• 대한소아치과학회지
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• 제27권3호
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• pp.388-393
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• 2000

순 구개열(cleft lip and palate)은 구강악안면 영역에서 가장 빈번하게 발생하는 선천성 기형 중 하나로 유전적, 환경적 요인에 의해 발생된다. 순 구개열 환자는 입술, 코 등의 기형을 보이며 치과적 문제점으로, 이환측 측절치는 결손되어 있거나 과잉치가 존재하고 형태적 이상을 보이는 경우가 많고, 맹출하지 못하거나 이소맹출을 하게된다. 이른 시기에 수행된 수술의 반흔조직(scar tissue)으로 인하여 상악골 성장의 장애가 발생되어 흔히 골격성 III급 부정교합이 야기되기 쉬우며, 섭식장애와 발음장애를 보이기도 한다. 이러한 복잡한 문제로 인하여 여러 분야의 전문가들로부터 다양한 관리가 필요하다. 순/구개열(cleft lip and alveolus only)은 악안면 영역에 제한적으로 영향을 미친다. 비이환측은 전방으로 회전되어 수평피개가 증가되고, 이환측은 내측으로 회전되어 견치부에서 end to end 관계, 혹은 반대교합을 보인다. 순/구개열 수술은 이와 같은 문제점 등을 개선시키기 위한 것이며, 상악골의 전후방적 성장에는 큰 영향을 미치지 않는 것으로 보고되고 있다. 본 증례는 좌측에 순/구개열을 가진 5세 3개월의 여아로 생후 3개월 및 3세에 두 번의 구순열 봉합 수술을 받았으며, 상악 좌측 유측절치와 영구측절치가 결손되어 있었고, 다발성 우식증 및 비구누공(oroantral fistula)이 존재하였으며, 골격성 3급 부정교합을 보였다. 그러나 본 증례가 지니고 있는 골격성 III급 부정교합은 구순열 수술후의 반흔조직에 의한 것은 아닌 것으로 판단되었으며, 환자의 기능과 심미성을 회복하기 위하여 혼합치열기 동안 공간관리(space supervision) 및 악기능 장치 (functional regulator)를 이용한 골격성 부정교합을 치료하였으며, 영구치열기 동안 고정성 교정치료를 시행한 후 보철 치료를 시행하여 비구누공을 key and keyway attachment와 Konus crown을 이용한 가철성 obturator로 폐쇄하여 양호한 결과를 보였다.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제13권3호
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• pp.278-290
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• 1991

Prediction of the sop tissue changes following hard tissue movements is very important in the preoperative analysis of surgical changes of the patient who have orthognathic surgery. This study examined post operative changes of the mid-facial sop tissues in Koreans depending upon two major positional changes of the maxilla following Le Fort - I type osteotomy for orthognathic purposes. Sixty patients(41 males and 19 females) of Koreans were selected and divided into two groups according to directional change of movement of anterior bony structures of the Maxilla as follows : Group I (44 patients) was mooed anteriorly and/or inferiorly, and Group II (16 patients) was mooed posteriorly and/or superioly. Postoperative changes of the sop tissue measurements following hard tissue changes were examined on pre - and post - operative cephalometrics by means of computerized digitation methods and the ratios of changes were analysed. The results were obtained as follows : 1. In Group I, all of the sop tissue measures except the Pn was closely followed by the changes of the hard tissue measures in the horizontal plane, but the Sn and the Cm were only correlated to the vertical changes(p<0.001). In group II, all of the sop tissue measures excluding of the N' and the Pn were significantly correlated to the hard tissue measures in horizontal plane(p<0.001), but the Ls and Stm were only correlated relatively to the vertical changes of the ANS(p<0.01). 2. Predictable ratio of the Sn was 66% of the ANS or 56% of the A in the horizontal plane and 89% of the A in the vertical plane in Group I. In Group II, the Sn was predictable as 85% of the ANS or 70% of the A in the horizontal plane but was not predictable in vertical plane. 3. Predictable ratio of the Cm was 28% of the ANS or 50% of the A in the horizontal plane and 56% of the ANS or 36% of the A in the vertical plane in Group I. In Group II, the Cm was predictable horizontally as 74% of the A. Predictable ratio of the Pn was 30% of the ANS or 38% of the A in horizontal plane in Group I, but it was not predictable both horizontally and vertically in Group II. 4. Predictable ratio of the Ls was 52% of the Pr in Group I and 77% in Group II in the horizontal plane. The Stm was predictable as 34% of the pr or 22% of the I in the horizontal plane in Group I, and was also predictable as 55% of the pr or 68% of the I horizontally and 21% of the pr or 65% of the I vertically in Group II. 5. All ratios of change in the thickness. length and area of the upper lip following maxillary movement were statiscally correlated, however, mangitudes of them were meaningful clinically.

• Journal of Periodontal and Implant Science
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• 제37권4호
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• pp.839-848
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• 2007

Purpose: Various kinds of biodegradable membranes are currently used in dental clinics. And the frequency and the necessity of their usage are increasing due to their numerous advantages. Therefore it is important to understand the difference of various membranes and histological reaction against implanted membranes. Materials and Methods: Biodegradable membranes of $Biogide^{(R)}$, $Resolute^{(R)}$, and $Tutodent^{(R)}$ were cut into small pieces by $1.0{\times}0.5cm$. The membranes were implanted 1.5cm apart from each other under the epithelium on the skull of 18 Sprague Dawley rats. The animals were sacrificed at 3, 7, and 14 days after surgical procedure. The specimens were examined by histological analysis. Results: 1. Early period after implantation of the membranes showed connective tissues surrounding membranes and there were a few inflammatory cells present. 2. In $Biogide^{(R)}$ and $Tutodent^{(R)}$ specimens, inflammatory cells and surrounding tissues were shown to infiltrate from outside with slight density difference inside. In $Resolute^{(R)}$ specimens, membranes were fragmented. Inflammatory cells and connective tissues were also observed inside. 3. In $Resolute^{(R)}$ specimen, giant cells were present which implicates that foreign body reaction has occurred. 4. $Biogide^{(R)}$ had lower integrity than other membranes and is not enough to be used alone in defect area. However, $Resolute^{(R)}$ had superior firmness than others. $Tutodent^{(R)}$ had middle level of integrity. Conclusion: This experimental model enabled to observe early inflammatory reactions and morphological changes of materials and can be used to develop and evaluate the efficacy of biodegradable membranes. Duplication of standardized human oral environment will be required in future experiments.

• Journal of Korean Biological Nursing Science
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• 제3권1호
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• pp.41-52
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• 2001

This study was undertaken to investigate the effects of n-6(corn oil) & n-3(fish oil) fatty acids on infarction size and the cerebral activities of antioxidant enzyme in rat focal brain ischemia model. Weaning Sprague-Dawley rats were fed with either corn oil supplemented diet(COD, 14% corn oil) or fish oil supplemented diet(FOD, 14% menhaden oil) for 6 weeks. The right middle cerebral artery was occluded for 2 hours with a silicon rubber coated nylon surgical thread. After 24 hours of recirculation, the rats were sacrificed and brain sections were photographed using CCD camera after staining with 2, 3, 5-triphenyltetrazolium chloride for 60 minutes in room temperature. The infarcted area was measured and the volume of infarction was calculated. Catalase(CAT), superoxide dismutase(SOD) activities, and fatty acid composition in the brain were also measured. The total and corrected infarction volumes were not significantly different between FOD and COD group. The docosagexaenoic acid(DHA) and DHA content/arachidonic acid(AA) ratio of the cerebral cortex, an index of defense against lipid oxidation, were significantly increased in FOD group compared to those of COD group(p<0.05). In the left cortex(non-infarction side) as well as the right cortex(infarction side) of FOD group, CAT and Cu/Zn SOD activities were higher than those of the COD group(p<0.05). However, CAT and Cu/Zn SOD activities were not significantly different between the left cortex(non-infarction side) and the right cortex(infarction side) of both FOD and COD group. GPx activities were also not significantly different between two groups. Our results demonstrate that the brain infarction size in FOD and COD were not significantly different. However, cerebral lipid composition and antioxidant enzyme activities in FOD and COD group were different. Fish oil, a source of n-3 polyunsaturated fatty acid(PUFA) and corn oil, that of n-6(PUFA) may have a protective effect against oxidative stress induced via different mechanisms.

• 대한의용생체공학회:의공학회지
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• 제29권1호
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• pp.32-39
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• 2008

This paper reports on a realtime OS based master-slave configuration robot control system for laparoscopic surgery robot which enables telesurgery and overcomes shortcomings with conventional laparoscopic surgery. Surgery robot system requires control system that can process large volume information such as medical image data and video signal from endoscope in real-time manner, as well as precisely control the robot with high reliability. To meet the complex requirements, the use of high-level real-time OS (Operating System) in surgery robot controller is a must, which is as common as in many of modem robot controllers that adopt real-time OS as a base system software on which specific functional modules are implemened for more reliable and stable system. The control system consists of joint controllers, host controllers, and user interface units. The robot features a compact slave robot with 5 DOF (Degree-Of-Freedom) expanding the workspace of each tool and increasing the number of tools operating simultaneously. Each master, slave and Gill (Graphical User Interface) host runs a dedicated RTOS (Real-time OS), RTLinux-Pro (FSMLabs Inc., U.S.A.) on which functional modules such as motion control, communication, video signal integration and etc, are implemented, and all the hosts are in a gigabit Ethernet network for inter-host communication. Each master and slave controller set has a dedicated CAN (Controller Area Network) channel for control and monitoring signal communication with the joint controllers. Total 4 pairs of the master/slave manipulators as current are controlled by one host controller. The system showed satisfactory performance in both position control precision and master-slave motion synchronization in both bench test and animal experiment, and is now under further development for better safety and control fidelity for clinically applicable prototype.

• Archives of Plastic Surgery
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• 제36권5호
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• pp.559-564
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• 2009

Purpose: Surgical reconstruction of an ischial soft tissue defect presents a challenging problem owing to a high rate of recurrence, especially paraplegic patients. Although various muscle, musculocutaneous and fasciocuta - neous flaps have been used in the reconstruction of ischial soft tissue defect, it is still debated which type of flaps are the best. We had performed a relatively durable adductor magnus perforator island flap based on the perforators originated from the first medial branch of the profunda femoris artery for coverage of ischial soft tissue defect where was not a region universally reconstructed by perforator flap. Methods: From August 2005 until January 2008, the adductor magnus perforator island flap had been used for resurfacing of the ischial soft tissue defects in a series of 6 patients (4 male and 2 female). Ages ranged from 26 to 67 years (mean, 47.5 years), and follow - up period from 13 to 26 months (mean, 16.7 months). Causes were 4 pressure ulcers, 1 cellulitis and 1 suppurative keratinous cyst. Results: The sizes of these flaps ranged from 12 to 18 cm in length and 7 to 9 cm in width. The flaps survived in all patients. Marginal loss over the distal area of the flap by infection was noted in one patient, which was treated successfully with a subsequent split - thickness skin graft. Average thickness of the flap was 0.94 cm, which was more thicker than other perforator flaps. Long term follow - up showed a good flap durability. Conclusion: In planning a reconstructive option of ischial soft tissue defect, the adductor magnus perforator island flap is a relatively large cutaneous flap with a durable thickness. With proper patient selection, careful vascular dissection and postoperative management, we recommend this flap is a good and suitable option for coverage of the ischial soft tissue defect.

• Journal of Chest Surgery
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• 제30권6호
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• pp.598-606
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• 1997

1994년 9월부러 1995년 8월까지 일년동안 부천 세종병원에서 시행된 승모판막질환 수술은 총 136례였으 며 이중 인공판륜을 사용하여 판막성형술을 시행된 44례를 대상으로 평가하였다 이 44례의 평균 연령은 38.2세(범위: 5세~63세)였으며 남성이 18례 여성이 26례였다, 사용된 인공판륜은 Carpentier ring이 32례, Dmm ring 이 12례였다. 판막질환의 원인은 류마치스가 30례(68%), 퇴행성 질환에 기인한 것이 13례(30%)였으며, 1례는 선천성 승 모판 부전증이었다. 판막질환의 형태로 보면 승모판막부전증이 33례(76%),승모판 협착증이 2 례(5%), 승모판 협착부전증이 9례(19%) 있었다. Carpentier의 기능적 분류는 I형이 5례(11%), II형이 24례(55%), III형이 4례(9%) 있었으며, II형과 III형의 혼합형이 11례(25%)에서 관찰되었고, 매 환자당 평균 3.7가지의 병변이 있었다. 승모판에 시행한 수술 수기는 전례에서 인공판륜성형술을 시행하였으며 한 환자 당 평균 3.4가지의 수기 를 사용하였다. 수술 사망은 2례에서 발생하였으며, 수술 후 승모판 부전증이 진행되어 2주에 시행한 재수술이 일 례 있 었다. 12개월의 추적 관찰에서 수술 전후의 NYHA 기능적 鈞畢\ulcorner평균 3.0에서 1.3으로 개선되었다. 심장 초음파 검사에서 술후의 승모판 면적은 2.07$\pm$0.11 cm2(평균 $\pm$ 표준오차)이었으며, 좌심실 수축력의 호전을 보였고, 판막부전의 정도는 전혀 판막부전 소견이 없어진 경우가 23례(53%), 경미한 폐쇄부전이 있는 경우가 18례(42%)였고, II도 부전의 소견을 보인 례가 2례(5%) 있었다.

• Journal of Trauma and Injury
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• 제20권1호
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• pp.52-56
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• 2007

Marjolin's ulcer is a rare and often-aggressive cutaneous malignancy that arises in previously traumatized or chronically inflamed skin, particularly after burns. We experienced two cases after burns. Case I involved a forty eight year-old man who had suffered from a flame burn at the parietal scalp area, where had been initially described three years earlier as a full-thickness wound including the pericranium. The man consulted us for a persistent ulcerative and infected wound on the burned lesion during the last 24 months, which turned out on the contrast-enhanced computed tomography (CT) and magnetic resonance imaging (MRI) to be the squamous cell carcinoma with involving the skull and the dura mater. Although the posterior auricular lymph node was enlarged on the ipsilateral side, recent positron emission tomography (PET) CT did not show any metastatic lesion. It was impossible for us to resect the intracranial involvement of the tumor radically, and the postoperative PET CT still showed a focal fluorodeoxyglucose (FDG) uptake around the wall of the superior sagittal sinus. We think that an aggressive combined approach is essential for treatment in early stages for a high success rate, before the intracranial structures are involved because there is no consensus on the treatment for advanced disease, and the results are generally poor. Case 1 also did not involve a radical resection because of the intracranial invasion to the wall of superior sagittal sinus and the possibility of damage to the major cortical veins. He received adjuvant radiotherapy and must be followed periodically. Case 2 involved an eighty six year-old women who suffered from a painful scalp ulcer lesion after flame burns three years earlier. Unlike case 1, neither tumor infiltration into the dura nor lymph node enlargement was observed on the contrast-enhanced computed tomography (CT), magnetic resonance imaging (MRI), or positron emission tomography (PET) CT. We did a radical resection of the tumor, including the involved bone, and a cranioplasty with bone cement.

• Journal of Preventive Medicine and Public Health
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• 제34권4호
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• pp.331-336
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• 2001

Objectives : To assess the prevalence of knee osteoarthritis through proper diagnosis in a rural community and to elucidate the relevant factors of this health problem in order to develop educational methods for the prevention of female knee osteoarthritis as well to provide basic data for prospective research. Methods : Over a period of three months starting from August, 2000, 432 women over the age of 40 and living in a rural area were selected by a multistage cluster sampling method in order to investigate the prevalence of knee osteoarthritis and the related factors. The study utilized interviews and radiological examination. The criteria of knee osteoarthritis used was the American College of Rheumatology classification criteria for osteoarthritis of the knee(1995). Results : The adjusted prevalence of knee osteoarthritis among the subjects was 55.0%, and multiple logistic regression analysis showed that the odds ratio(OR) of knee osteoarthritis among subjects 50-59 years of age and subjects older than 60 years of age as compared to subjects 40-49 years of age were 2.43(95% CI: 1.30-4.70) and 4.40(95% CI: 2.47-7.83), respectively. The OR of knee osteoarthritis among factory workers or farmers as compared to others was 1.79(95% CI: 1.03-3.12). The OR of knee osteoarthritis among subjects who had a family history and subjects who had knee injury or surgical history against those subjects had neither were 2.56(95% CI: 1.42-4.03) and 4.70(95% CI:1.45-15.19), respectively. The OR of knee osteoarthritis among smokers against non smokers was 0.47(95% CI: 0.22-0.97). Conclusions : Related factors of knee osteoarthritis included age, occupation, family history, smoking, knee injury and history of surgery In order to prevent knee osteoarthritis in high risked rural woman, education concerning self-care methods and safety guideline must be provided at the work place by the public and private health sectors. Additionally, these women should be continually encouraged to exercise, including jogging and swimming regularly.

• 대한관절경학회지
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• 제13권2호
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• pp.179-182
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• 2009

목적: Bankart병변에서 봉합나사못을 이용한 관절경적 치료는 관절와 가장자리에 점고정(point fixation)을 하여, 관절와 골 결손시에 적절한 부착부 족문(foot print)치유를 이루지 못한다는 한계점이 있다. 이에 본 저자들은 골성 Bankart병변에서 나사못 고정으로 인한 점접촉의 단점을 피하고 관절순의 교차압박을 통해 기계적 안정성을 개선시킬수 있는 경골-유사 교량형 봉합술식을 소개하고자 한다. 수술 술기: 본 술식은 교량형 봉합술식을 통한 경 골-유사 회전근개 봉합술에서 응용되었으며, 이는 부착부 족문과 건 사이 평균압력과 압력이 가해지는 접촉면적을 개선시킨다. 골성 Bankart 병변의 경우 관절와 부착부의 돌출된 골병변은 제거하거나 다듬어주며, 골편이 가동성이 있는 경우 관절순과 함께 분리시킨다. 이후 2개의 나사못(3.0 mm Biofastak, $Arthrex^{(R)}$, Naples, FL)을 골성 Bankart병변 위, 아래 부위의 내측 연에 삽입한다. 관절와를 적당한 두께로 덮을수 있도록 하 상완관절와인대 부근 관절낭순의 내측에 봉합갈고리를 이용하여 봉합사를 각각 통과시켜 mattress봉합을 시행한다. 교량형 봉합을 위해서, 전방 관절와연의 관절측 가장자리에 3.5 mm pushloc 나사못 ($Arthrex^{(R)}$, Naples, FL) 구멍을 만든 후 먼저 원위 교량형 봉합을 시행하고, 이어 근위 교량형 봉합을 시행함으로써 근위방향으로 관절순을 가동시킬 수 있다. 본 술식은 나사못 고정으로 인한 점 접촉의 기술적 단점을 피하고 관절순 교차압박을 통해 간격형성을 감소시킬수 있는 이점이 있다.