• 제목/요약/키워드: treatment methods

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GFRP 보강근의 설계 인장강도 발현을 위한 적정 그립시스템 개발 (Development of Optimum Grip System in Developing Design Tensile Strength of GFRP Rebars)

  • 유영찬;박지선;유영준;박영환;김금환
    • 콘크리트학회논문집
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    • 제17권6호
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    • pp.947-953
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    • 2005
  • 기존 연구자에 의해 수행된 GFRP 보강근의 인장특성치 분석을 위한 많은 시험 결과에 의하면, 현행 ASTM 규격에서 제안하는 그립을 사용하여 GFRP보강근에 대한 인장강도 시험을 할 경우, 설계용 인장강도 특성치가 충분히 발현되지 않는 것으로 보고되고 있다. 이러한 원인은 두개의 금속재 블록에 내부 홈을 성형하여 마찰저항 방식에 의해 GFRP보강근을 고정하는 것을 특징으로 하고 있는 ASTM그립은 다양한 외피조건 및 단면형상을 지니고 있는 GFRP보강근의 물리적 특성을 충분히 반영하지 못하고 있는 것에 기인하는 것으로 판단된다. 따라서 본 연구에서는 GFRP 보강근의 인장강도 특성치가 충분히 발현될 수 있도록 ASTM 그립에서의 최적의 내부 홈 치수를 도출해 내는 방법을 제안하고 시험을 통하여 입증하고자 한다. 본 연구에서 제안하는 ASTM그립에서의 내부 홈 치수에 대한 최적화 방법은 GFRP 보강근의 인장내력을 발현하기 위해 요구되는 최소한의 압축력과 평형을 이루도록 압축변형률 적합조건을 적용하여 GFRP보강근의 직경에 대해 ASTM그립의 내부 홈 직경을 조정하는 방법을 적용하였다. 본 시험에 사용된 시험편의 제작, 가력 및 측정장치의 설치 등은 nh 5806-02에서 제안하는 권고사항에 따라 실시하였다. ASIM그립의 내부 홈 직경크기를 달리하여 실시된 CFRP 보강근의 인장강도 시험결과에 의하면 측정된 인장강도 최대치는 ASTM 그립의 내부 홈 직경의 크기에 큰 영향을 받는 것으로 나타났으며, 그 중에서 본 연구에서 제안한 방법에 의해 산정된 ASTM그립을 이용한 시험결과가 가장 큰 인장강도 값을 기록하는 것으로 나타났다 따라서 본 연구에서 제안하는 방법은 GFRP 보강근의 인장강도 특성치 분석을 위한 ASTM 그립의 제작에 매우 유용할 것으로 판단된다.

두부규격 방사선 사진을 이용한 미소 시의 중안면부 연조직의 변화량 측정 (Cephalometric Evaluation of the Midfacial Soft Tissue Changes on Smiling)

  • 천강용;신동환;전원배;김수호;김유진;박형욱;조진용;윤준용;서미현;이원덕;서제덕;이호
    • Maxillofacial Plastic and Reconstructive Surgery
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    • 제34권6호
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    • pp.421-425
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    • 2012
  • Purpose: The aim of this study is to compare the soft tissue changes of the midfacial area at the repose position and the natural smiling position for the improvement of evaluation and planning in the orthognathic surgery. Methods: The total of 30 subjects, 15 male and 15 female, were included in this study. The metal point landmarks were placed at the cheek, orbital rim, subpupil, and nasal base. The movements of the landmarks were evaluated at the repose position and smiling position in the lateral and posteroanterior cephalograms. Paired t test and correlation analysis were used for the evaluation of the soft tissue changes statistically. Results: In the lateral cephalograms, the cheek point (4.49 mm in female, 4.87 mm in male) showed the most distant movement. All points presented significant movements, except the orbital rim and nasal base point in male. Cheek point presented significant positive correlation between the horizontal and vertical change in male. Subpupil point presented significant positive correlation between horizontal and vertical change in both male and female. In the posteroanterior cephalograms, the nasal base point (5.41 mm in female, 6.30 mm in male) showed the most distant movement. Subpupil point and nasal base point presented significant movements in both female and male. Nasal base point presented significant negative correlation between the horizontal and vertical change in both male and female. In the lateral and posteroanterior cephalograms, the positional changes of all points presented significant positive correlation with each other in both female and male. Conclusion: The cheek point in the sagittal view and the nasal base point in the frontal view showed the most distant movement on smile. In the sagittal view, the subpupil point and cheek point moved anteriorsuperiorly on smile. In the frontal view, the nasal base points moved laterosuperiorly on smile. In both the sagittal and frontal view, the positional changes of all point were highly correlated to each other. These results may be used in the soft tissue references for the treatment planning of the dentofacial deformity patients.

제4경추의 형태와 초경을 통한 성숙지표에 관한 연구 (Skeletal maturation associated with the fourth cervical vertebra and menarcheal timing)

  • 이규홍;황용인;김윤지;백승학;차경석;박양호
    • 대한치과교정학회지
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    • 제38권1호
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    • pp.52-59
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    • 2008
  • 본 연구는 측모 두부 규격 방사선사진을 이용하며 성장 중인 아동의 제4경추 형태를 경추 몸체부 하연의 만곡 정도에 따라 분류하고 초경의 시기와 수완부 골 성숙 단계를 평가하여, 성장 중인 아동의 골격적 부정교합의 진단 및 악정형 치료를 위한 성장 시기 평가에 제4경추의 형태 변화가 진단의 참고자료로 활용될 수 있는지를 연구하였다. 11-14세 여자 환자 중, 같은 날짜에 촬영된 측모 두부 규격 방사선사진과 수완부 방사선사진이 모두 있는 81명을 대상으로 환자의 측모 두부 규격 방사선사진상 제4경추 몸체부 하연의 만곡 정도에 따라 세 그룹으로 분류하였다. (Group A - 제4경추 몸체부 하연의 만곡 정도가 1.05 mm 이하, Group B - 제4경추 몸체부 하연의 만곡 정도가 1.05 - 2.07 mm 사이, Group C - 제4 경추 몸체부 하연의 만곡 정도가 2.07 mm 이상) 세 그룹에서 각각 제4경추 몸체부의 수직 길이, 수평 길이, 수직/수평 비율, 초경의 시기, 수완부 골 성숙 단계를 측정한 결과 다음과 같은 결론을 얻었다. 평균 수완부 골 성숙 단계는 Group A가 SMI $5.67{\pm}2.57$단계, Group B 는 SMI $8.73{\pm}2.41$ 단계, Group C 는 SMI $10.00{\pm}1.47$ 단계로 나타났다. Group A에서 Group B, Group C 로 갈수록 제4 경추의 수직 길이, 수평 길이, 수직/수평 비율, 수완부 골 성숙 단계에 있어서 각각 유의하게 더 큰 값을 보였다. 본 연구대상 아동의 평균 초경 시기는 $11.64{\pm}0.92$세를 보였다. 제4경추 몸체부 하연의 만곡 정도, 수직 길이, 수평 길이, 수직/수평 비율은 수완부 골 성숙 단계와 각각 서로 유의한 양의 상관관계를 나타냈다. 초경을 경험한 그룹이 초경을 경험하지 않은 그룹에 비해 제4경추의 수직 길이, 수평 길이, 수직/수평 비율, 수완부 골 성숙 단계에 있어서 유의하게 큰 값을 보였다. 연구 결과 측모 두부 규격 방사선사진상 제4경추 하연의 만곡 갚이가 2.07 mm 이상인 경우 성장의 완료 단계에 가까운 시기로 나타나 이 시기의 악정형적 치료는 큰 효과를 얻을 수 없을 것으로 사료된다.

인회석 박막 피복 도관과 Brain-derived neurotrophic factor(BDNF) 유전자 이입 슈반세포를 이용한 백서 좌골신경 재생에 관한 연구 (SCIATIC NERVE REGENERATION USING CALCIUM PHOSPHATE COATED CONDUIT AND BRAIN-DERIVED NEUROTROPHIC FACTOR GENE-TRANSFECTED SCHWANN CELL IN RAT)

  • 최원재;안강민;황순정;정필훈;김명진;김남열;유상배;장정원;김현만;김중수;김윤희;김성민;이종호
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • 제31권3호
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    • pp.199-218
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    • 2005
  • Purpose of Study: Peripheral nerve regeneration depends on neurotrophism of distal nerve stump, recovery potential of neuron, supporting cell like Schwann cell and neurotrophic factors such as BDNF. Peripheral nerve regeneration can be enhanced by the conduit which connects the both sides of transected nerve. The conduit maintains the effects of neurotrophism and BDNF produced by Schwann cells which can be made by gene therapy. In this study, we tried to enhance the peripheral nerve regeneration by using calcium phosphate coated porous conduit and BDNF-Adenovirus infected Schwann cells in sciatic nerve of rats. Materials and Methods: Microporous filter which permits the tissue fluid essential for nerve regeneration and does not permit infiltration of fibroblasts, was made into 2mm diameter and 17mm length conduit. Then it was coated with calcium phosphate to improve the Schwann cell adhesion and survival. The coated filter was evaluated by SEM examination and MTT assay. For effective allogenic Schwann cell culture, dorsal root ganglia of 1-day old rat were extracted and treated with enzyme and antimitotic Ara-C. Human BDNF cDNA was obtained from cDNA library and amplified using PCR. BDNF gene was inserted into adenovirus shuttle vector pAACCMVpARS in which E1 was deleted. We infected the BDNF-Ad into 293 human mammary kidney cell-line and obtained the virus plaque 2 days later. RT-PCR was performed to evaluate the secretion of BDNF in infected Schwann cells. To determine the most optimal m.o.i of BDNF-Ad, we infected the Schwann cells with LacZ adenovirus in 1, 20, 50, 75, 100, 250 m.o.i for 2 hours and stained with ${\beta}$-galactosidase. Rats(n=24) weighing around 300g were used. Total 14mm sciatic nerve defect was made and connected with calcium phosphate coated conduits. Schwann cells$(1{\times}10^6)$ or BDNF-Ad infected Schwann cells$(1{\times}10^6)$ were injected in conduit and only media(MEM) was injected in control group. Twelve weeks after surgery, degree of nerve regeneration was evaluated with gait analysis, electrophysiologic measurements and histomorphometric analysis. Results: 1. Microporous Millipore filter was effective conduit which permitted the adhesion of Schwann cells and inhibited the adhesion of fibroblast. We could enhance the Schwann cell adhesion and survival by coating Millipore filter with calcium phosphate. 2. Schwann cell culture technique using repeated treatment of Ara-C and GDNF was established. The mean number of Schwann cells obtained 1 and 2 weeks after the culture were $1.54{\pm}4.0{\times}10^6$ and $9.66{\pm}9.6{\times}10^6$. 3. The mRNA of BDNF in BDNF-Ad infected Schwann cells was detected using RT-PCR. In Schwann cell $0.69\;{\mu}g/{\mu}l$ of DNA was detected and in BDNF-Adenovirus transfected Schwann cell $0.795\;{\mu}g/{\mu}l$ of DNA was detected. The most effective infection concentration was determined by LacZ Adenovirus and 75 m.o.i was found the most optimal. Conclusion: BDNF-Ad transfected Schwann cells successfully regenerated the 14mm nerve gap which was connected with calcium phosphate coated Millipore filter. The BDNF-Ad group showed better results compared with Schwann cells only group and control group in aspect to sciatic function index, electrophysiologic measurements and histomorphometric analysis.

생발음(生髮飮)-II 피부도포가 C57BL/6 마우스의 육모촉진에 미치는 효과 (Study on Effect of Saengbal-eum-II(Shēngfà-yĭn-II)on Hair Regrowth Promotion in C57BL/6 Mice)

  • 한애리;손낙원;정석희;김성수;송미연
    • 한방재활의학과학회지
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    • 제19권4호
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    • pp.95-113
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    • 2009
  • Objectives : Saengbal-eum-II($Sh{\bar{e}}ngf{\grave{a}}-y{\breve{i}}n-ll$) is a hair care product which is composed of ten plant extracts used in oriental medicine. This study was carried out to investigate the effects of Saengbal-eum-II($Sh{\bar{e}}ngf{\grave{a}}-y{\breve{i}}n-ll$) on hair regrowth and cytokine changes in a shaving model of C57BL/6 mice. Materials and Methods : Five-week-old mice were acclimated for 1 week at a temperature between $21-23^{\circ}C$, 40-60% relative humidity, and 12h of a light/dark cycle before beginning of the experiment. There were three experimental groups including 50% ethanol (EtOH, control), a positive control of 3% Minoxidil, and 30% Saengbal-eum-II($Sh{\bar{e}}ngf{\grave{a}}-y{\breve{i}}n-ll$) in 50% ethanol in 18 female mice. The test compounds were topically treated once a day over 12 days. The hair regrowth was photographically and histologically determined during the experimental period of 12 days. Revelation of EGF, $TGF-{\beta}1$ and IL-6 in hair follicle were also determined using immunohistochemistry. In addition to that, IL-6, $TNF-{\alpha}$, and $IL-1{\beta}$ in skin tissue were determined using enzyme-linked immunosorbent assay(ELISA). Results : Hair regrowth in 3% Minoxidil and Saengbal-eum-II($Sh{\bar{e}}ngf{\grave{a}}-y{\breve{i}}n-ll$) groups was promoted earlier and faster than the control group. Concentrations of hairs and thick-hair ratio in 3% Minoxidil and Saengbal-eum-II($Sh{\bar{e}}ngf{\grave{a}}-y{\breve{i}}n-ll$) groups were promoted than the control group. EGF was moderately positive in hair follicle of 3% Minoxidil and Saengbal-eum-II($Sh{\bar{e}}ngf{\grave{a}}-y{\breve{i}}n-ll$) groups, but negative in the control group. $TGF-{\beta}1$ was not significantly difference between the groups. IL-6 in hair follicle of Saengbal-eum-II($Sh{\bar{e}}ngf{\grave{a}}-y{\breve{i}}n-ll$) group was negative, but weakly positive in 3% Minoxidil and control group. IL-6 and $IL-1{\beta}$ in skin tissue were significantly decreased in Saengbal-eum-II($Sh{\bar{e}}ngf{\grave{a}}-y{\breve{i}}n-ll$) group, but there was not significantly decreased in 3% Minoxidil and control group. $TNF-{\alpha}$ in skin tissue was significantly decreased in 3% Minoxidil and Saengbal-eum-II($Sh{\bar{e}}ngf{\grave{a}}-y{\breve{i}}n-ll$) groups. Conclusions : These results suggest that Saengbal-eum-II($Sh{\bar{e}}ngf{\grave{a}}-y{\breve{i}}n-ll$) has hair growth promoting activity and it can be used for treatment of alopecia. And these effects relate to EGF revelation of hair follicle and a decrease IL-6, $TNF-{\alpha}$, and $IL-1{\beta}$ in skin tissue.

백서 두개골 결손부에서 홍화씨 추출물의 골조직 재생 유도 효과 (The Effect of Safflower Seed Extract on the Bone Formation of Calvarial Bone Model in Sprague Dawley rat)

  • 김성태;전길자;임소형;조규성;김종관;최성호
    • Journal of Periodontal and Implant Science
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    • 제30권4호
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    • pp.835-852
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    • 2000
  • The ultimate goal of periodontal therapy is the regeneration of periodontal tissue and repair of function. For more than a decade there have been many efforts to develop materials and methods of treatment to promote periodontal wound healing. Recently many efforts are concentrated on the regeneration potential of material used in oriental medicine. In some in vitro and in vivo experiments, there have been many evidences that these materials have an effect on bone regeneration. The purpose of this study was to evaluate histologically and radiologically in Sprague-Dawley rats the effects of safflower seed extracts on the regeneration of the calvarial defects surgically produced. So in this study, the critical size defects were surgically produced in the calvarial bone of 30 Sprague-Dawley rats using the 8mm trephine bur. The safflower seed extract was applied into the defect of each rat in experimental group, whereas nothing was applied into the defect of each rat in control group. Rats were sacrificed at 2, 4, 8 weeks following operation and histomorphometric and radiodensitometric analysis were performed. 1. The newly formed bone length was $102.91{\pm}22.05$, $178.29{\pm}24.40$ at 2 week in the each control, experimental group, $130.95{\pm}39.24$, $242.62{\pm}50.33$ at 4 week and $181.53{\pm}76.35$, $240.36{\pm}22.00$ at 8 week($unit,{\mu}m$). In the 2, 4 week, there were statistically significant difference between control and experimental group(P<0.05). 2. The newly formed bone area was $2962.06{\pm}1284.48$, $10648.35{\pm}1284.48$ at 2 week, $5103.25{\pm}1375.88$, $9706.78{\pm}1481.81$ at 4 week, $8046.02{\pm}818.99$, $12057.06{\pm}740.47$ at 8 week($unit,{\mu}m^2$). In every week, there were statistically significant difference between control and experimental group(P<0.05). 3. The radiopacity was $14.26{\pm}.33$, $25.47{\pm}4.33$ at 2 week, $20.06{\pm}9.07$, $26.61{\pm}2.78$ at 4 week, $22.99{\pm}3.76$, $27.29{\pm}1.54$ at 8 week(unit, %). In the 2 week, there was statistically significant difference between control and experimental group(P<0.05). In conclusion, the results of the present study suggest that safflower seed extract initially has an effect on the newly formed bone area, length and radiopacity when it is applied to the calvarial defect of Sprague - Dawley rat. Then. the material has an effect on newly formed bone area and length.

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백서 두개골 결손부에서 항생제를 함유한 키토산 차단막의 골재생 유도 효과 (The Bone regenerative effects of tetracycline blended chitosan membranes on the calvarial critical size defect in Sprague dawley rats)

  • 채경준;김태균;정의원;이수복;정용식;이용근;김창성;채중규;조규성;김종관;최성호
    • Journal of Periodontal and Implant Science
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    • 제35권4호
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    • pp.1019-1037
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    • 2005
  • The major goals of periodontal therapy are the functional regeneration of periodontal supporting structures already destructed by periodontal disease as well as the reduction of signs and symptoms of progressive periodontal disease. There have been many efforts to develop materials and therapeutic methods to promote periodontal wound healing. There have been increasing interest on the chitosan made by chtin. Chitosan is a derivative of chitin made by deacetylation of side chains. Chitosan has been widely studied as bone substitution and membrane material in periodontology. Many experiments using chitosan in various animal models have proven its beneficial effects. Tetracycline has been considered for use in the treatment of chronic periodontal disease and gingivitis. The aim of this study is to evlauate the osteogenesis of tetracycline blended chitosan membranes on the calvarial critical size defect in Sprague Dawley rats. An 8mm surgical defect was produced with a trephine bur in the area of the midsagittal suture. The rats were divided into five groups: Untreated control group versus four experimental group. Four types of membranes were made and comparative study was been done. Two types of non-woven membranes were made by immersing non-woven chitosan into either the tetracycline solution or chitosan-tetracycline solution. Other two types of sponge membranes were fabricated by immersing chitosan sponge into the tetracycline solution, and subsequent freeze-drying. The animals were sacrificed at 2 and 8 weeks after surgical procedure. The specimens were examined by histologic analyses. The results are as follows: 1. Clinically the use of tetracycline blended chitosan membrane showed great healing capacity. 2. The new bone formations of all the experimental group, non-woven and sponge type membranes were greater than those of control group. But, there was no significant difference between the experimental groups. 3. Resorption of chitosan membranes were not shown in any groups at 2 weeks and 8 weeks. These results suggest that the use of tetracycline blended chitosan membrane on the calvarial defects in rats has significant effect on the regeneration of bone tissue in itself. And it implicate that tetracycline blended chitosan membrane might be useful for guided tissue regeneration.

치조골 결손부 치료시 calcium carbonate와 calcium sulfate 혼합물의 임상적 효과 (The clinical effects of Calcium Sulfate combined with Calcium Carbonate in treating intrabony defects)

  • 이승범;채경준;정의원;김창성;최성호;조규성;김종관;채중규
    • Journal of Periodontal and Implant Science
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    • 제38권2호
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    • pp.237-246
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    • 2008
  • Purpose: If bone grafts and guided tissue regeneration are effective individually in treating osseous defects, then the questionis, what would happen when they are combined. Bone grafts using Calcium Carbonate(Biocoral) and Guided Tissue Regeneration using Calcium Sulfate(CALMATRIX) will maximize their advantages and show the best clinical results in intrabony defects. This study was to compare the effects of a combination of CS and CC with control treated only with modified widman flap in a periodontal repair of intrabony defects. Materials and Methods: 30 patients with chronic periodontitis were used in this study. 10 patients were treated with a combination of CS and CC as the experimental group II and another 10 patients were treated with CC as the experimental group I, and the remaining 10 patients, the control group were treated only with modified widman flap. Clinical parameters including probing depth, gingival recession, bone probing depth and loss of attachment were recorded 6 months later. Results: The probing depth changes were $3.30{\pm}1.34\;mm$ in the control group, $4.2{\pm}1.55\;mm$ in the experimental group I(CC) and $5.00{\pm}1.33\;mm$ in the experimental group II(CS+CC). They all showed a significant decrease 6 months after surgery(p<0.01). There was a significant difference(p<0.05) between the control and experimental group. However there were no significant difference(p<0.05) between the experimental group I and II. The gingival recession changes w $-1.30{\pm}1.25\;mm$ in the control group, This is a significant difference(p<0.01). However, there was a $-0.50{\pm}0.53\;mm$ change in the experimental group I(CC) and $-0.60{\pm}0.97\;mm$ in the experimental group II(CS+CC). In addition, in terms of gingival recession, there was a no significance difference(p<0.05) among the groups. The clinical attachment level changes were $2.00{\pm}1.33\;mm$ in the control group, $3.60{\pm}1.58\;mm$ in the experimental group I(CC) and $4.40{\pm}1.17\;mm$ in the experimental group II(CS+CC). They all showed a significant decrease 6 months after surgery(p<0.01). There was a significant difference(p<0.05) between the control and experimental group. However there was a no significance difference(p<0.05) between the experimental group I and II. The bone probing depth changes were $0.60{\pm}0.52\;mm$ in the control group, $3.20{\pm}1.48\;mm$ in the experimental group I(CC) and $4.60{\pm}1.43\;mm$ in the experimental group II(CS+CC). All of them showed a significant decrease 6 months after surgery(p<0.01), there was a significance difference(p<0.05) among the groups. Conclusion: Treatment using a combination of CS and CC have a potential to improve periodontal parameters in intrabony defects and More efficient clinical results can be expected in intrabony defects less than 2 walls grafted with CS and CC.

위분문부 및 식도암 환자에서 경열공 식도절제술 (Transhiatal Esophagectomy in Cardia and Esophageal Cancer)

  • 최동휘;정경원;김동헌
    • Journal of Gastric Cancer
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    • 제5권1호
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    • pp.1-9
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    • 2005
  • 목적: 현재 위분문부 및 식도암에 대한 근분 치로 원칙은 수술적 치료이며, 이에 대한 방법으로는 기존에는 주로 개흉을 요하는 McKeown술식(transthoracic esophagectomy, TTE)을 시행하였으나 최근에는 개흉술을 시행하지 않고 경열공을 통한 식도절제술(transshiatal esophagectomy, THE)도 많이 시행하고 있다. 이에 최근 본원에서 시행한 TTE와 THE의 임상 및 병리 결과를 분석하여 봄으로써 기존의 TTE에 대한 THE의 유용성에 대해 고찰해 보고자 한다. 상 및 방법: 최근 10년간 부산대학교병원에서 식도 및 위분문부암으로 진단 받고 수술적 치료를 받은 52예를 대상으로 후향적으로 자료를 수집, 분석하였다. 결과: 총 52예 중 20예에서 TTE를 32예에서 THE를 시행하였다. TTE는 중간부식도암 12예, 하부식도암 8예에서 시행되었고, THE는 중간부식도암 7예, 하부식도암 15예, 위분문부암 10예에서 시행되었다. TTE 후 식도대체장기로는 17예에서 위를, 3예에서 대장을 사용했으며, THE에서는 29예에서 위를, 3예에서 대장을 사용하였다. 술 후 합병증은 TTE를 시행한 13예(폐렴, 흉수 등 호흡기게 합병증 5예, 문합부유출 3예, 간병증 2예, 창상감염 1예, 패혈증 1예)에서, THE를 시행한 19예(문합부협착 13예, 흉수 3예, 문합부유출 1예, 창상감염 1예, 회귀후두신경마비 1예)에서 발생했다. 술 후 치료기간 동안 사망한 예는 TTE에서 1예 있었다. 수술 후 입원기간은 TTE에서 평균 25.6일, THE에서 20.6일 이었다. 결론: THE가 수술 이환율(morbidity)과 사망률(mortality)이 낮고 술식이 간편하여 시행하기가 용이하여 기존의 개흉을 통한 TTE 술식과 비교했을 때 식도절제를 요하는 대부분의 암환자들에게 유용한 술식이라 하겠다.

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위 절제술 후 발생한 위 폴립의 임상 병리학적 특징 (Clinicopathologic Evaluation of Gastric Polyps Remainding in the Stomach after a Gastrectomy)

  • 윤기영;조성진;김정훈;김영식;이상호
    • Journal of Gastric Cancer
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    • 제5권3호
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    • pp.169-173
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    • 2005
  • 목적: 위폴립은 위장에 발생하는 흔한 양성 신생물로서, 증식폴립과 샘종폴립으로 크게 나눈다. 대개의 위폴립은 증식폴립이며 아직 정확한 병인은 밝혀져 있지 않다. 샘종폴립의 경우 보통 장화생 현상을 동반한 미성숙 상피세포로 변화할 수 있어, 악성 변화를 나타낼 수 있는 것으로 알려져 있다. 따라서 샘종폴립에 비해 증식폴립에서는 악성으로 잘 이행하지 않는다고 하는, 지금까지 알려진 위폴립의 지식을 바탕으로 하여 저자들은 위절제술 후 생긴 위 폴립 병변의 특성을 알아보고자 하였다. 대상 및 방법: 1995년 1월부터 2004년 1월까지 위암으로 위절제술을 받은 환자 중 6개월 또는 1년을 단위로 하여 내시경 경과관찰을 한 환자의 잔위에서 생긴 위 폴립을 병리조직 학적 분류와 빈도, 내시경적 크기와 Yamada형 소견, 수술 방법에 따른 차이를 보이는지를 비교 관찰하였다. 결과: 전체 대상 환자는 138명, 정상 위에서 발생한 폴립은 115예, 위절제술 후에 발생한 폴립은 23예였다. 정상 위에서의 폴립의 발생 부위를 보면 전정부에서의 발생이 가장 많았으나, 위절제술 후에는 수술 후 문합부위에서 가장 높은 빈도를 보였다. 정상 위에서의 폴립의 조직학적 분류는 증식폴립 86예(75%), 샘종폴립 24예(21%), 염증폴립 4예(3%), 장피 화생 1예(0.8%)의 발생빈도를 보였다. 위절제술 후의 폴립의 조직학적 분류는 위십이지장 문합술 후 증식폴립 3예(18%), 샘종폴립 1예(6%), 염증폴립 13예(76%)였고 위공장 문합술 후 증식폴립 3예(50%), 샘종폴립 1예(17%), 염증폴립 2예(23%)였다. 위절제 수술 후 폴립의 크기는 정상 위의 폴립의 크기보다 작은 양상을 보였다. 정상 위에서 폴립의 Yamada 형태의 분류는 위절제 수술 후에는 I, IV형이 정상 위의 폴립에 비하여 적은 빈도로 생기는 양상을 보였다. 결론: 위절제 수술 후의 폴립은 수술 문합부에서의 발생빈도가 높았고, 주로 염증폴립 이 대부분을 차지하였으며, 자주 내시경 관찰을 하는 이유로 정상 위에서 보다 일찍 발견되어 크기는 작았으며, 육안적으로 폴립의 Yamada 형태의 분류는 II, III의 형태를 띠고 있었다.

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