• Title/Summary/Keyword: generalized

검색결과 8,514건 처리시간 0.03초

모혈(募穴)의 탄력(彈力) 상태(狀態) 측정(測定)에 의한 허실(虛實) 진단(診斷) 연구(硏究) (Study for the Deficiency and Excessiveness Diagnosis in the Front Point by Elastic State)

  • 나창수;윤여충;박현철;이동규;최찬헌;장경선;소철호
    • Journal of Acupuncture Research
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    • 제17권1호
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    • pp.27-41
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    • 2000
  • The meridian system is the most essential and basic connecting structure that maintains the vital activities of viscera and bowels by connecting them with each part of body's surface. Doctors can understand the healthy condition, and the region and deficiency-excessiveness of disease by observing the condition of Qi flowing. Deficiency and excessiveness could be differentiated by various symptoms expressed in meridian system. Especially there could be several clues like pain, heat-cold, protuberance-depression, change of color and shine in the line of channel leads to the judgment of deficiency-excessiveness The diagnosis of deficiency and excessiveness can be generalized by quantification of elastic status in skin surface along the meridian system. By comparing data from measurement of elastic condition with those from traditional deficiency and excessiveness, it could be utilized for the development of oriental medicine. All biological activities in the human body are based on meridian system according to the oriental medicine. Also the meridian system is viewed as basic and essential structure connecting internal viscera and each part of body. The areas of expressed channel phenomena are muscle to bone, muscle to muscle and bone to bone. These areas are called depression where meridian system is present and any changing state on those points can be measured. It could be difficult in diagnosing the reaction of meridian system because doctor can depend on his own judgment. Therefore, it is necessary to quantify and indexate channel reactions. To quantify the channel reactions, specially manufactured instrument was used to quantify the protuberance and depression to differentiate the deficiency and excessiveness. The results follow as below; 1. The elastic index measurement by the equipment proved a pattern of agreement showing the values that ranged within standard deviation 0.05kgf/cm throughout the experiment except few cases' measurement in CV-17. 2. To evaluate the state of deficiency & excessiveness of elastic index measurements in frontal point, elastic index measurements in the front paint were compared to the elastic index measured surrounding the point within 2.5 cm. Such result of indexing procedure was closely matched to the concept of palpitation. 3. If the elastic index values in the surrounding front point closely located to the elastic index values in the front point, the judgement on the state of deficiency and excessiveness was delayed. Otherwise, it was judged as deficiency or excessiveness. 4. Out of total 12 cases of comparing the elastic index values to the elastic index values in the surrounding front point, Three to nine front points were judged as either in the state of deficiency or excessiveness. 5. Among the nine front points judged as either in the state of deficiency or excessiveness, Four cases were matched to the electric index measured by EAV that evaluating the internal organs by five different phases. If more clinical cases are accumulated, it is expected to systematically theorize and improve the concept of deficiency and excessiveness in the internal organs using the front point.

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소아 간질 환자에서 oxcarbazepine의 효용성과 안전성 (Efficacy and safety of oxcarbazepine in epileptic children)

  • 신혜경;이윤;이지연;최욱선;은소희;은백린;홍영숙;이주원
    • Clinical and Experimental Pediatrics
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    • 제51권2호
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    • pp.162-169
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    • 2008
  • 목 적 : Oxcarbazepine(OXC)은 대표적인 부분간질의 치료제로 2001년 미국 식약청으로 부터 승인을 받았으며 1970년대 말부터 임상 보고가 시작되었고 소아를 대상으로 OXC의 효용성 및 안전성에 대한 다수의 보고가 있다. 국내에는 1999년부터 임상적 적용이 시작되었으나 국내 소아 대상의 연구 보고가 제한적이다. 방 법 : 2001년 1월부터 2006년 12월까지 6년간 고려대학교 의료원 구로병원 소아과에 내원하여 OXC 투약을 시행하였던 환자 144명을 대상으로 후향적 자료 분석을 통해 효용성과 안전성을 연구하였다. 결 과 : OXC 투약 6개월 후 회복군은 77명(53.5%, n=144), 호전군은 48명(33.3%), 유지군은 14명(9.7%), 그리고 악화군은 5명(3.5%)이었고, 치료 12개월 후에는 회복군은 88명(61.1%, n=133), 호전군은 27명(18.8%), 유지군은 8명(5.6%), 그리고 악화군은 8명(5.6%)이었다. 단일요법 군의 회복군은 6개월 치료 후에 63명(66.3%, n=95), 12개월 치료 후에는 86명(90.5%, n=95)였으며 복합요법 군에서 6개월 투약 후에 회복군은 14명(28.6%, n=49), 치료 12개월 후에는 45명(91.8%, n=49)으로 유의한 차이를 보였다. OXC 투약 기간동안 부작용이 발생한 경우는 73명으로, 그 중 졸림(20.1%), 두통(12.5%), 어지러움(9.7%), 발진(8.3%), 피로함(4.2%) 등이 관찰되었으며 나이, 성별 및 약물 용량과는 유의한 인과관계가 없었다. 혈액 검사상 저나트륨혈증이 관찰된 경우는 총 24명(16.7%)이며 그 외 투약 후 검사 상 이상소견은 유의하게 관찰되지 않았다. 반면 투약 이후 빈혈의 빈도가 감소하였는데 혈색소와 체중 간에 유의한 상관관계는 없었다. 결 론 : 본 연구 결과 OXC 의 효용성은 국외 보고와 비교하여 우수하거나 큰 차이가 없었으며, 위중한 부작용 사례는 없었다. 소아 간질 환자의 OXC 치료 시 참고가 되는 자료가 될 수 있을 것이다.

급성 증후성 경련 환아에서 비유발성 경련의 위험인자들에 대한 연구 (Risk Factors of Unprovoked Seizures after Acute Symptomatic Seizures in Children)

  • 이은주;김원섭
    • Clinical and Experimental Pediatrics
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    • 제50권11호
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    • pp.1097-1103
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    • 2007
  • 목 적 : 급성 증후성 경련이란 일시적인 중추 신경계 또는 전신적인 병태생리의 변화와 밀접히 연관되어 발생하는 경련으로 이와 달리 특별한 유발 인자 없이 발생하는 경련은 비유발성 경련으로 분류한다. 급성 증후성 경련이 추후에 비유발성 경련으로 이행할 수 있다는 문헌은 다수 보고되고 있으나 증후성 경련에서 비유발성 경련의 이행에 영향을 미치는 관련 인자들에 대한 자료는 미비한 실정이다. 이에 본 논문에서는 증후성 경련으로 입원한 환아들을 대상으로 지속적인 추적 관찰을 통해 비유발성 경련과 관련된 인자들에 대해 후향적으로 조사하였고, 이러한 관련 인자들과 비유발성 경련 이행 여부에 관해 통계적인 분석을 통해 그 유의성을 알아보고자 하였다. 방 법 : 급성 증후성 경련으로 진단된 환아들을 대상으로 최소 1년간의 추적 관찰을 통해 비유발성 경련으로의 이행 여부를 후향적으로 조사하였고, 이에 따른 관련 인자로써 호발 연령, 성별, 가족력, 경련의 유형, 발달 정도 등을 포함하여 다양한 원인들을 분류하고 뇌파 검사 및 뇌영상 검사 등의 결과를 조사하여 비유발성 경련과의 관계를 통계적으로 분석하였다. 결 과 : 급성 증후성 경련에서 비유발성 경련으로 이행하는 경우는 2-6세에 가장 호발하고 성별에 따른 차이는 없으며 뇌증과 중추 신경계 감염이 많은 원인을 차지한다. 비유발성 경련으로 이행하는 경우의 관련 인자로는 간질 지속 상태를 동반한 경우와 부분 발작의 경우에 통계적으로 유의한 차이를 보이며, 이외에 뇌파 검사와 뇌 영상검사에서 이상 소견을 보이는 경우에도 비유발성 경련으로 이행하는 데 있어 통계적으로 유의한 값을 보였다. 그러나 성별, 경련성 질환의 가족력, 발달 정도, 경련시의 각성 상태 등의 인자들과 비유발성 경련의 관계에는 통계적인 유의성을 갖지 못하였다. 결 론 : 급성 증후성 경련 환아들의 비유발성 경련 이행에 따른 관련 인자로는 경련의 지속 시간, 경련의 유형, 이상 뇌파 소견 및 이상 뇌 영상검사 소견을 들 수 있다. 따라서 이러한 인자들에 해당하는 경우에는 급성 증후성 경련의 치료 후에도 지속적인 추적 관찰을 통해 향후 발생할 수 있는 비유발성 경련에 대한 적절한 검사와 대처가 필요하다고 생각된다.

상악동저 거상술 후 Osstem Implant (US II / SS II)의 다기관 후향적 임상연구 (A RETROSPECTIVE MULTICENTER CLINICAL STUDY OF INSTALLED US II / SS II IMPLANTS AFTER MAXILLARY SINUS FLOOR ELEVATION)

  • 국민석;박홍주;김수관;김영균;조용석;최갑림;오영학;오희균
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • 제34권3호
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    • pp.341-349
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    • 2008
  • Purpose: The purpose of this study was to evaluate the $Osstem^{(R)}$ implants (US II/SS II implants) through the retrospective study for the clinical success rate during the installation of the $Osstem^{(R)}$ implants (US II/SS II implants) by using of the procedures of maxillary sinus floor elevation. Materials and methods: The current study was researched in the 6 medical institutions: Chonnam National University, Chosun University, Pusan DaeDong Hospital, Bundang Seoul National University Hospital, Ap-Seon Clinic, and All Clinic. Based on the total number of 116 patients whose treatment was the installation of the US II/SS II implants with the procedures of the maxillary sinus floor elevation, they were conferred on the dental records of the patients under the joint consultation of the 6 medical institutions. On the dental recording charts, there were included in as the following; the name of the institutions, gender, age, with or without smoking or drinking, with or without the generalized diseases, the height of the alveolar bone on the operational sites, elapsed edentulous state period, the state of the opposed or adjacent teeth, the methods of the maxillary sinus floor elevation, secondary time period for surgery, the lengths, types, and diameters of implants, with or without bone transplantation or the types of bone, postoperative current bone height, current adjacent soft tissue state of the implants, with or without the success of the installations of the implants. We have done our survey with the clinical and radiolographical examinations and dental questionaries. The success and survival rate of the implants was evaluated. Results 1. Total number of the patients with the installation of the US II implants were 62. The 252 numbers of US II implants were installed on the 89 maxillary sinuses. The patient's mean age was 54.1 years old and there were 36 men and 27 women. 2. Total number of patients with the installation of SS II implant were 57. The 165 numbers of SS II implants were planted on the 80 maxillary sinuses. Their mean age was 48.7 years old and there were 37 men and 20 women. 3. The follow-up period was 30.7 months(21-49 mon) on average. The vertical bone loss of installed implants after the procedures of the maxillary sinus elevation was 1.1 mm on average in SS II and 1.3 mm on average in US II. There existed no statistical significance on each group. The mean enlarged bone height after the maxillary sinus floor elevation was 8.2 mm. 4. For the procedures of the maxillary sinus elevation, the Lateral approach technique occupied 87.1%, which was the most used one. In addition, the most frequently used transplanted bone was autogenous bone only which was 72.7% during the maxillary sinus floor elevation. 5. The complication of maxillary sinus floor elevation were perforation of sinus membrane, disesthesia on doner site, exposure of cover screw and exposure of maxillar bone. 6. The survival rate of US II and SS II after maxillary sinus floor elevation was 99.2% and 95.8%, respectively. And the success rate of US II and SS II after maxillary sinus floor elevation was 97.6% and 89.7%, respectively. Conclusion : On the evaluation of the analysis of our study, both US II and SS II implants showed the excellent clinical results by use of the procedures of maxillary sinus floor elevation.

간호사(看護師)들의 간호사고(看護事故) 경험(經驗)과 사고원인(事故原因)에 관한 지각(知覺) (Perception on the Nursing Accident Experience of the Nurses and Its Cause)

  • 이순복;문희자
    • 간호행정학회지
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    • 제1권2호
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    • pp.246-267
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    • 1995
  • Recently the request of the patients to participate in the medical courses has been expanding due to the elevated sense of right on the people's health, merchandised medical treatment by mass supply, human right declaration of the patients, generalized medical informations by the mass media and the change of human relation between the medical personnels and the patients. Under these phenomena the patients have been in the thought of solving such accidents only by regulation of the laws which they think to be all powerful, Such trends are same in the area of nursing service. Also today the accident by the nurses have been increasing by the area of the nurses having been expanded and their independent roles having been increased. Such nursing accidents are the important subject which the professional occupation of the nurse has been facing but legal protective capability of the nurses has been very weak. Therefore this study has examined the degree of the experience of the nursing accident that happens in the clinical nursing scenes in the general hospital to provide the basic materials for the protection and the counter measures of the nursing accident. The following is the conclusion based by the above examination. 1) The experience degree of the whole nursing accidents has been appeared as 1.90 in average. And the degree according to service area has been 1.77 in the area of supervising management of patients, 1.54 in the area of the same management of patients by head-nurses, 1.84 in the area of doctors' treatment performances, 14 in the enforcement and education areas of the nursing technology, 2.04 in the area of observing patients and judgement and 2.07 in the area of nursing records and maintaining confidentials. Accordingly there has been higher degree of accidental experiences in the independent service areas of the patients than in the dependent ones directed by the doctors. 2) The perception of the nurses showed that the cause of the nursing accident has been due to the heavy work of the nurses with the 60.4% of the response rate, the highest rate. They report the accident to the head nurse first by 2/3 nurses after accident. And the hour of the accident has been frequently happened regardless of service hours with 48.1% in response rate, the highest rate, and the nursing accident happens in the night more than the daytime with the rate of 37.5% at night while 14. 4% daytime. 3) The nurses are in the perception that the patients are responsible for the accident with 48.2% response rate while 43.9% rate in response showed that it has been caused by many people. They are in the perception that 41.7% when the nursing power was lacking, 46.7% lower recognition of actual state about indivitual patient in the section of technical speciality and 35.8% when the patients were not cooperative and 37.8% when the wards were dirty and in disorder. 4) the attitude of the patients after the various nursing accidents has been violent words in 72.7%, violence in 17.4% and 3.9% in attending the court by the sue of the patient's side(18 nurses). 5) The action of the hospital has been : requesting the submission of the story of the accident in 22.8%, the report of the accidents in 14.4%, thus the written statement disposal was most, 4.5% was the transfer to the other departments when the accident was larger or the patients' guardians protested strongly and 0.6% of the dismissals of the nurses. 6) In regard to the responsiblity of the nurse accidents, 78.9% was the highest rate of supplying the nursing manpowers, 48.4% of mutual cooperation of the medical personnels, 37.2% of strengthening the education for the nurses and hospital facilities reformation in 32.7%. 7) The review of relation between the general characters of the object of the study and the degree of experience of nursing accidents showed the significant differences in ages (F=4.04, p=0.000).

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강화군 석모도 일대의 선캠브리아기 변성암류 및 중생대 화강암류에서 발달하는 단열계의 분포특성 (Characteristics of Fracture System in Precambrian Metamorphic Rocks and Mesozoic Granites from Seokmo-do, Ganghwa-gun)

  • 박덕원;이창범
    • 암석학회지
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    • 제19권2호
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    • pp.123-139
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    • 2010
  • 강화군 석모도 일대의 선캠브리아기 및 중생대 화강암류에서 발달하는 단열계의 특성이 조사 분석되었다. 노두에서 측정한 대부분의 단열은 경사가 거의 수직이거나 급하다. 빈도등급에 의한 단열 조의 방향성은 다음과 같다: Set $1:N2^{\circ}E/77^{\circ}SE$, Set $2:N17^{\circ}E/84^{\circ}NW$, Set $3:N26^{\circ}E/64^{\circ}SE$, Set $4:N86^{\circ}W/82^{\circ}SW$, Set $5:N80^{\circ}W/77^{\circ}NE$, Set $6:N60^{\circ}W/85^{\circ}SW$, Set $7:N73^{\circ}E/87^{\circ}NW$, Set $8:N82^{\circ}W/53^{\circ}NE$, Set $9:N23^{\circ}W/86^{\circ}SW$, Set 10: $N39^{\circ}W/61^{\circ}NE$ 단열군으로 나타났다. 특히, 단열의 주향(N:240)을 표시한 장미도에서는 남-북~북북동 및 서북서의 대표적인 2 방향을 지시한다. 석모도에서 발달하는 단열의 이러한 분포형태는 기존의 연구에서 시사한 국내의 주요 선구조선의 분포형태와 부합한다. 한편, 단열 모집단의 길이분포에 대한 스케일링 성질을 조사하였다. 먼저 선캠브리아기 장봉편암 및 중생대 화강암류(북부 및 남부암체)에서 측정한 단열 조는 주향 과 빈도수에 의하여 5개 그룹(그룹 I~V)으로 분류하였다. 그 다음, 상기한 5개 그룹에 대한 개개 길이-누적빈도 도표를 종합한 분포도를 작성하였다. 관계도에서 거의 멱법칙의 길이 분포를 따르는 상기한 5개 부집단(그룹 I~V)은 지수(-0.79~-1.53)의 넓은 범위를 보여준다. 이러한 5개 그룹 사이의 지수의 상대적인 차이는 방향성 효과의 중요성을 강조한다. 관계도에서 5개 그룹 중 그룹 Ⅲ의 도표가 보다 상위영역을 차지한다. 마지막으로, 각 암체에 대한 길이 빈도 분포의 특성을 보여주는 분포도를 작성하였다. 관계도에서 각 암체의 도표는 반상흑운모화강암 < 각섬석화강섬록암 < 중립질흑운모화강암(남부암체) < 중립질흑운모화강암(북부암체) < 장봉편암의 순으로 배열되어 있다. 관계도에서 생성시기가 보다 고기인 암체의 도표가 보다 상위영역을 차지하는 경향이 있다. 특히, 선캠브리아기 장봉편암의 도표는 중생대 화강암류의 도표에 비하여 보다 상위영역을 차지한다. 이와 같은 분포특성은 암체의 생성 이후에 작용한 응력장과 부합하는 신규 단열의 발생과 더불어 기존 단열의 성장작용의 공존을 시사한다.

환경 인쇄 기술의 발전과 인쇄물의 $CO_2$ 발생량에 관한 연구 (A Study about Development of Environment Printing Technology and $CO_2$)

  • 이문학
    • 한국인쇄학회지
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    • 제30권3호
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    • pp.89-114
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    • 2012
  • For as to world, the concern about the environment problem is enhanced than any other time in the past because of being 21 century. And the environment problem is highlighted as the world-wide issue. The time of the environment problem intimidates the alive of the mankind and presence of an earth over the time. It becomes the essentiality not being selection in the personal living or the economical viewpoint now to prepare for the climatic modification. As to the company management, the green growth period which it excludes the environment management considering an environment, cannot carry on the company the continued management comes. That is, in the change center of the management paradigm, there is the environment management. Nearly, the greenhouse gas which the publication industry is the environmental toxic material like all industries is generated. The greenhouse gas is ejected in the process of running the manufacturing process and print shop of the various kinds material used as the raw material of the book. Particularly, the tree felling for getting the material of the paper is known to reach the direct influence on the global warming. This study does according to an object it considers and organizes the environment parameter based on this kind of fact as to the publication industry. And it is determined as the reference which is used as the basic materials preparing the case that carbon exhaust right transaction(CAP and TRADE) drawing are enforced in all industries and is sustainable the management of the publication industry and reduces the environmental risk among the company many risk management elements and plans and enforces the publication related policy that there is a value. In the printing publication industry, this study tried to inquire into elements discharging the environmental pollutant or the greenhouse gas. Additionally, in the printed publication production process, it tried to inquire into the effort for an environment-friendly and necessity at the printing paper and the printers ink, regarded as the element discharging the greenhouse gas all kinds of the printing materials, operation of the print shop and all kinds of the machines and recycle process, and etc. These considerations make these industrial field employees aware of the significance about a conservation and environmental protection. They try to give a help in the subsequent study producing quantitatively each environmental parameter emission of green house gas. This makes the calculation of the relative $CO_2$ output reproached ultimately possible. Meanwhile, in a sense, many research protects and improving an environment in connection with the contents of research at the printing publication industrial field is in progress. There will be the voluntary human face that it has to protect an environment but this can not do by the outside factor according to all kinds of environment related law and regulation. Anyway, because of acting on company management as the factor of oppression, the increase of this environment-related correspondence cost could know that the research that the environment loading relates with a procurement and development, environment management system introduction, quality control standard, including, normalizing including a material, and etc. through the part of the effort to reduce the cost low was actively in progress. As to the green growth era, as follows, this paper prescribed the subject and alternative of the print publication industry. It is surrounded by the firstly new digital environment and the generation of the subject. And secondly the printing industry is caused by the point of time when the green growth leaves by the topic which is largest in the global industry and it increases. The printing publication industry has to prepare the bridgehead for the environment-friendly green growth as the alternative for this resolution with first. The support blown in each industry becomes the obligation not being selection. Prestek in which the print publishing was exposed to spend many energies and which is known as the practice of the sustainable print publishing insisted that it mentioned importance of the green printing through the white pages in 2008 and a company had to be the green growth comprised through the environment-friendly activity. The core management for the sustainable printing publication industry presented from Presstack white pages is compacted to 4 words that it is a remove, reduce, recover, and recycle. Second, positively the digital printing(POD) system should be utilized. In the worldwide print out market, the digital printing area stops at the level of 10% or so but the change over and growth of the market of an analog-to-digital will increase rapidly in the future. As to the CEO Jeff Hayes of the Infoland, the offset print referred to that it of the traditional method got old and infirm with the minor phase of the new printing application like the customer to be wanted publication and the print of the digital method led the market. In conclusion, print publishers have to grasp well the market flow in the situation where a digitalization cannot be generalized and a support cannot avoid. And it keeps pace with the flow of the digital age and the recognition about the effort for the development and environment problem have to be raised. Particularly, the active green strategy is employed for the active green strategy.

국내 해양 CCS 사업의 HSE 관리 프레임워크 구축 전략 (Strategy for Development of HSE Management Framework for Offshore CCS Project in Korea)

  • 노현정;강관구;강성길;이종갑
    • 한국해양환경ㆍ에너지학회지
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    • 제20권1호
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    • pp.26-36
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    • 2017
  • 지구온난화를 방지하기 위해 대량의 $CO_2$를 감축 시킬 수 있는 해양 CCS(Carbon dioxide Capture and Storage) 실증 및 상용화를 국내에서 준비 중이다. 해양 CCS 사업은 해양내 심부 퇴적층을 대상으로 대규모 $CO_2$를 수송, 주입, 저장하는 기술로써, 누출 등의 사고 발생 시 인명, 환경, 재산 등에 큰 피해를 야기할 잠재적 가능성을 가지고 있다. 따라서 해양 CCS 사업 안전성을 확보하기 위해서는 생애주기에 걸쳐서 유 가스 생산 해양플랜트에 준하는 엄격한 HSE(Health, Safety and Environment) 관리 방안이 요구된다. 하지만 국내에는 CCS 사업에 적용 가능한 HSE 법 또는 규정이 없을 뿐만 아니라 관련 연구도 미비한 상황이다. 이에 본 연구에서는 국외 해양플랜트 관련 HSE 관리 방법론, 해양 CCS HSE 관리 가이드라인 및 국외 사례를 분석하고, 이를 통하여 국내에서 해양 CCS를 추진시 HSE 관리 프레임워크 구축에 필요한 요구사항을 도출하였다. 이를 위해 본 연구에서는 먼저 범용적으로 활용되는 위험 관리방법론인 ISO 31000에 대한 분석을 수행하였다. 또한 해양플랜트 HSE 관리체계를 체계적으로 구축 운영 중인 노르웨이와 영국의 해양 CCS HSE 관리가이드라인 및 적용사례를 각각 분석하였다. 이를토대로 국내에서 해양 CCS 사업 추진시 HSE 관리 프레임워크 구축을 위해 우선적으로 수행해야할 사항으로 HSE Philosophy의 작성의 필요성을 피력하였고 생애주기 단계에 따른 HSE 관리 프로세스를 제안하였다. 본 논문에서 제안한 HSE 관리 프레임워크를 통해 국내 해양 CCS 실증 사업 추진시 기획 설계 단계부터 HSE 관리를 한다면 보다 안전하고 체계적인 사업을 이행할 수 있을 것으로 기대된다.

영아에서 경련을 동반한 저칼슘혈증에 관한 연구 (Hypocalcemic Convulsion in Formula Feeding Young Infants)

  • 김미정;고철우;구자훈
    • Childhood Kidney Diseases
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    • 제2권1호
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    • pp.14-19
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    • 1998
  • 목적 : 최근 6개월 이하의 영아에서 저칼슘혈증의 임상 경험의 예가 증가하여 이의 원인, 증세, 치료 및 임상 경과를 알아보기 위하여 본 연구를 시행하였다. 방법 : 1994년 2월 부터 1991년 4월까지 경북대학교 병원 소아과에 경련을 주소로 내원하였던 환아 중 그 원인이 저칼슘혈증으로 확인되었던 11예를 대상으로 하였다. 이들은 모두 6개월 이하였으며 평균 $2.2{\pm}1.1$개월이었다. 이들 환아의 병력지를 통하여 후향적으로 각종 검사를 분석하였다. 결과 : 이 환아들의 저칼슘혈증의 원인으로는 비타민 D 결핍이 8예였고, 무기인의 과다한 섭취가 3예였다. 경련의 양상은 전신성 간-근대성이 9예였고 부분 근대성이 2례였다. 경련의 지속시간은 30초에서 20분까지 다양하였으며, 경련의 횟수는 평균 6.5회였다. $Bonky^{(R)}$, 칼슘 단독 또는 병합 요법 후 혈청 칼슘은 치료 전 $6.3{\pm}0.9$ mg/dL서 치료 후 $9.9{\pm}1.7$ mg/dL로 통계학적으로 의미있게 증가하였고(P=0.0008), 혈청 ALP는 치료 전 $1,418{\pm}864$ U/L에서 치료후 $772{\pm}503$ UL로 통계학적으로 의미있게 감소하였다(P=0.0112). 입원 당시 iPTH은 $176.7{\pm}129$ pg/mL로 증가되어 있었고 3명의 환아에서 치료 이후 추후 검사상 정상 범위로 회복 되었다. 모든 환아에서 치료 전$25(OH)D_3$는 감소되어 있었으며 평균 $3.9{\pm}2.7$ ng/mL였고, 치료 후 1예에서 정상으로 회복되었다. $1,25(OH)_{2}D_{3}$는 6예 중 2예에서 감소되어 있었다. 결론 : 최근 비타민 D가 보강된 것으로 알려진 조제 분유 영양아에서 발생된 경련을 동반한 저칼슘혈증의 원인은 상당수에서 비타민 D 결핍이었으며 $1,25(OH)_{2}D_{3}$의 단기간 투여로 성공적으로 치료되었으며, 조제 분유 영양아에서도 저칼슘혈증의 원인으로 비타민 D 결핍을 반드시 생각해야 한다고 사료 된다.

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임플란트 식립 부위의 골밀도 평가에 관한 연구 (The study of bone density assessment on dental implant sites)

  • 박수원;장수미;최병환;손한나;박봉찬;김창환;손장호;성일용;이지호;조영철
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • 제36권5호
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    • pp.417-422
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    • 2010
  • Introduction: Bone density is one of the important factors for the long term success of endosseous implants. The bone density varies from site to site and from patient to patient. A preoperative evaluation of the bone density is quite useful to oral surgeons for planning dental implantation. More accurate information on the bone density will help surgeons identify suitable implant sites, thereby increase the success rate of dental implantation. This study examined the correlation between the bone density measured preoperatively by computed tomography (CT) and the implant primary stability measured by resonance frequency analysis. Furthermore, the effects of the implant sites, gender, age and generalized systemic disorder patients on the bone density and primary implant stability were examined. Materials and Methods: One hundred and fourteen patients were selected. None of the patients had undergone a tooth extraction or bone graft history in the previous year. Preoperatively, the patients underwent CT scanning to evaluate the Hounsfield unit (HU), and resonance frequency analysis (RFA) was used to evaluate the implant primary stability at the time of implant installation. All implants were 4.0 mm diameter and 11.5 mm length US II. All patients were recorded and the HU and implant stability quotient (ISQ) value were evaluated according to the sites, gender and age. Results: The highest HU values were found in the mandibular anterior site ($827.6{\pm}151.4$), followed by the mandibular molar site ($797{\pm}135.1$), mandibular premolar site ($753.8{\pm}171.2$), maxillary anterior site ($726.3{\pm}154.4$), maxillary premolar site ($656.7{\pm}173.8$) and maxillary molar site ($621.5{\pm}164.9$). The ISQ value was the highest in the mandibular premolar site ($81.5{\pm}2.4$) followed by the mandibular molar site ($80.0{\pm}5.7$), maxillary anterior site ($77.4{\pm}4.1$), mandibular anterior site ($76.4{\pm}11.9$), maxillary premolar site ($74.2{\pm}14.3$) and maxillary molar site ($73.7{\pm}7.4$). The mean HU and ISQ value were similar in females and males. (HU: P=0.331, ISQ: P=0.595) No significant difference was also found in the age group respectively. However, the correlation coefficients between the variables showed a closed correlation between the HU and ISQ value. Conclusion: These results showed close correlation between the bone density (HU) and primary stability value (ISQ) at the time of implant installation (Correlation coefficients=0.497, P<0.01). These results strengthen the hypothesis that it might be possible to predict and quantify the initial implant stability and bone density from a presurgical CT diagnosis.