• Journal of Korean Neurosurgical Society
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• 제58권3호
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• pp.197-204
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• 2015

Objective : Aneurysms arising from the pericallosal artery (PA) are uncommon and challenging to treat. The aim of this study was to report our experiences of the endovascular treatment of ruptured PA aneurysms. Methods : From September 2003 to December 2013, 30 ruptured PA aneurysms in 30 patients were treated at our institution via an endovascular approach. Procedural data, clinical and angiographic results were retrospectively reviewed. Results : Regarding immediate angiographic control, complete occlusion was achieved in 21 (70.0%) patients and near-complete occlusion in 9 (30.0%). Eight procedure-related complications occurred, including intraprocedural rupture and early rebleeding in three each, and thromboembolic event in two. At last follow-up, 18 patients were independent with a modified Rankin Scale (mRS) score of 0-2, and the other 12 were either dependent or had expired (mRS score, 3-6). Adjacent hematoma was found to be associated with an increased risk of poor clinical outcome. Seventeen of 23 surviving patients underwent follow-up conventional angiography (mean, 16.5 months). Results showed stable occlusion in 14 (82.4%), minor recanalization in two (11.8%), and major recanalization, which required recoiling, in one (5.9%). Conclusion : Our experiences demonstrate that endovascular treatment for a ruptured PA aneurysms is both feasible and effective. However, periprocedural rebleedings were found to occur far more often (20.0%) than is generally suspected and to be associated with preoperative contrast retention. Analysis showed existing adjacent hematoma is predictive of a poor clinical outcome.

• 대한치과보철학회지
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• 제31권3호
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• pp.351-384
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• 1993

Complete denture occlusion must be developed to function efficiently and with the least amount of trauma to the supporting tissues. For the preservation of supporting tissues, it is imperative to reduce to a minimum the functional stress induced by dentures. The magnitude of the horizontal component of functional stress contributed by various occlusal teeth forms has not been studied. This study was aimed to investigate the influence of different occlusal teeth forms on the mode of distribution of the stresses in the mandibular tissue, and the displacement of lower dentures during the variant functional movement of mandible for this study three dimensional finite element analysis was used. FEM models were created using commercial software Super Sap for IBM 32 bit computer. The model was composed of 3380 brick elements and 4346 nodes. The results were as follows. 1. The magnitude of stress was similar between two models in centric occlusion, in the case of anatomic model, the stress was concentrated on the buccal side of alveolar ridge beneath the bicuspids. 2. During the protrusive movement, the increasing of stress from the posterior to anterior part of mandible was seen in the case of anatomic model. 3. During the lateral movement, the stress of anatomic model was greater than that of nonanatomic model. 4. The stress of anatomic model was concentrated on the anterior region of residual ridge during the lateral movement. 5. In the case of anatomic model the anterior part of denture was displaced severely at the centric and lateral position, but the denture of nonanatomic model was displaced minutely at the protrusive and lateral position.

• 대한치과보철학회지
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• 제58권4호
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• pp.328-334
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• 2020

치과의사는 악간관계기록 오류로 인해 발생하는 교합오차를 줄이기 위해 진료실재부착을 시행한다. 진료실재부착으로 수정된 의치를 사용하면 일반적으로 통증이 감소하고 의치 사용이 편해지며 더 편하게 저작할 수 있다고 한다. 하지만 이러한 평가는 환자의 주관적인 평가이므로 본 연구에서는 실험적인 지표를 통해 진료실재부착의 효과를 확인하고자 하였다. 7명의 환자를 대상으로 전치부에서 1 - 2 mm의 공간이 있도록 중심위 악간관계를 채득하여 진료실재부착을 시행한 후 미끄러짐 유무를 확인하였으며, 압력감지센서로 교합력을 측정하였고 실리콘인기재로 교합면적을 측정하였다. 진료실재부착후 교합압의 변화는 없었으나 교합면적 증가와 함께 접촉 후 미끄러짐이 줄어드는 것을 확인할 수 있었다. 진료실재부착을 시행하면 조기접촉이 감소하고 교합면적이 증가하므로 시행하는 것이 필요하다.

• 대한치과보철학회지
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• 제33권3호
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• pp.440-452
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• 1995

A success of complete denture prosthesis can be determined by the satisfaction degree of the dentist and the patient. There are many factors influencing on the satisfaction of the complete denture patients. The purpose of this study is to analyze the correlation between the masticatory satisfaction and clinical evaluation, and the speech satisfaction and clinical evaluation in complete denture patients. 79 patients(total 119 complete dentures) were examined in this study who were treated in Seoul National University Dental Hospital. Through clinical evaluation, 2 examiners evaluated sex, age, edentulous period, the years of having used present complete denture, the number of the previous dentures, the state of the opposite arch, retention, stability, support, occlusion, vertical dimension of the complete denture and the condition of the residual alveolar ridge. Through questionnaires concerned with mastication and speech, examiners evaluate the satisfaction degree of the patients. This study led to the conclusion that : 1. The satisfaction degree of the mastication was lower in older patients(p<0.001) and in patients whose present complete denture period was shorter(p<0.05). The satisfaction degree of the mastication in male was higher than in female patients(p<0.01). 2. The satisfaction degree of the mastication was high when the retention of the complete denture was good(p<0.05), and when the condition of the residual alveolar ridge was good(p<0.05). 3. The satisfacion degree of the speech was high when the retention of the complete denture was good(p<0.01). 4. The satisfaction degree of the mastication was higher in patients with upper and lower complete denture than in patients with single complete denture whose oppsite arch was unilateral partial denture(p<0.05).

• 구강회복응용과학지
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• 제40권2호
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• pp.91-99
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• 2024

골격성 3급 무치악 환자의 경우 총의치 제작 시 잔존치조제 관계를 고려하여 교차교합을 형성해 줌으로써 의치의 안정을 얻을 수 있다. 골격성 3급 악간관계에서 전치부를 정상교합 관계로 형성하는 것은 전방 캔틸레버를 가중시켜 의치의 안정을 저하시킬 수 있다. 하지만, 환자들은 총의치를 사용할 때 기능적인 면 뿐 아니라 심미적인 면 또한 중요시한다. 전치부 인공치들이 어떻게 배열되느냐에 따라 총의치의 심미성이 좌우되어, 골격성 3급 악간관계를 갖는 무치악 환자에서 정상교합이나 절단교합을 활용한 총의치 제작 증례가 보고되고 있다. 본 증례에서는 3급 악간관계를 갖는 무치악 환자에게 상악 전치부에 중립대를 고려하여 전치부 절단교합을 형성하여 의치를 제작하였고, 우수한 심미적, 기능적 결과를 얻었다.

• 대한치과보철학회지
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• 제61권2호
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• pp.160-178
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• 2023

보철 치료 시 교합관계의 진단과 분석은 중요한 요소 중 하나이다. 치료 시행 전 면밀한 교합분석 및 평가가 선행되어 안정적인 악간 관계를 회복시켜 주어야 하며, 치료 과정 및 정기 검진 시에도 이에 대한 평가는 필수적이다. 최근, 치과용 기기와 디지털 처리 방식의 발달로 환자의 교합관계를 기록할 수 있는 새로운 정량적 분석 방법들이 소개되고 있다. 그 중 T-Scan Novus (Tekscan Inc., S. Boston, MA, USA)는 압력측정센서를 이용하여 상하악 치아의 초기접촉점과 교합접촉점의 상대적인 강도를 나타내며 치아의 교합접촉 시간, 교합력의 전후방, 좌우균형을 비교할 수 있다. Dental prescale II (GC Co., Tokyo, Japan)는 압력감지필름을 이용하여 교합접촉점을 스캔하여 접촉점의 밀도를 분석하는 방법으로 최대한 자연스러운 교합상태 치열의 교합력 분포와 강도를 측정할 수 있다. 환자의 치아 상실 부위와 범위에 따라 4-unit 고정성 국소의치, 가철성 국소의치, 총의치, 완전구강회복술을 시행하였다. 적절한 교합 분석을 위해, 초진, 각 치료 단계, 치료 직후 및 정기검진 시의 환자의 교합을 T-Scan Novus와 Dental prescale II를 이용하여 정량적으로 비교, 평가하였다. 보철수복 치료과정에서 교합 분석에 대한 이해도를 제고할 수 있었고, 기능 및 심미적으로 환자와 술자 모두 만족할 만한 결과를 얻었기에 이를 보고하고자 한다.

• 구강회복응용과학지
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• 제18권3호
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• pp.197-204
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• 2002

Polymers are the dominant material for fabrication of denture bases. However, resin base can't fufill the patients' satisfactions completely and solve the pronunciation problem and prevent the denture fracture. In spite of many advantages, metal denture bases do not widespread in clinical practice. The main reasons are the difficulties in fabrication and additional time and cost, inability to rebase such prostheses. The use of the metal base can be one of options in complete denture treatments. This study helps, through reveiwing previous reports and literature about the metal base, metal base to be useful in the clinical application by recommend the materials, indications and advantage/disadvantage of the metal base and introduce variable designs. The clinical application of the metal base have many advantages, but the dentists have to select cases carefully and apply designs according to patient's various conditions. In conclusion, the use of the metal base can't alternate treatment of inadequate conventional complete denture. Adequate complete denture is very important for the treatment of the metal base complete denture.

• Journal of Korean Neurosurgical Society
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• 제58권6호
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• pp.518-527
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• 2015

Objective : The treatment of complex intracranial aneurysms remains challenging. One approach is the application of surgical flow alteration to treat aneurysms that are neither clippable, trappable, or coilable. The efficacy and limitations of surgical flow alteration have not yet been established. Methods : Cases of complex aneurysms treated with surgical flow alteration (proximal occlusion with or without bypass, distal occlusion with or without bypass and bypass only) were included in this retrospective study. Results : Among a total of 16 cases, there were 7 giant aneurysms (${\geq}25mm$ diameter) and 9 large aneurysms (>10 mm diameter); 15 of 16 aneurysms were unruptured. There were 8 aneurysms located in the anterior circulation, while the other 8 were in the posterior circulation. Aneurysms were treated with proximal occlusion in 10 cases and distal occlusion in 5 cases; in 1 case, the aneurysm occluded spontaneously after bypass without parent artery occlusion. All but 2 cases underwent prior or concurrent bypass surgery. Complete obliteration of the aneurysm at the latest imaging follow-up was shown in 12 of 16 cases (75.0%). Bypass patency was confirmed in 13 of 15 cases (86.7%). Surgery-related morbidity developed in 3 cases (18.8%, Glasgow outcome scale of 4) and all were perforator infarctions. There were no mortalities. Conclusion : Surgical flow alteration resulted in a high rate of aneurysmal obliteration with acceptable morbidity. Although several limitations remained, it could represent an alternative method for treating complex aneurysms.

• 대한치과보철학회지
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• 제62권1호
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• pp.82-94
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• 2024

본 증례는 치아의 전반적 마모를 보이며 구치부 지지가 소실된 환자를 대상으로 전악 수복을 진행한 증례이다. 측두 하악 관절의 상태를 분석 후, 붕괴된 교합을 회복하기 위해 다수의 임플란트가 식립되었다. 고정체/지대주 수준의 인상 채득에서, 교차 마운팅을 위한 여러 번의 복잡한 교합 기록을 동반하는 전통적 인상 채득 방법 대신 구강 스캐너를 이용한 방식을 채득하였다. 하악의 불안정한 움직임을 반영하기 위해, '하악 운동 추적(jaw motion tracking)'장치와 '디지털 안궁 이전(digital face-bow transfer)'을 이용하였고, 이차 임시 수복물을 기반으로 하여 최종 수복물로 복제하는 '이중 스캔 기법(double scan technique)'으로 최종 수복물을 제작하였다. 위와 같은 디지털 기술을 이용하여 불안정한 교합을 갖는 환자에게 보다 짧은 체어 타임으로 완전 구강 회복을 진행할 수 있다.

• 대한견주관절학회:학술대회논문집
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• 대한견주관절학회 2008년도 제16차 학술대회
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• pp.175-175
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• 2008

We report a rare case of late-onset brachial artery occlusion caused by subclavian artery stenosis with excessive scar tissue after open reduction and plate fixation for clavicular fracture. When he referred to us, the right hand were pale and the radial and ulnar pulses at the wrist were absent. CT-angiogram showed compression of subclavian artery by excessive scar tissue beneath the fracture site and angiography revealed stenosis of subclavian artery with thrombus and complete obstruction of blood flow in the brachial artery with emboli. Therefore, we performed embolectomy. 2 years after operation, patient was essentially asymptomatic except mild pain after long standing elevation of arm. We recommend that minimal soft tissue dissection should be needed in the operative treatment of clavicular fracture, especially soft tissue beneath the clavicle should be protected maximally.