치과 임플란트 식립을 위한 드릴링시 발생하는 열의 직접 측정

학위논문 (박사) -- 서울대학교 대학원 : 치의학대학원 치의과학과, 2021. 2. 안진수.The aim of present study is to evaluate the heat production directly when performing osteotomy for implant placement. We made a comparison the values that were acquired through this study with the other from the former studies. A specially designed bur was manufactured and applied for the present study. A thermosensor was installed inside the drill which is made of stainless steel utilizing a 18-gauge needle and mercury containing slip ring. In addition, three thermocouples were placed into the artificial bone model with various depth of 10mm, 5mm, and 1mm. The location of the thermocouples inside the bone was as close as of 0.5mm from the lateral margin of the osteotomy site. The diameter of the drill was 3.4mm. Rotational speed of the drill was ranged from 500rpm to 2000 rpm. The experiment of drilling was repeated 10 times, and the average was analyzed. The temperature measured from the inside of the drill surged up very quick, and the temperature inside the bone achieved its highest peak when the measured temperature from the drill initiate to drop. The maximum inner temperature observed from the bone model was at the depth of 10mm. The trends of the temperature alteration shared similarity regardless of the drilling speed. Present study elucidates that there is significant discrepancy between the highest temperature measured from the drill and the temperature inside the bone, the value observed from the former is much higher than the latter.본 연구의 목적은 임플란트 식립을 위해 드릴링을 시행할 때 발생하는 열을 직접적으로 측정하는 것이다. 실험을 통해 측정된 온도는 치조골 내에서 측정되었던 방식으로 이전에 수행되었던 연구에서의 온도와 비교 하였다. 드릴의 온도변화는 18게이지 needle과 수은을 포함하는 slip ring을 사용하여 스테인리스 스틸 드릴의 내부에 열-센서를 삽입하는 방식으로 측정하였다. 그리고 세개의 추가적인 열-센서를 치조골 모델 에 삽입시켰고 각각 10 mm, 5 mm, 1 mm 등의 다른 두께로 치조골 모 델에 위치시키도록 하였다. 열-센서들은 드릴 직경 3.4 mm로 치조골 모델에 형성된 구멍과 수평적으로 0.5 mm 떨어져 위치하도록 하였다. 30 드릴의 회전 속도는 500 rpm 1200 rpm, 2000 rpm 등으로 다양하게 회 전시키도록 하였다. 각각의 드릴링 시술은 10 회씩 반복하여 그 평균을 계산하였다. 드릴에서 측정된 온도는 드릴링 시작 후 급작스럽게 증가하 였고 드릴의 온도가 감소하기 시작한 후에 치조골 모형에 삽입된 열센서 에서 측정된 온도가 최대치에 도달하였다. 깊이에 따른 온도변화를 보면 깊이 10 mm에서 치조골 모델에서 측정된 수치 중에서 최대치를 보였다. 치조골 모델에서의 드릴링 시 온도 변화의 추세를 보면 다양한 드릴 회 전수에도 열변화의 패턴은 증가했다가 최대치에 다다르고 서서히 감소하 는 형태로 유사한 양상을 보였다. 실제 이번 연구에서 측정된 드릴과 치 조골 모델 계면에서의 최대 온도는 골 내부에서 측정을 시행한 이전 연 구들에서 보고된 측정 수치들 보다 유의하게 높게 측정되었다.1. Introduction 1 2. Material and Methods 4 2.1. Themosensor located in bone for the heat evaluation 4 2.2. Themosensor located in contact with the proximal end of the drill for the heat evaluation 4 2.3. Rotating themosensor in complete-contact with the drill for the improved heat evaluation 5 2.4. Equipment set up 7 2.5. Statistical Analysis 8 3. Results 10 4. Dicussion 16 5. Conclusion 22 6. References 23 7. Korean Abstract 29Docto

Hinman Syndrome: Long Term Follow up of 14 Cases

Purpose Hinman syndrome is the most severe form of nonneurogenic neurogenic bladder causing damage of the upper urinary tract. Fourteen patients with Hinman syndrome followed at our institution were evaluated for their clinical characteristics and prognosis. Here we report the findings of this series of patients for this poorly understood syndrome. Materials and Methods The medical records of 14 patients, 8 boys and 6 girls, diagnosed with Hinman syndrome from March 1993 to June 2006 were reviewed. The mean duration of follow up was 69 months. The ultrasonography, 99m Tc-dimercaptosuccinic acid renal scan (DMSA), voiding cystourethrogram (VCUG), and urodynamic study (UDS) results were retrospectively analyzed and efficacy of each treatment method was evaluated based on the medical records on follow up. Results Hydronephrosis of grade III or greater on ultrasonography and renal scarring of both kidneys on the DMSA renal scan were observed in 12 and 14 patients, respectively. Severe bladder trabeculation and high grade VUR (IV, V) were observed on the VCUG in 14 and 8 patients, respectively. Decreased bladder compliance on the UDS was noted in 13 and detrussor-sphincter dyssynergia (DSD) was observed in eight. Medical treatment was not effective in all 14 cases and six patients who underwent botulinum injection of the bladder were unresponsive to that treatment as well. In spite of conservative treatments such as clean intermittent catheterization (CIC), seven patients eventually underwent bladder augmentations after a mean period of thirty-seven months from diagnosis because of concern about the loss of bladder capacity and renal function. One patient who did not perform CIC progressed to end-stage renal disease and had to be transferred to pediatric nephrology for dialysis. Conclusions Patients diagnosed with the Hinman syndrome were treated similar to patients with neurogenic bladder. However, from the long-termfollow up data at our outpatient clinic, many patients eventually had bladder augmentation to prevent further loss of bladder capacity and renal function. Therefore, urologists must not hesitate in performing such treatment when necessary.ope

Association between CCR5 Promoter Polymorphisms and Hepatitis B Virus Infection

Background/Aims: Immunogenetic factors may play a role in determining the susceptibility of an individual to viral infection. CCR5 promoter polymorphisms are known to be associated with HIV infection. However, there has been no report on the association between CCR5 promoter polymorphism and HBV infection. Therefore, we investigated the relationship between the CCR5 promoter polymorphism and HBV infection. Methods: A total of 377 patients were classified into two groups according to their HBV infection status: ① the spontaneous clearance group (SC); HBsAg (-), anti-HBc (+), anti-HBs (+) ② the chronic HBsAg (+) carrier group (CC); HBsAg (+), anti-HBc (+), anti-HBs (-). CCR5 polymorphisms were detected by employing matrix-assisted laser desorption/ionization time of flight mass spectrometry (MALDI-TOF MS)-based SNP scoring assay, termed Restriction Fragment Mass Polymorphism (RFMP), which exploits the differences in molecular masses between the common allele and rare allele bases of interest. Results: We found that the genotype frequencies of CCR5 A59029G significantly differed between the SC group (n=138) and CC group (n=239) (P<0.05). The CCR5 59029A allelic genotype was associated with an increased risks of chronic infection rather than spontaneous clearance (P=0.002), and the presence of the CCR5 59029G allele was significantly associated with the spontaneous clearance of HBV (P=0.001). Strong linkage disequilibrium between the CCR5-59029 and the CCR5-59353 polymorphic variants was identified. None of the 377 subjects had the CCR5-32 bp deletion mutation. Conclusions: The CCR5 promoter polymorphisms at position 59029 might play a role in the clearance of HBV infection. This primary experimental evidence needs further studies to clarify the clinical usefulness of CCR5 promoter polymorphisms as a target for the screening or treatment of HBV infection.ope

Recombinant interferon-Beta-1alpha plus ribavirin for the treatment of chronic HCV infection: a prospective, randomized, comparative pilot study

BACKGROUND/AIMS: Interferon beta (IFN-beta) has been shown to have antiviral activity, and thus could be useful in treating viral infections. Therefore, we compared the efficacy and safety of recombinant IFN-beta (IFN-beta-1a) plus oral ribavirin versus interferon alpha (IFN-alpha) plus ribavirin therapy for the treatment of chronic hepatitis C (HCV). METHODS: Twenty treatment-naïve patients were randomized into two equal-sized treatment groups. Both IFN-beta-1a (44 microg) and IFN-alpha (3 MIU) were given subcutaneously three times a week, while ribavirin was given orally at 1,000-1,200 mg/day. Patients were treated for 24 weeks and followed for an additional 24 weeks. RESULTS: After 24 weeks of treatment, six (60%) and four patients (40%) in the IFN-beta-1a group and IFN-alpha groups, respectively, achieved viral clearance. The sustained virological response (SVR) at the end of the observation period was similar in both groups (40%). However, the baseline viral load was significantly higher (p=0.034) in the IFN-beta-1a group than in the IFN-alpha group, and there were more HCV genotype 1 patients in the IFN-beta-1a group (eight versus seven). The IFN-beta-1a group was associated with similar adverse events in terms of frequency and severity. CONCLUSIONS: The SVR rate and safety profile were similar for the combination of IFN-beta-1a and ribavirin and that of IFN-alpha and ribavirinope

Perirenal Fat Invasion(pT3a) in Renal Cell Carcinoma Less Than 4cm in Size(cT1a): Analysis of the Prognostic and Pathological Implications

Purpose: To investigate the incidence and histopathological factors of perirenal fat invasion (pT3a) in cT1a renal cell carcinomas. The implication for postoperative perirenal fat invasion, as a prognostic factor in patients with tumors less than 4cm tumor in size is also discussed. Materials and Methods: Of 503 patients who underwent an operation for a renal cell carcinoma at our institution, between June 1995 and April 2004, we retrospectively reviewed the records of 176 with T1a renal cell carcinomas. We evaluated the pathological grade, cell type, tumor size, location and incidence of perirenal fat invasion using the Fisher's exact test. The overall survival was estimated using the Kaplan-Meier method and log-rank test, and the prognostic factors influencing the survival were estimated using the Cox proportional hazard regression model. Results: In this study, a radical nephrectomy was performed in 128 men and 48 women, with a mean age of 54.6 years, ranging from 23 to 77. The mean follow-up was 31.3 months, ranging from 6 to 106 months. The average size of the renal cell carcinomas was 3.0cm, ranging from 1 to 4cm. The incidence of perirenal fat invasion in the T1a renal cell carcinomas was 5.7% (n=10). The nuclear grade (p<0.001) was a statistically significant factor in the incidence of postoperative perirenal fat invasion. Conclusions: In the patients with a renal cell carcinoma less than 4cm in size (cT1a), those in the postoperative perirenal fat invasion group had a significantly poorer prognosis. The tumor size and Fuhrman nuclear grade were implicated in the incidence of perirenal fat invasion in the T1a renal cell carcinomas. Therefore, in the case of nephron sparing surgery, more precise preoperative staging of the primary tumor is required.ope

Ovarian Cystadenofibroma in a Patient with Familial Adenomatous Polyposis

Familial adenomatous polyposis (FAP) is a hereditary disease characterized by the appearance of numerous polyps in the large bowel with a high potential for malignant transformation unless untreated. A variety of extracolonic manifestations were reported such as osteoma, epidermoid cyst, desmoid tumor, gastroduodenal polyps, small bowel tumor, congenital hypertrophy of the retinal pigment epithelium, hepatobiliary tumor, thyroid tumor, and tumor of 12 the central nervous system. However, the ovarian involvement of FAP as an extracolonic manifestation was very rare and there have been only few reports. We experienced a rare case of ovarian cystadenofibroma in a patient with FAP as an extracolonic manifestation. We also found colon cancer with multiple hepatic metastasis initially manifested as intestinal obstruction in the same patient. Surgical treatment and subsequent chemotherapy for colon cancer and intraoperative radiofrequency ablation of hepatic metastasis were 15 performed.ope

TRPV1 길항제 구조활성 연구 : 2-(4-Methansulfonylaminophenyl) Propanamide 계 및 6-5 Fused Heterocyclic Urea/Propanamide 계 유도체 연구

TRPV1(Transient Receptor Potential Vanilloid 1)은 통각 자극의 분자 매개체로써 무 수초 통각 감각 신경 섬유인 C-fiber 와 small A-delta fiber 에 발현하는 수용체이다. TRPV1은 다양한 외인성 인자(vanilloid such as Capsaicin and Resiniferatoxin, 42℃ 이상의 열 등)와 내인성 인자(낮은 pH, anandamide, arachidonic acid 대사체, bradykinin, ATP, NGF와 같은 pro-nociceptive 대사체 등)의 물리적, 화학적 자극에 의해 활성화 되는 비선택적인 양이온 채널이다. 특히 높은 Ca2+ 의 투과를 하여 이온 채널이 활성화 되고, 이 활성화는 세포 내에 Ca2+ 의 양이 증가되며 일차 감각 신경(primary sensory neurons)의 흥분을 야기 시켜 결국 통증을 인지하게 된다. TRPV1 수용체는 여러 조직의 신경 섬유에 존재하는데 DRG neuron 에 가장 많이 분포하며 척수에서도 발견되고 시상하부, 해마, 흑색질 등 뇌에서도 많이 분포되어 있으며 신장, 방광 등에서도 발견된다. TRPV1 수용체는 다양한 통증의 통합자로써 뿐만 아니라 통증의 전달과 modulation 의 역할이 알려지고 있으며, 이 작용을 길항하는 기전의 화합물들이 진통제로 개발되는 연구가 활발히 진행되고 있다. 더 나아가 선택적으로 중추신경계의 혈액 뇌관문(Blood Brain Barrier)에 통과가 가능한 TRPV1 수용체 길항제의 개발은 새로운 통증학적 치료로 기대되고 있다. 본 연구실은 2-(4-Methansulfonylaminophenyl) Propanamide 계열의 유도체들을 합성하여 TRPV1 길항효과를 갖는, 진통제로써 가능성 있는 약물을 찾는 연구를 수행하였다. 그리고 다국적 제약회사인 아보트 (Abbott Inc.) 사에서 도출한 화합물 ABT-102 의 A-region 인 indazole 의 구조변환을 하여 새로운 A-region 을 설계 하였다. 이 설계를 기초로 본 연구실은 A-region 에 다양한 6-5 Fused Heterocyclic 화합물을 (indole, benzimidazole, benzotriazole, benzoxazole, benzothiazole) 합성하였고, 구조-활성 관계를 연구하였다. 특히 6개의 화합물이 2 nM 이하의 강력한 TRPV1 antagonism 을 나타내었고, 진통제로써 가능성 있는 약물 후보 물질을 본 연구를 통해 발견하였다.The transient receptor potential cation channel subfamily V member 1 (TRPV1), also known as the capsaicin receptor and the vanilloid receptor 1, is a protein that, in human, is encoded by the TRPV1 gene. TRPV1 is primarily expressed on, small myelinated and unmyelinated medium size, sensory neurons in dorsal root and trigeminal ganglia, where sensory neurons cluster. TRPV1 is a non-selective cation channel that may be activated by a wide variety of exogenous and endogenous physical and chemical stimuli. The best-known activators of TRPV1 are heat greater than 43 0C and capsaicin, the pungent compound in hot chili peppers and resiniferatoxin (RTX). The activiation of TRPV1 leads painful, burning sensation. Its endogenous activators include low pH (acidic conditions), the endocannabinoid anandamide, N-arachionyl dopamine. In addition TRPV1 activation can be potentiated by pro-nociceptive mediators such as bradykinin, ATP, NGF, and others. TRPV1 receptors are found mainly in the nociceptive neurons of the peripheral nervous system, but they have also been described in many other tissues, including the central nervous system. TRPV1 receptors are also found in muscles, joints, the urinary bladder and kidneys. The functional activity of TRPV1 has been demonstrated, within the central nervous system, in the spinal cord and specific sites in the brain including the hypothalamus, cerebellum, locus coeruleus, periaqueductal grey and cortex. Activation of TRPV1 sets off an influx of calcium and sodium, ions which in turn initiates a cascade of events that result in memebrane depolarization, neuronal firing and transduction of neural impulses. TRPV1 phosphorylates as a response to several algesic agents, resulting in a lower threshold of channel activation. Some substances such as bradykinin, nerve growth factor and protons have been reprted to sensitize the TRPV1 receptor. Activation of TRPV1 results in the release of pro-nociceptive peptides, which decreases when treated with TRPV1 antagonists. In general, most channel antagonists bind in the pore region, interacting with residues from all four monomers of the tetrameric channe. The siginificant role of this receptor plays as the transmission and modulation of pain (nociception), as well as the integration of diverse painful stimuli. For this reason, the discovery of small molecule antagonists of TRPV1 has been the subject of intense investigations among many pain research groups. Further more recently, it was demonstrated that the analgesic profile of TRPV1 antagonists can be siginificantly broadened if the receptor blockade occurs both in the peripheral and in the central nervous system. Therefore, development of selective TRPV1 receptor antagonists with good CNS penetration presents an important opportunity to treat a variety of pathological pain states. For finding promising analgesic with excellent antagonism, studies are performed not only by desigining and synthesizing TRPV1 receptor ligands which have 2-(4-methasulfonyaminophenyl) propanamide and 6-5 fused heterochcylic at A-region, urea/propanamide at B-region, but also by introducing various substituent based on rational method.Docto

습관성 유산과 관련된 단백질체 분석 : 비이상적으로 발현된 일련의 단백질 동정 연구

Thesis(doctoral)--서울대학교 대학원 :농생명공학부 동물생명공학전공,2006.Docto

응력과 결함이 산화물 페로브스카이트 박막의 강유전성에 미치는 효과

Thesis(doctors)--서울대학교 대학원 :물리학부,2008.2.Docto