• Title/Summary/Keyword: internal medicine

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두개골의 3차원 영상 분석을 위한 전산화단층촬영 방법의 비교-상층 두께가 3차원 영상의 계측에 미치는 영향 (Three-dimensional image analysis of the skull using variable CT scanning protocols-effect of slice thickness on measurement in the three-dimensional CT images)

  • 정호걸;김기덕;박혁;김동욱;정해조;김희중;유선국;김용욱;박창서
    • Imaging Science in Dentistry
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    • 제34권3호
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    • pp.151-157
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    • 2004
  • Purpose : To evaluate the quantitative accuracy of three-dimensional (3D) images by means of comparing distance measurements on the 3D images with direct measurements of dry human skull according to slice thickness and scanning modes. Materials and Mathods : An observer directly measured the distance of 21 line items between 12 orthodontic landmarks on the skull surface using a digital vernier caliper and each was repeated five times. The dry human skull was scanned with a Helical CT with various slice thickness (3, 5, 7 mm) and acquisition modes (Conventional and Helical). The same observer measured corresponding distance of the same items on reconstructed 3D images with the internal program of V-works 4.0/sup TM/(Cybermed Inc., Seoul, Korea). The quantitative accuracy of distance measurements were statistically evaluated with Wilcoxons' two-sample test. Results: 11 line items in Conventional 3 mm, 8 in Helical 3mm, 11 in Conventional 5mm, 10 in Helical 5mm, 5 in Conventional 7mm and 9 in Helical 7mm showed no statistically significant difference. Average difference between direct measurements and measurements on 3D CT images was within 2mm in 19 line items of Conventional 3mm, 20 of Helical 3mm, 15 of Conventional 5mm, 18 of Helical 5mm, II of Conventional 7mm and 16 of Helical 7mm. Conclusion: Considering image quality and patient's exposure time, scanning protocol of Helical 5mm is recommended for 3D image analysis of the skull in CT.

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임플랜트 지지 상부구조물에서 나사조임순서와 조임방법이 풀림토크값에 미치는 영향 (THE EFFECT OF SCREW TIGHTENING SEQUENCE AND TIGHTENING METHOD ON THE DETORQUE VALUE IN IMPLANT-SUPPORTED SUPERSTRUCTURE)

  • 최정한;김창회;임영준;김명주;이석형
    • 대한치과보철학회지
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    • 제45권5호
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    • pp.653-664
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    • 2007
  • Statement of problem: The screw detorque value is a measure of the preload remaining in the screw just before detorquing. Purpose: This study evaluated the effect of different screw tightening sequences and tightening methods on detorque values for a well-fitting implant superstructure. Material and method: An implant superstructure that connected directly to four implants (Astra Tech) was fabricated on a fully edentulous mandibular acrylic resin model. Six well-fitting dental stone casts were made with a pickup impression of the superstructure from the acrylic resin model. To evaluate the effect of three screw tightening sequences (1-2-3-4, 2-4-3-1, and 2-3-1-4) and two tightening methods (2-step and 1-step) on the stability of screw joint, the detorque values for a well-fitting implant superstructure were measured twice after screw tightening using 20 Ncm. Detorque values were analyzed using multi-way analysis of variance and two-way analysis of variance at a .05 level of significance. Results: 1. The mean detorque values for three screw tightening sequences were 12.3 Ncm, 12.6 Ncm, and 12.0 Ncm, respectively. 2. The mean detorque values for two screw tightening methods were 12.0 Ncm, and 12.2 Ncm, respectively. 3. The mean of mimimum detorque values for three screw tightening sequences and for two tightening methods were 10.6 Ncm, 11.1 Ncm, 10.5 Ncm, and 9.8 Ncm, respectively. 4. No statistically significant differences among the variables of screw tightening sequence and tightening method were found (p>.05) for detorque values and for mimimum detorque values. Conclusion: Within the limitations of this study, the screw tightening sequence and tightening method did not have a significant effect on the detorque values for a well-fitting implant superstructure.

중증도 분류체계를 이용한 중증도분류(Triage) (Severity of Emergency Patient classified by Triage System)

  • 배정희;손수경
    • 한국간호교육학회지
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    • 제7권2호
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    • pp.264-274
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    • 2001
  • About the patients who visited the emergency department of a hospital, investigative study was performed to assess and to classify them with triage tool, and to estimate the characteristics of them. 210 patients older than 15 years were investigated. Among them 11 patients who had responded inappropriately were excluded and remaining 210 patients were chosen as study subjects. Investigation had been performed for 30 days from Jan. 10, 2001 to Feb. 9, 2001. The triage tool was designed through the modification of triage tools developed by Kim and Choi. The data were analyzed with the SPSS program using mean, standard deviation, frequency, percentage, ANOVA and Scheffe's test. The results were as follows: 1. Of the characteristics of the study subjects, mean age of patients were 55.76 years and 70-79 years group which included 41 patients(20.6%) were most numerous. 101 (51.8%) patients visited emergency room by 119 emergency service and 91(45.7%) patients walked with assistance. 127 patients were cared in internal medicine department. 2. The distribution of triage scores were from minimum 6 points to maximum 18 points with mean $13.76{\pm}2.58$ points. 3. Triage scores had significant relationship with age(F=13.349,P=0.000), visiting method (F=8.832, P=0.000), walking status(F=28.185, p=0.000), care department(F=2.596, P=0.019), and preexisting disease(F=12.012, P=0.000). 4. After trage there were no urgent patient, 35 emergent patients(17.6%),109 subemergent patients(54.8%), and 55 nonemergent patients (27.6%). The result of emergency care were 80 admission(40.2%), 59 discharge (29.6%), 34 ICU admission(17.1%), 14 transfer to other hospital(7%), 10 operation (5%), and 2 death (2%). 5. About the time required for triage, mean duration to triage were $7.54{\pm}2.28$ mins in emergent patients, mean $7.23{\pm}2.50$ mins in subemergent patients and mean $6.49{\pm}2.19$ mins in nonemergent patients. There were no differences in duration to triage according to the severity of triage. 6. Time required in emergency treatment were mean $116.23{\pm}88.10$ in emergent patients mean $101.61{\pm}73.27$ in subemergent patients and mean $81.56{\pm}61.01$ in nonemergent patients. There were no significant difference among groups. This study depicted that triage scores were below the middle level and there were many geriatric patients in this hospital. Among the characteristics of patients, age, visiting method, walking status, care department, and accompanying disease could be data for triage of emergency patients. With triage score of a patient, the outcome of emergency care of a patient could be anticipated and this could be basal data in determining the priority of emergency nursing.

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기관지 천식의 병인에서 Matrix Metalloproteinase의 역할 (Role of Matrix Metalloproteinase in the Pathogenesis of Bronchial Asthma)

  • 이용철
    • Tuberculosis and Respiratory Diseases
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    • 제53권2호
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    • pp.101-112
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    • 2002
  • 연구배경 : 알레르기성 천식에서 기관지 재모형의 기전이 세포외 기질 침착에 의한다는 것은 잘 알려져 있다. MMP족중 특히 MMP-9은 천식의 기관지 재모형을 유발하는 주요 단백분해 효소이다. 또한, MMP-9은 기저막을 통한 호산구와 중성구의 이동을 유발한다고 알려져 있다. 최근에는 MMP가 천식의 쥐 모형에서 기도 과민성의 유발과 oval bumin 유발성 기도 염증 세포의 침윤에 있어서 중요한 역할을 한다고 보고되어졌다. 그러나, TDI 유발성 천식에 있어서 MMP의 역할에 대한 유효한 자료는 거의 없는 실정이다. 연구방법 : 특정 항원이 없는 암컷 BALB/c 쥐를 약간 변형된 Sugawara 등의 방법에 따라 ethyl acetate에 3% TDI를 녹인 용액을 5일 연속 매일 한번씩 비강내 주입하여 쥐를 감작시켰다. 기관지폐포 세척액의 채취하여 세포 분석과 MMPs의 측정하였고 폐조직에서 면역화학적 검사를 시행하였다. MMP 억제재를 TDI 부하(challenge) 30분전에 시작하여 24시간 간격으로 3회 복강내로 (10 또는 20mg/kg) 주입하고 기도 반응도를 측정하였다. 결 과 : TDI 감작 부하군에서 기관지폐포 세척액 염증 세포수와 MMP-9 및 폐조직의 면역화학적 검사상 MMP-9의 발현의 유의한 증가가 관찰되었다. MMP 억제재투여후 TDI 감작 부하군에서 기관지 폐포 세척액 염증 세포수와 MMP-9 및 폐조직의 면역화학적 검사상 MMP-9의 발현의 유의한 감소를 보였고 기도 과민성을 억제하였다. 결 론 : 본 연구의 결과는 MMP 억제재가 TDI 유발성 천식에 대한 훌륭한 치료제로서 향후 연구의 가치가 있음을 강력히 시사한다.

Aesthetic outcomes after surgical repair of pectus excavatum in females: Differences between patients and professional evaluators

  • Wachter, Tanja;Frari, Barbara Del;Edlinger, Michael;Morandi, Evi Maria;Mayerl, Christina;Verstappen, Ralph;Celep, Emre;Djedovic, Gabriel;Kinzl, Johann;Schwabegger, Anton Herbert;Wolfram, Dolores
    • Archives of Plastic Surgery
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    • 제47권2호
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    • pp.126-134
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    • 2020
  • Background Pectus excavatum is less common in females than in males, and it often aggravates a coexistent breast asymmetry. We conducted a study comparing female patients' versus medical professionals' evaluation of pectus excavatum repair to assess differences in aesthetic outcome ratings. Moreover, we evaluated the influence of surgical correction on patients' self-perception. Methods Of 30 female patients who were initially screened, 18 patients (mean age, 20 years) who underwent bar removal after surgical correction of pectus excavatum deformity participated in the survey (60%). They completed a questionnaire rating their appearance before and after surgery and responded to a psychological questionnaire about the changes that they had experienced. The mean interval between pectus bar removal and evaluation was 28 months. Standardized preoperative and postoperative patient photographs were evaluated using the same questionnaire by a panel of medical professionals and students (n=24) and the results were compared. Results Patients rated their preoperative deformity as more severe than the other evaluators, revealing the significant impact of the deformity on patients' self-perception. Postoperatively, patient and professional evaluations were much better than before and were very similar. The psychological evaluation showed a clear improvement in well-being. The ratings of the medical professionals were not influenced by their degree of medical education. Conclusions Surgical correction of pectus excavatum in female patients positively influences body perception and psychological well-being. It should therefore not be considered as a merely aesthetic correction, but as an important procedure to restore a patient's self-perception.

무릎관절의 미만형 색소 융모 결절성 활액막염에서 관절경을 이용한 육안적 활액막 전 절제술 후 방사선치료: 증례보고 (Combined Arthroscopic Gross Total Synovectomy and Radiotherapy for Diffuse Pigmented Villonodular Synovitis of the Knee: A Report of 2 Cases)

  • 장세경;김재화;하두회;강혜운;정소영;신현수
    • Radiation Oncology Journal
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    • 제24권3호
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    • pp.201-206
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    • 2006
  • 색소 융모 결절성 활액막염(pigmented villonodular synovitis, PVNS)은 병인이 밝혀지지 않은 증식성 질환으로, 병변의 범위에 따라 국소형과 미만형으로 분류되며, 조직학적으로 양성이지만 파괴적인 성향을 보이므로 연골의 파괴나 주위 조직으로 광범위한 침윤이 가능한 질환이다. 활액막 절제술이 일차적인 치료방법이지만 미만형인 경우에는 주위 조직을 침윤하는 성향 때문에 재발률이 높다. 재발이 반복된 후에는 수술적 절제가 어려워져서 병변부위의 절단이 필요하게 되므로, 광범위한 병변인 경우, 수술이 용이하지 않은 경우, 또는 불완전 절제가 시행된 경우 등에서 방사선치료를 시행하여 재발을 방지할 수 있다고 보고되고 있다. 저자들은 무릎관절의 미만형 색소 융모 결절성 활액막염으로 관절경을 이용한 육안적 활액막 전 절제술 후 방사선치료를 시행한 2예를 경험하였기에 문헌고찰과 함께 보고하고자 한다.

실험적(實驗的) 절식(絶食)에 있어서 혈액세포(血液細胞) 및 조혈기능(造血機能)의 변화(變化)에 관(關)한 연구(硏究) 1. 가토(家兎)의 절식경과(絶食經過)에 있어서 예비적(豫備的) 혈액학적(血液學的) 관찰(觀察) (ALTERATIONS OF BLOOD CELLS AND HEMATOPOIETIC FUNCTION DURING THE EXPERIMENTAL STARVATION I. PRELIMINRY HEMATOLOGICAL OBSERVATION IN THE COURSE OF STARVATION ON RABBITS)

  • 이방환
    • 대한수의학회지
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    • 제1권1호
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    • pp.1-29
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    • 1961
  • A routine hematological observation in the course of starvation was carried out on eight experimentel1y starved rabbits. They were strictly selected and restricted all of food intake with the exception of optional water intake until death. The body weight of each rabbit on the day before starvation was about 2 kilograms. The results are summarized as follows. 1. The average decrememt ratio of body weight on the terminal day before death was $34.3{\pm}7.5$ per cent with the range from 24.5 to 46.3 per cent. The average life duration until death was $10.25{\pm}2.6$ days, the range being from 6 to 14 days. 2. The decrease in number of reticulocytes with a parallel disappearance of polychromatic erythrocytes in peripheral blood in the course of starvation Was the most remarkable change in erythrocytic series, an evidence suggesting marked restriction of the erythropoietic function on 3rd to 4th day and almost complete suspension in about a week of starvation. 3. Erythrocyte count, hemoglobin content and haematocrit value of peripheral blood, were normal or indicative of slight hemoconcentration. 4. Mean Corpuscular Hemogloin Concentration was slightly higher than normal and Mean Corpuscular Volume tended to be low and no appreciable shifts were observed in Mean Corpuscular Diameter and Price-Jones curve of erythrocytes, while fewer macrocytes than normal were seen. These changes were considered to have resulted from a marked decrease in young erythrocytes in peripheral blood in the course of starvation. 5. Neither poikilccytoses or anisosytosis was observed. 6. Leukopenia was observed in all of 8 starved rabbits. The decrement ratio on the terminal day of starvation was between 13 to 64 per cent. The leukopenia was mainly due to fall of lymphocytes in 6 cases and to fall of neutrophilic leukocytes in the other 2 cases. In many cases, irregular fluctuation of neutrophilic leukocytes in its biological curve were seen in contrast to the relatively smooth changes of lymphocytes. Eosinophilic leukocytes tended to decrease in absolute number especially in later stage of starvation. Little significance in regard to monocytes and basophilic leukocytes in this study was discussed. 7. Proplasma cells, rarely plasma cells, appeared with a tendency to increase in number at later stage of starvation. 8. The most characteristic changes on circulating blood cells in complete starvation of rabbits were the leukoponia and failure of regeneration of erythroctes. These changes were considered as adaptive phenomena in response to the catabolic consumption of body constituents.

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걷기운동 및 근육강화운동이 류마티스 관절염 여성환자의 대퇴골 및 요추골 골밀도에 미치는 효과 (Effect of Brisk Walking and Muscle Strengthening Exercise on Bone Mineral Density of the Lumbar and Femur in Rheumatoid Arthritis Women)

  • 이은남;정원태;이성원;황은정;민혜숙
    • 근관절건강학회지
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    • 제7권2호
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    • pp.294-308
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    • 2000
  • This study was conducted to test the effect of brisk walking & muscle strengthening exercise program on bone mineral density(BMD) of the lumbar & femur in rheumatoid arthritis women. Research design was a quasi-experimental study of non-equivalent control group pretest-posttest design(16 weeks). 14 for the experimental group and 14 for the control group were selected from the outpatients on rheumatoid arthritis clinic of Dong-A University Hospital. The experimental group underwent 16 weeks of brisk walking and muscle strengthening exercise. Bone mineral density was measured before and after 16 weeks of exercise by DXA at lumbar spine, femoral neck, Ward's triangle and trochanter. The results were summarized as follows : 1. BMD of the lumbar spine in experimental group who carried out the brisk walking and muscle strengthening exercise was not significantly increased after 16weeks and there was no significant difference between experimental and control group(U=70.00 p>.05). 2. BMD of the femoral neck in the experimental group who carried out the brisk walking and muscle strengthening exercises was significantly increased after 16 weeks(Z=-2.901 p<.01). But, there was no significant difference between experimental and control group(U=83.00 p>.05). 3. BMD of the femoral Ward's triangle in the experimental group who carried out the brisk walking and muscle strengthening exercises was significantly increased after 16 weeks (Z=-2.355 p<.05). But, there was no significant difference between experimental and control group(U=86.00 p>.05). 4. BMD of the femoral trochanter in experimental group who carried out the brisk walking and muscle strengthening exercise was not significantly increased after 16weeks and there was no significant difference between experimental and control group(U=75.00 p>.05). These results suggest that brisk walking and muscle strengthening exercise program has an effect on promoting bone mineral density of femoral neck and Ward's triangle in rheumatoid arthritis women.

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Bioequivalence Evaluation of Two Brands of Zolpidem Tartrate 10 mg Tablets(Zanilo and Stilnox) in Healthy Male Volunteers

  • Ryu, Ju-Hee;Lee, Heon-Woo;Lee, Hyun-Su;Kang, Il-Mo;Seo, Ji-Hyung;Kang, Jin-Yang;Lee, Kyung-Tae
    • Journal of Pharmaceutical Investigation
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    • 제36권5호
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    • pp.343-348
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    • 2006
  • The purpose of the present study was to evaluate the bioequivalence of two zolpidem tartrate tablets, Stilnox tablet(Sanofi-aventis Korea, reference product) and Zanilo tablet(ChoDang Pharm Co., Ltd., Korea, test product), according to the guidelines of Korea Food and Drug Administration(KFDA). After adding an internal standard(cimetropium), 250 ${\mu}L$ plasma samples were extracted using 1.3 mL of ethyl acetate. Extracted compounds were analyzed by HPLC with triple-quadrupole mass spectrometry. This method for determination of zolpidem is proved accurate and reproducible with the limit of quantitation of 1 ng/mL in human plasma. Twenty-four healthy male Korean volunteers received each medicine at the zolpidem tartrate dose of 10 mg in a $2{\times}2$ crossover study. There was one-week washout period between the doses. Plasma concentrations of zolpidem were monitored for over a period of 8 hr after the administration. $AUC_{0-t}$(the area under the plasma concentration-time curve) was calculated by the linear trapezoidal rule. $C_{max}$(maximum plasma drug concentration) and $T_{max}$(time to reach $C_{max}$) were compiled from the plasma concentration-time data. Analysis of variance was carried out using logarithmically transformed $AUC_{0-t}$ and $C_{max}$. No significant sequence effect was found for all of the bio-availability parameters indicating that the crossover design was properly performed. The 90% confidence intervals for the log transformed data were acceptable range of log 0.8 to log 1.25(e.g., log 0.92-log 1.06 for $AUC_{0-t}$, log 0.96-log 1.13 for $C_{max}$). The major parameters, $AUC_{0-t}$ and $C_{max}$ met the criteria of KFDA for bioequivalence indicating that Zanilo tablet is bioequivalent to Stilnox tablet.

흰쥐 적출 흉부대동맥근의 자외선 수축반응에 관하여 (Contractile Effect of Ultraviolet Light on Isolated Thoracic Aortae of Rats)

  • 백영홍;강성돈;강정채
    • 대한약리학회지
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    • 제29권1호
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    • pp.65-72
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    • 1993
  • 자외선조사는 흰쥐흉부대동맥의 휴지기장력에 거의 영향을 미치지 못했으나, phenylephrine으로 수축된 표본에서는 자외선조사로 내피세포가 존재하면 수축반응을, 내피세포가 제거되면 이완반응이 나타났다. 이 수축반응은 조사시간의 길이($10{\sim}320$초)에 비례하여 증가하였으나 이완반응은 그렇지 못하였다. 내피세포 존재표본에서 자외선의 수축반응은 phenylephrine농도의 증가($10^{-7}{\sim}10^{-5}M$) 그리고 $acetylcholine(10^{-6}M)$, $isoproterenol(10^{-7}M)$$nitroglycerin(3.5{\times}10^{-8} M)$의 추가투여시 크게 강화되었다. 그러나 $phentolamine(10^{-6}M)$ 또는 $LY83583(10^{-7},10^{-6}M)$의 추가투여시에는 자외선 수축반응이 억제 또는 이완반응으로 역전되었다. 내피세포 제거표본에서의 자외선 이완반응은 phenylephrine농도의 증가 그리고 isoproterenol, nitroglycerine, phentolamine 및 LY83583의 추가투여시 유의하게 감약되었다. 이상의 성적은 흰쥐 적출 흥부대동맥에서 자외선조사는 내피세포 존재유무에 따라 수축과 이완반응이 각각 나타나며, 수축반응은 자외선에 의한 EDRF 유리억제 또는 부분적으로 어떤 EDCF와도 관련이 있음을 시사하고 있다.

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