• Journal of Oral Medicine and Pain
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• 제32권1호
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• pp.35-43
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• 2007

본 연구는 숙지황과 가시오가피 복합추출물 (OPB)이 난소절제 흰쥐의 골밀도 및 골대사 변화에 미치는 영향을 관찰하기 위하여 수행하였다. 13주된 20마리의 Sprague-Dawley 암컷 흰쥐를 대조군과 실험군으로 나누었고, OPB의 골밀도 및 골대사 변화에 대한 효과를 관찰하기 위하여 난소절제 후 3일 후부터 OPB를 100 mg/kg씩 8주 동안 경구투여 하였다. pQCT 방식으로 골밀도, 골함유량, 골강도를 측정하였고, 혈청 중 CTx (C-telopeptide of type I collagen)의 변화를 관찰하였다. 난소절제 후 대조군의 골밀도는 $-29.8{\pm}3.0%$로 현저히 감소하였으며, 이러한 감소는 OPB의 투여에 의해 $-21.4{\pm}2.3%$로 억제되었다. 골강도의 변화에서는 anti-fracture 값과 anti-twisting 값이 대조군에 비해 OPB 처리군에서 유의성 있는 차이를 나타냈다. 또한 혈청 중 골흡수 지표인 CTx 농도는 대조군에 비해 OPB 처리군에서 낮게 나타났다. 이상의 결과로 숙지황과 가시오가피의 복합 추출물인 OPB가 난소를 절제한 흰쥐에서 골 소실을 억제하므로 임상에서 난소절제 후 또는 폐경 후 골다공증의 개선제로 이용될 수 있으리라 여겨진다.

• 대한치과보철학회지
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• 제42권4호
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• pp.425-442
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• 2004

Statement of problem: A difficulty in achieving a passive-fitting prosthesis can be overcome by individual crown restoation of multiple implants. But individualized crown has another difficulty in control of contact tightness and stress distribution. Purpose: This in vitro study is to evaluate the stress distribution and the magnitude in the supporting tissues around Endopore implants with different crown lengths, interproximal contact tightness, and the splinting effects. Material & methods: Three Endopore implants($4.1{\times}9mm$) were placed in the mandibular posterior edentulous area distal to the canine and photoelastic model was made with PL-2 resin(Measurements Group, Raleigh, USA). Restorations were fabricated in two crown lengths: 9, 13 mm. For non-splinted restorations, individual crowns were fabricated on three custom-milled titanium abutments. After the units were cemented, 4 levels of interproximal contact tightness were evaluated: open, ideal($8{\mu}m$ shim stock drags without tearing), medium($40{\mu}m$), and heavy($80{\mu}m$). For splinted restorations, 3-unit fixed partial dentures were fabricated. This study was examined under simulated non-loaded and loaded conditions(6.8 kg). Photoelastic stress analysis was carried out to measure the fringe order around the implant supporting structure. Results: 1. When restorations were not splinted, the more interproximal contact tightness was increased among the three implants, the more stress was shown in the cervical region of each implant. When crown length was increased, stresses tended to increase in the apex of implants but there were little differences in stress fringes. 2. When nonsplinted restorations were loaded on the first or third implant, stresses were increased in the apex and cervical region of loaded implant. Regardless of interproximal contact tightness level, stresses were not distributed among the three implants. But with tighter interproximal contact, stresses were increased in the cervical region of loaded first or third implant. 3. When the nonsplinted restorations were not loaded, there were little stresses on the supporting structure of implants, but low level stresses were shown in the splinted restorations even after sectioning and soldering. 4. With splinted restorations, there were little differences in stresses between different crown lengths. When splinted restorations were loaded, stresses were increased slightly on the loaded implant, but relatively even stress distribution occurred among the three implants. Conclusions: Splinting the crowns of adjacent implants is recommended for Endopore implants under the overloading situation.

• 대한치과보철학회지
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• 제42권4호
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• pp.458-470
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• 2004

Statement of problem: Br${\aa}$nemark or ITI are two currently most widely used implant systems but with contrasting design, surgical and restoration methods. Purpose: The purpose of this study was to compare changes and its statistical significance in bone height and shape which may rise due to the differences between two implant systems. Also to analyse the effect of inter-implant distance on annual bone height changes. Material & Method: Those patients who were treated with two or more of either Br${\aa}$nemark or ITI implants at posterior mandibular area at Yonsei University Dental Hospital, Implant Clinic were selected. At annual examination appointments, standardised radiographs using parallel technique were taken. Marginal bone and inter-implant crestal bone changes were measured and following results were obtained. Results: 1) When ITI and Br${\aa}$nemark system were compared, both annual marginal and inter-implant crestal bone height changes in ITI system in the first two years were smaller than Br${\aa}$nemark and they were statistically significant. On the third year, however, there was no statistical difference between two implant systems on their annual bone level changes (p>0.05). 2) The Marginal and inter-implant crestal bone changes were compared when inter-implant distance was less than 4mm. Statistically significant bone level changes were noted on the first year only for ITI implants but in the first and second year for Br${\aa}$nemark implants (p>0.05). 3) When comparing angulation changes between marginal bone and implant fixture, ITI system had smaller angulation changes but the annual changes were not statistically significant (p>0.05). Conclusion: Within the limitation of this study, it could be concluded that Br${\aa}$nemark implant systems had more changes in marginal and inter-implant crestal bone level in the first and second year after loading with statistical significance. Further studies are recommended to see the effects of these bone loss during the first and second year after loading on the long term prognosis of Br${\aa}$nemark Implants.

• 대한치과보철학회지
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• 제53권3호
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• pp.262-275
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• 2015

상악 전치부와 같은 심미성이 요구되는 부위의 치료 시에는 건강하고, 주위조직과 조화를 이루며 매력적인 미소선의 형성을 염두에 두어야 한다. 이에 관하여 미소선, 연조직 및 경조직의 형태뿐 아니라 치아의 해부학적 형태와 비율 또한 고려하여야 한다. 상악 측절치의 왜소치(peg lateralis)로 인한 치간이개 및 부적절한 치은 형태로 인해 비심미적인 상악 전치부 비율을 가진 환자에서는 교정치료만으로 심미적 수복이 이루어지기 힘들 수 있다. 이런 경우, 교정치료가 끝난 이후 치아-치은-안면 구도에서의 진단 및 분석을 통한 치은절제술 및 보철적 수복을 통해 치아간의 근/원심, 폭/길이 비율을 개선시켜야 심미적으로 만족할 만한 결과를 얻어낼 수 있다. 또한, 상악 측절치의 왜소치(peg lateralis) 치아 비율 개선을 위한 보철물 제작 시 치질삭제가 적으며 인접치와 유사한 색조가 재현 가능하고 투명도가 높은 도재 라미네이트 비니어(Porcelain laminate veneer, PLV)가 선호되고 있다. 본 증례에서는 두 명의 20세 여자 환자로 교정치료 후 상악 측절치의 왜소치로 인한 치간이개 및 부적절한 치은 형태로 인해 비심미적인 상악 전치부 비율을 가진 환자에서의 체계적인 진단 및 치료과정을 통해 심미성이 개선된 보철 수복 증례를 보고하고자 한다.

• Journal of Periodontal and Implant Science
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• 제37권1호
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• pp.125-136
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• 2007

Periodontal regenerative therapy and tissue engineering on defects destructed by severe periodontitis need maintaining of space, which provides the environment for cell migration, proliferation and differentiation. Application of bone grafts may offer this environment in periodontal defects. This study evaluated bone graft materials, $MBCP^{(R)}$ and $Algipore^{(R)}$ , in surgically created i-wall periodontal intrabony defects of minipigs by histological analysis. Critical sized($4mm{\times}4mm$), one wall periodontal intrabony defects were surgically produced at the proximal aspect of mandibular premolars in either right and left jaw quadrants in four minipigs. The control group was treated with debridement alone, and experimental group was treated with debridement and $MBCP^{(R)}$ and $Algipore^{(R)}$ application. The healing processes were histologically observed after 8 weeks and the results were as follows. 1. In the control group, limited new bone formation was observed. 2. In MBCP group, more new bone formation was observed compared to other groups. 3. Histologically, dispersed mixture of new bone, biomaterial particles and connective tissue were shown and osteoblasts, osteoclasts and new vessels were present in this area. 4. Defects with Algipore showed limited new bone formation and biomaterial particles capsulated by connective tissue. 5. Histologically, lots of osteoclasts were observed around the biomaterial but relatively small numbers of osteblasts were shown. Within the limitation to this study protocol, $MBCP^{(R)}$ application in 1-wall intrabony defect enhanced new bone formation rather than $Algipore^{(R)}$ application.

• Journal of Gastric Cancer
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• 제5권4호
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• pp.266-272
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• 2005

목적: 위암의 근치적 절제술 후에 재발은 여러 형태로 발생한다. 특히 현행성 재발은 간 부위에서 주로 나타나는데 이러한 간계발의 임상병리학적 위험인자를 예측하기 위해 본 연구를 시행하였다. 대상 및 방법: 1992년 1월부터 1999년 12월까지 전북대학교병원에서 위암으로 근치적 수술치료를 받았던 838명의 환자 중 201명의 재발환자를 대상으로 간 재발과 관련된 임상병리학적 위험인자를 찾기 위해 후향적 연구를 하였다. 결과: 201명의 재발환자 중 59명이 간재발을 보였다. 로지스틱 회귀분석을 통한 다변량분석에서 간재발의 독립적인 위험인자로는 Lauren의 분류에서 장형인 경우(OR, 6.66; 95% Cl, 1.53 to 28.9; P=0.011), 근위부 절제연의 길이가 6cm 미만인 경우(OR, 3.76; 95% Cl, 1.03 to 13.67; P=0.045)가 관련되어 있었다. 결론: 위암의 수술 치료 후 간재발의 임상병리학적 위험인자들의 다양한 연구 조사와 더불어 분자생물학적인 연구가 더해진다면 간 재발에 대한 예측이 가능할 것이며 고위험 환자에게 적절한 치료법의 개발에도 도움이 될 수 있을 것이다.

• 한국수학교육학회지시리즈D:수학교육연구
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• 제4권1호
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• pp.33-43
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• 2000

본 논문은 한국 수학 교육학계에서 사회적 구성주의자로서 소개되어지고 있는 Vygotsky의 이론의 재분석을 통해 우리에게는 아직 낱선 그의 이론인 사회문화주의 이론(sociocultural theory)을 소개하는 것을 그 주목적으로 하였다. 특히 아동의 수학 학습에 있어 교사의 역할의 중요성을 어떻게 Vygotsky가 사회문화주의 이론이라는 렌즈를 통해 설명하고 있는 지를 분석하였다. Vygotsky는 사회주의문화를 주장함으로써 Piaget와 같은 아동중심적 학습이론과 그 색채를 매우 다르게 취하고 있는데, 첫째, 그는 수학 학습이란 아동의 개인적인 수준에서보다는 사회적 수준에서 이루어진다고 주장하고 있다. 이는 본질적으로 Vygotsky가 왜 구성주의자로서 이해될 수 없는가를 보여주는 근본적인 이유이다. 둘째, 어떻게 사회문화작인 구조(예: 학교, 교실) 속에서 학습이 일어나는가를 설명하기 위해 근접 발달 영역 (Zone of Proximal Development: ZPD)이라는 개념을 도입하였다. 이는 아동이 누군가의 도움을 통해 도달할 수 있는 잠재적 발달 영역을 의미하며 Vygotsky 이론의 핵심이 되는 개념이다. 셋째, 사회문화주의 이론은 행동(mediated action)과 심리학적 도구(psychological tool)를 강조하며 결과적으로 학습의 아동 내부에서의 독립적이고 내재적인 생성보다는 외부적인 환경과의 제휴 된 모습과 그 결과들을 강조한다. 넷째, 따라서 아동의 수학 학습 과정에 있어 주체는 아동 홀로가 아니며, 교사와 보다 우수한 아동들의 역할이 매우 중요함을 강조하고 있다. 본 논문에서는 이러한 사회문화주의 이론에 대한 이해를 돕는 것과 아울러, 이를 통해 수학 학습에서 교사의 역할에 대한 그 이론적 기반을 제공하고 있다. 구성주의가 활성시켜 온 아동 스스로의 지식의 건설이라는 중요성에 비추어, 사회문화주의 이론의 제안을 통해 아동의 수학 학습에서의 교사의 적극적인 역할의 가능성을 제시하고 있다.

• The Journal of Korean Physical Therapy
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• 제22권3호
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• pp.71-77
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• 2010

Purpose: To determine whether upregulation of inducible nitric oxide synthase (iNOS) transcription and translation is related to radicular pain in a model of lumbar disc herniation. Also, to investigate the temporal changes of mRNA expression of iNOS and the identity of iNOS and transient receptor potential vanilloid (TRPV) 1 channel expression cells in dorsal root ganglion (DRG) of a model of lumbar disc herniation. Methods: A lumbar disc herniated rat model was developed by implantation of the autologous nucleus pulposus, harvested from the coccygeal vertebra of each tail, on the left L5 nerve root just proximal to the DRG. Rats were tested for mechanical allodynia of the plantar surface of both hind paws 2 days before surgery and 1, 5, 10, 20 and 30 days postoperatively. Reverse transcription polymerase chain reaction (RT-PCR) was used to follow iNOS mRNA expression. To stain iNOS and TRPV1 in DRG, an immunohistochemical study was done 10 days after surgery. Results: A significant drop in mechanical withdrawal threshold on the ipsilateral and contralateral hind paws was observed 1 day after surgery and was prolonged to 30 days in rats with lumbar disc herniation. The expression of mRNA for iNOS peaked at postoperative day 10 on both sides of the DRG. iNOS-positive sensory neurons in the DRG varied in size from large to small diameter cells. A majority of small and intermediate sensory neurons were TRPV1-positive cells. Double immunofluorescence staining for TRPV1 and iNOS revealed that most intermediate TRPV1-positive sensory neurons co-localized with iNOS-positive neurons. Conclusion: Nucleus pulposus-induced mechanical allodynia can be generated without mechanical compression. This pain is related to temporal changes in expression of iNOS mRNA in the DRG. Co-localization of TRPV1 and iNOS in intermediate neurons of the DRG is correlated with pain modality and intensity.

• Investigative Magnetic Resonance Imaging
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• 제12권2호
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• pp.148-152
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• 2008

목적 : 장무지굴근 기능장애의 자기공명영상 소견을 알아보고, 이 질환에서 자기공명영상의 유용성을 알아보고자 하였다. 대상 및 방법 : 1992년부터 2003년까지 수술로 확진된 40명의 장무지굴근 기능장애 환자 중 자기공명영상을 시행한 22명, 총 24예(2명은 양측성)를 대상으로 하였다. 자기공명영상에서 장무지굴근과 장무지굴근 건의 신호강도, 장무지굴근 건초와 건초 삼출액, 발목의 골병변을 후향적으로 분석하였다. 결과 : 비특이적인 장무지굴근 건초 삼출액의 증가가 12예(50%)에서 나타났으며 다량의 건초 삼출액은 5예(21%)에서 관찰되었다. 장무지굴근 건은 모든 환자에서 정상적으로 관찰되었고, 1예(4%)에서 장무지굴근의 근건 접합부위 상방에 고신호 강도가 관찰되었으며, 거골의 골부종과 거골의 박리성골연골염이 각각 1예(4%)에서 나타났다. 결론 : 장무지굴근 기능장애 환자의 자기공명영상 소견은 비특이적 장무지굴근 건초 삼출액의 증가로 나타났다. 그러므로 장무지굴근 기능장애의 진단에 자기공명영상은 제한적인 역할을 할 것으로 생각되며, 내측 발목통증을 유발하는 건이나 골질환을 배제하는 데 도움을 줄 것으로 생각된다.

• Archives of Reconstructive Microsurgery
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• 제6권1호
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• pp.29-38
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• 1997

A peripheral nerve when approximation of the ends imparts tension at the anastomosis and with a relatively long segment defect after excision of neuroma and neurofibroma cannnot be repaired by early primary suture. The one of the optimistic reconstruction method of severed peripheral nerves is to restore tension-free continuity at the repair site putting an autogenous nerve graft into the neural gap despite of ancipating motor or sensory deficit of the donor nerve area. To overcome the deficit of the autogenous nerve graft, several other conduits supplying a metabolically active environment which is able to support axon regeneration and progression, providing protection against scar invasion, and guiding the regrowing axons to the distal stump of the nerve have been studied. An author have used ipsilateral femoral vein, ipsilateral femoral vein filled with fresh thigh muscle, and autogenous sciatic nerve for the sciatic nerve defect of around 10 mm in length to observe the regeneration pattern in rat by light and electron microscopy. The results were as follows. 1. Light microscopically regeneration pattern of nerve fibers in the autogenous graft group was more abundant than vein graft and vein filled with muscle group. 2. On ultrastructural findings, the proxial end of the graft in various groups showed similar regenerating features of the axons, myelin sheaths, and Schwann cells. The fascicular arrangement of the myelinated and unmyelinated fibers was same regardless of the type of conduits. There were more or less increasing tendency in the number and the diameter of myelinated fibers correlated with the regeneration time. 3. In the middle of the graft, myelinated nerve fibers of vein filled with muscle group were more in number and myelin sheath was thinner than in the venous graft, but the number of regenerating axons in autogenous nerve graft was superior to that in both groups of the graft. The amount of collagen fibrils and amorphous materials in the endoneurial space was increased to elapsed time. 4. There was no difference in regenerating patterns of the nerve fibers of distal end of the graft. The size and shape of the myelinated nerve fbers were more different than that of proximal and middle portion of the graft. From the above results, the degree of myelination and regenerating activity in autogenous nerve is more effective and active in other types of the graft and there were no morphological differences in either ends of the graft regardless of regeneration time.