluntarily while moving from lower central incisor to canine, 1st premolar, End premolar, 1st molar and 2nd molar. The lever actions on the pivot were revealed in all subjects. The equilibrium of moment were revealed on the pivots of 1st premolar(14 subjects), End premolar(4 subjects), and canine(2 subjects) areas. 2. The changes of loading on the TMJ according to antero-posterior positional changes of metal pivoting ball were able to recognize as follow. Compression on the TMJ was increased when the pivot moves anteriorly from the equilibrium point, and tension on the TMJ was increased when posteriorly. 3. 13 subjects were recognized their habitual chewing sides(Rights, Left8), and 7 subjects were not. During maximal biting, mandible was displaced toward their habitual chewing sides on the metal pivoting ball in the frontal plane. 4. In cephalometric analysis, the average genial angle of 20 subjects was $116.75^{\circ}$ and the average mandibular body length was 79.77mm. The equilibrium points of mandibular moment were positioned more posteriorly in the subjects having larger Genial angle than in the smaller(p<0.05). Relationships among the angle between FH plane and occlusal plane, the angle between occlusal plane and mandibular plane , and mandibular body length were not significant(p>0.05).

• 한국임상수의학회지
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• 제32권6호
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• pp.544-547
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• 2015

11살 수컷 페키니즈가 10일간의 발작을 주증으로 내원하였다. 내원 15일전 파행으로 지역병원에서 소염제를 처방 받았었고 10일 전 간헐적 전신발작을 시작으로 내원 2일 전에는 실조와 정신둔감이 함께 발생하였다. 혈액검사와 영상학적 검사상 특이소견은 관찰되지 않았으나, 신경계 검사상 위협반사와 동공 빛 반사가 떨어짐을 확인할 수 있었다. 내원 9시간 후 호흡곤란이 발생하였고 그 후 12시간 후 보호자의 요청으로 안락사를 실시하였다. 부검상 가로 단면에서 확장된 종양으로 인해 현저한 중심선 이동을 관찰할 수 있었다. 조직학적 분석을 통해 신경아교세포의 거짓 울타리화된 괴사와 미세혈관의 증식을 확인할 수 있었다. 면역염색 결과 종양 부위에서 GFAP, PCNA, Iba-a 에 염색된 세포가 관찰되었다. 이와 같은 결과를 바탕으로 아교모세포종으로 진단되었다. 원발성 두강내 종양은 수의학에서 흔하지 않다. 이번 증례는 페키니즈견에서 아교모세포종의 임상적, 조직학적 발견에 대한 보고이다.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제47권5호
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• pp.373-381
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• 2021

Objectives: In the present study, the effects of sagittal split ramus osteotomy (SSRO) combined with intraoral vertical ramus osteotomy (IVRO) for the treatment of asymmetric mandible in class III malocclusion patients were assessed and the postoperative stability of the mandibular condyle and the symptoms of temporomandibular joint disorder (TMD) evaluated. Materials and Methods: A total of 82 patients who underwent orthognathic surgery for the treatment of facial asymmetry or mandibular asymmetry at the Department of Oral and Maxillofacial Surgery, Dong-A University Hospital, from 2016 to 2021 were selected. The patients that underwent SSRO with IVRO were assigned to Group I (n=8) and patients that received bilateral SSRO (BSSRO) to Group II (n=10, simple random sampling). Preoperative and postoperative three-dimensional computed tomography (CT) axial images obtained for each group were superimposed. The condylar position changes and degree of rotation on the superimposed images were measured, and the changes in condyle based on the amount of chin movement for each surgical method were statistically analyzed. Results: Group I showed a greater amount of postoperative chin movement. For the amount of mediolateral condylar displacement on the deviated side, Groups I and II showed an average lateral displacement of 0.07 mm and 1.62 mm, respectively, and statistically significantly correlated with the amount of chin movement (P=0.004). Most of the TMD symptoms in Group I patients who underwent SSRO with IVRO showed improvement. Conclusion: When a large amount of mandibular rotation is required to match the menton to the midline of the face, IVRO on the deviated side is considered a technique to prevent condylar torque. In the present study, worsening of TMD symptoms did not occur after orthognathic surgery in any of the 18 patients.

• Journal of Korean Neurosurgical Society
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• 제62권6호
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• pp.643-648
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• 2019

Objective : Shunt-dependent hydrocephalus (SdHCP) is a well-known complication of aneurysmal subarachnoid hemorrhage (SAH). The risk factors for SdHCP have been widely investigated, but few risk scoring systems have been established to predict SdHCP. This study was performed to investigate the risk factors for SdHCP and devise a risk scoring system for use before aneurysm obliteration. Methods : We reviewed the data of 301 consecutive patients who underwent aneurysm obliteration following SAH from September 2007 to December 2016. The exclusion criteria for this study were previous aneurysm obliteration, previous major cerebral infarction, the presence of a cavum septum pellucidum, a midline shift of >10 mm on initial computed tomography (CT), and in-hospital mortality. We finally recruited 254 patients and analyzed the following data according to the presence or absence of SdHCP : age, sex, history of hypertension and diabetes mellitus, Hunt-Hess grade, Fisher grade, aneurysm size and location, type of treatment, bicaudate index on initial CT, intraventricular hemorrhage, cerebrospinal fluid drainage, vasospasm, and modified Rankin scale score at discharge. Results : In the multivariate analysis, acute HCP (bicaudate index of ${\geq}0.2$) (odds ratio [OR], 6.749; 95% confidence interval [CI], 2.843-16.021; p=0.000), Fisher grade of 4 (OR, 4.108; 95% CI, 1.044-16.169; p=0.043), and an age of ${\geq}50years$ (OR, 3.938; 95% CI, 1.375-11.275; p=0.011) were significantly associated with the occurrence of SdHCP. The risk scoring system using above parameters of acute HCP, Fisher grade, and age (AFA score) assigned 1 point to each (total score of 0-3 points). SdHCP occurred in 4.3% of patients with a score of 0, 8.5% with a score of 1, 25.5% with a score of 2, and 61.7% with a score of 3 (p=0.000). In the receiver operating characteristic curve analysis, the area under the curve (AUC) for the risk scoring system was 0.820 (p=0.080; 95% CI, 0.750-0.890). In the internal validation of the risk scoring system, the score reliably predicted SdHCP (AUC, 0.895; p=0.000; 95% CI, 0.847-0.943). Conclusion : Our results suggest that the herein-described AFA score is a useful tool for predicting SdHCP before aneurysm obliteration. Prospective validation is needed.

• Journal of Korean Neurosurgical Society
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• 제64권5호
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• pp.776-783
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• 2021

Objective : The purpose of this study was to identify risk factors for distal adding on (AO) or distal junctional kyphosis (DJK) in adolescent idiopathic scoliosis (AIS) treated by posterior spinal fusion (PSF) to L3 with a minimum 2-year follow-up. Methods : AIS patients undergoing PSF to L3 by two senior surgeons from 2000-2010 were analyzed. Distal AO and DJK were deemed poor radiographic results and defined as >3 cm of deviation from L3 to the center sacral vertical line (CSVL), or >10° angle at L3-4 on the posterior anterior- or lateral X-ray at ultimate follow-up. New stable vertebra (SV) and neutral vertebra (NV) scores were defined for this study. The total stability (TS) score was the sum of the SV and NV scores. Results : Ten of 76 patients (13.1%) were included in the poor radiographic outcome group. The other 66 patients were included in the good radiographic outcome group. Lower Risser grade, more SV-3 (CSVL doesn't touch the lowest instrumented vertebra [LIV]) on standing and side bending films, lesser NV and TS score, rigid L3-4 disc, more rotation and deviation of L3 were identified risk factors for AO or DJK. Age, number of fused vertebrae, curve correction, preoperative coronal/sagittal L3-4 disc angle did not differ significantly between the two groups. Multiple logistic regression results indicated that preoperative Risser grade 0, 1 (odds ratio [OR], 1.8), SV-3 at L3 in standing and side benders (OR, 2.1 and 2.8, respectively), TS score -5, -6 at L3 (OR, 4.4), rigid disc at L3-4 (OR, 3.1), LIV rotation >15° (OR, 2.9), and LIV deviation >2 cm from CSVL (OR, 2.2) were independent predictive factors. Although there was significant improvement of the of Scoliosis Research Society-22 average scores only in the good radiographic outcome group, there was no significant difference in the scores between the groups. Conclusion : The prevalence of AO or DJK at ultimate follow-up for AIS with LIV at L3 was 13.1%. To prevent AO or DJK following fusion to L3, we recommend that the CSVL touch L3 in both standing and side bending, TS score is -4 or less, the L3/4 disc is flexible, L3 is neutral (<15°) and ≤2 cm from the midline and the patient is ≥ Risser 2.

• 구강회복응용과학지
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• 제38권4호
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• pp.242-248
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• 2022

최근 CAD/CAM 기술의 발달을 통해 의치 제작에도 활용되고 있다. 디지털 방식으로 의치를 제작했을 때 전통적인 방법과 비교하여 제작 과정을 용이하게 하고 내원 횟수 감소, 오차 감소 등의 이점을 갖는다. 본 증례는 오래된 의치의 사용으로 인해 수직 고경 회복이 필요한 환자에서 CAD 프로그램을 이용하여 수직 고경을 증가시켰으며 최종 의치는 밀링방식을 통해 monolithic disc를 이용하여 제작한 증례이다. 기존 의치를 이용하여 중심위를 인기하였으며 구내 스캔과 기존 의치 모델 스캔을 정보를 이용하여 시적용 의치를 제작하고 환자에게 장착해 정중선, 교합관계 등을 평가하였다. 시적용 의치 평가를 기반으로 밀링방식 및 monolithic disc를 이용하여 최종 의치를 제작하였고 최종 의치는 기능적 및 심미적으로 만족스러운 결과를 보였다.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제49권3호
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• pp.125-134
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• 2023

Objectives: The aim of the study was to quantify and compare craniofacial asymmetry in subjects with and without symptoms of temporomandibular joint disorders (TMDs). Materials and Methods: A total of 126 adult subjects were categorized into two groups (63 with a TMDs and 63 without a TMDs), based on detection of symptoms using the Temporomandibular Joint Disorder-Diagnostic Index (TMD-DI) questionnaire. Posteroanterior cephalograms of each subject were traced manually and 17 linear and angular measurements were analyzed. Craniofacial asymmetry was quantified by calculating the asymmetry index (AI) of bilateral parameters for both groups. Results: Intra- and intergroup comparisons were analyzed using independent t-test and Mann-Whitney U test, respectively, with a P<0.05 considered statistically significant. An AI for each linear and angular bilateral parameter was calculated; higher asymmetry was found in TMD-positive patients compared with TMD-negative patients. An intergroup comparison of AIs found highly significant differences for the parameters of antegonial notch to horizontal plane distance, jugular point to horizontal plane distance, antegonial notch to menton distance, antegonial notch to vertical plane distance, condylion to vertical plane distance, and angle formed by vertical plane, O point and antegonial notch. Significant deviation of the menton distance from the facial midline was also evident. Conclusion: Greater facial asymmetry was seen in the TMD-positive group compared with the TMD-negative group. The mandibular region was characterized by asymmetries of greater magnitude compared with the maxilla. Patients with facial asymmetry often require management of temporomandibular joint (TMJ) pathology to achieve a stable, functional, and esthetic result. Ignoring the TMJ during treatment or failing to provide proper management of the TMJ and performing only orthognathic surgery may result in worsening of TMJ-associated symptoms (jaw dysfunction and pain) and re-occurrence of asymmetry and malocclusion. Assessments of facial asymmetry should take into account TMJ disorders to improve diagnostic accuracy and treatment outcomes.

• 대한안과학회지
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• 제58권11호
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• pp.1313-1316
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• 2017

목적: 학대뇌손상 영아에서 스마트폰으로 촬영한 안저소견을 보고하고자 한다. 증례요약: 생후 8개월 남아가 소파에서 떨어진 후 지속적인 발작과 의식저하를 보여 응급실로 내원하였다. 표면적인 외상이나 두개골과 긴뼈에서 골절소견은 관찰되지 않았지만, 뇌 전산화단층촬영에서 광범위한 우측 경막하출혈과 혈종, 심한 뇌부종으로 우측 뇌실과 뇌바닥수조가 소실되고 정중선이 좌측으로 치우쳐져 있었다. 두개내압을 감소시키기 위해서 즉시 머리뼈절제술을 시행하였다. 응급수술 직후 시행한 안저검사에서 망막의 여러 층에 걸친 광범위한 다발성 출혈이 양안에서 관찰되었고, 융기되어 있는 망막주름 주변에 체리모양 망막출혈이 있었다. 환아 눈에서부터 5 cm 높이에 20디옵터렌즈를, 15-20 cm 높이에 스마트폰을 두고 동영상촬영방식으로 안저를 촬영하였다. 촬영된 안저소견은 유리체망막 부착이 강한 영아에서 반복적인 가속-감속력이 안구에 가해지면 발생하는 전형적인 소견이어서, 진단과 가해자의 진술을 받는 데 중요한 역할을 하였다. 결론: 학대뇌손상 진단에서 안저검사는 매우 중요하다. 특별한 장비 없이도 시행할 수 있는 스마트폰 안저촬영이 하나의 중요한 법의학적 단서로 사용될 수 있었다.