수종의 실러를 이용한 single-cone 충전법의 미세누출과 체적변화에 대한 연구

학위논문 (석사)-- 서울대학교 대학원 : 치의과학과, 2017. 2. 손원준.국문초록 수종의 실러를 이용한 single-cone 충전법의 미세누출과 체적변화에 대한 연구 홍 석 찬 서울대학교 대학원 치의학과 치과보존학 전공 (지도교수 손 원 준) 목 적 본 연구의 목적은 새롭게 고안된 유체침투측정기기를 이용해서 변형수직가압법과 single-cone 충전법의 미세누출을 나노단위로 비교하는 것이다. 또한 충전 1일 후와 8주 후 single-cone 충전군의 부피를 미세 컴퓨터단층촬영기로 관찰하여 실러에 따른 체적변화를 비교 분석 하였다. 방 법 56개의 인간의 발치된 상악 대구치의 구개측 치근을 이용하였다. Glide path를 ProGlider(Dentsply)를 이용해서 만든 후 WaveOne Gold Primary(Dentsply) 로 근관성형을 하였으며, 최종적으로 Protaper NEXT X4(Dentsply)를 이용하여 치근단부를 형성하였다. 각 시편을 4그룹의 실험군(n=13)과 2그룹의 대조군(n=2)으로 임의 배정하였다. Group CW(n=13) 는 AH plus(Dentsply)와 변형수직가압법을 이용하여 근관충전 하였다. Group AH(n=13)는 AH plus와 single-cone충전법을 이용하여 근관 충전하였다. Group GF(n=13)는 GuttaFlow2(Coltene Whaledent)와 single-cone충전법을 이용하여 근관충전 하였다. Group ES(n=13)는 Endoseal MTA(Maruchi)와 single-cone 충전법을 이용하여 근관 충전 하였다. 모든 시편은 마스터 콘으로 .06 taper #40 거타퍼차(Meta Biomed, Chungju, Korea)를 사용하였다. 충전 24시간 후 백악-법랑경계 부위에서 치근 부위를 자르고 구개 치근을 미세 컴퓨터단층촬영기(SkyScan1172)를 통해서 single-cone 실험군을 촬영하였다. 이 후 모든 시편을 5ml phosphate buffering solution에 8주 동안 보관하였다. 8주 후 다시 미세 컴퓨터단층촬영기를 통해 실험군을 촬영 후 Mimics®, 3-matic®(Materialise) 소프트웨어를 통해서 3차원적으로 재구성 후 체적변화를 계산하였다. 이 후 치근의 길이를 10mm로 통일 하고, 치근단 2mm를 제외한 부위를 아크릴릭 레진과 메니큐어로 어떤 액체도 통과하지 못하도록 밀폐하였다. 시편을 유체침투장비(Nanoflow, IB systems)에 금속 튜브와 실리콘튜브로 연결하여 70cmH2O의 정수압으로 측정 시작 15분에서 30분까지의 미세누출 양을 실시간으로 측정하였다. 체적변화량 및 미세누출값은 95% 신뢰구간으로 Kruskal-Wallis 시행 후 Mann-Whitney U post hoc test으로 통계학적 분석을 시행하였다. (SPSS statistics data editor version 20, IBM, NY, USA) 결 과 평균 미세누출 값을 비교하였을 때, 변형수직가압법으로 충전한 Group CW는 0.0728±0.0281nl/min/cmH2O, single cone으로 충전한 Group AH, Group GF 및 Group ES는 각각 0.0281±0.0208nl/min/cmH2O, 0.0885±0.0440nl/min/cmH2O, 0.0950±0.0544nl/min/cmH2O 값을 보였다. Group AH의 미세누출값이 통계학적으로 유의하게 낮았고(p 0.05). 음성대조군은 0.0004nl/min/cmH2O 의 값을 보였고, 양성대조군은 유체의 유출 속도가 너무 빨라서 해당 구간(15분-30분) 내에서 본 실험 장비가 측정 할 수 없었다. 평균 체적변화를 비교 하였을 때 Group AH는 -1.99±2.37%, Group GF는 3.75±3.71%, Group ES는 1.51±1.16%의 값을 보였다. Group AH가 통계학적으로 유의하게 수축하였고(p 0.05). 결 론 나노리터단위의 자동화된 유체침투기기를 이용하여 측정했을 때single-cone을 이용한 충전은 사용한 실러에 따라 변형수직가압법과 비슷하거나 더 우수한 밀폐 능력을 보인다. 미세 컴퓨터단층촬영으로 조사한 체적변화는 레진 계열 실러를 사용한 실험군이 실리콘, calcium-silicate 계열 실러를 사용한 실험군보다 통계학적으로 유의하게 수축하였다.Ⅰ. 서론 1 Ⅱ. 재료 및 방법 3 Ⅲ. 결과 9 Ⅳ. 토의 10 Ⅴ. 결론 16 Ⅵ. 참고문헌 18 ABSTRACT 31Maste

급성 바이러스 감염 시 일차 체액성 면역반응에서의 형질아세포에 관한 연구

학위논문(박사) - 한국과학기술원 : 의과학대학원, 2013.8, [ vi, 65 p. ]B cells provide several lines of immunity in host defense against viral infection, including the production of neutralizing antibodies. Following exposure to antigen, na"ive B cell differentiate into antibody-producing short-lived plasmablasts (PBs) and thus contribute to the first line of defense. With T cell help, some of B cells undergo a number of events, characterized by affinity maturation and isotype switching, lead to more specific immunity. Immunoglobulins (Ig) exist as distinct different classes, which are distinguished by structure of their constant region. In primary immune response, IgM is the first antibody to be produced before B cells have un-dergone affinity maturation, and thus it has been considered as a low affinity antibody than isotype-switched Ig such as IgG. In addition to its low binding affinity to antigen, the poly-reactivity of antibody, the ability to bind to various unrelated antigens, has been described in IgM. While B cells play a critical role in defense immunity through the production of antibodies, research on humoral immunity largely depend on serological study. Therefore, cellular analysis of antibody secreting cells (ASCs) still largely unexplored. Recently, research on ASCs during viral infection has shown that robust PB res-ponses were detected in peripheral blood. These studies reported that ASC responses in dengue or influenza virus infection were characterized by antigen specific, IgG-producing PBs. It is likely that these results represent sec-ondary response but not primary immune response since human adult usually have a history of encounter with these pathogen. Therefore, PB responses during acute phase of primary infection with virus re-main largely unexplored. In current study, we detected robust PB responses in the peripheral blood of patients with acute hepatitis A (AHA), which is an attractive disease to address the humoal responses in the primary acute viral infection. These PB responses were dominated by Ig...한국과학기술원 : 의과학대학원

Comparative efficacy of low-dose versus regular-dose colchicine to prevent flares in gout patients initiated on urate-lowering therapies

Objective: The objective of this study was to compare the prophylactic effect of regular-dose (RD, 1.2 mg/day) vs low-dose (LD, 0.6 mg/day) colchicine on gout flare when initiating urate-lowering therapy. Methods: In this retrospective cohort study, we included gout patients who were initiated on either allopurinol or febuxostat, in combination with colchicine therapy and followed them up for 3 months. We analysed the rates of gout flare and adverse events according to the dose of colchicine. We performed the inverse probability of treatment weighting (IPTW) and weighted logistic regression analysis to assess the treatment effect. Analysis of gout flares and adverse events was performed on an intention-to-treat (ITT) and per-protocol (PP) basis. Results: Of the total of 419 patients with gout, 177 patients (42.2%) received LD colchicine, whereas 242 patients (57.8%) received RD colchicine. Lower BMI and estimated glomerular filtration rate, and higher incidence of cardiovascular disease were seen in the LD group than in the RD group. In IPTW-adjusted analysis, events of gout flare were not significantly different between the LD and RD groups [ITT: 14.3% vs 11.3%; odds ratio (OR): 1.309, 95% CI: 0.668, 2.566, P = 0.432; PP: 15.3% vs 10.0%; OR: 1.623, 95% CI: 0.765, 3.443, P = 0.207]. However, LD colchicine was associated with a lower rate of adverse events than RD colchicine [ITT: 8.2% vs 17.9%; OR: 0.410, 95% CI: 0.217, 0.777; P < 0.05; PP: 8.4% vs 17.2%; OR: 0.442, 95% CI: 0.223, 0.878; P < 0.05]

Spinal Bony Involvement of IgG4-related Disease Treated by a Spondylectomy

Immunoglobulin G4-related sclerosing disease (IgG4RD) is an emerging immune-mediated fibro-inflammatory disorder which can involve any organ. We describe the first IgG4-RD spondylitis treated with total en-bloc spondylectomy (TES). A 55-year-old man presented with back pain. Magnetic resonance imaging (MRI) of the thoracic spine revealed a pathologic compression fracture on T11 vertebral body and both pedicles suggestive of primary bone tumor or bone metastasis. We conducted TES of T11, because we could not exclude the possibility of primary bone tumor including giant cell tumor. Immunohistochemical examination of the pathology specimens from pleura around the pedicle demonstrated diffuse infiltration of IgG4-bearing plasma cells. Six weeks later from the surgery, a delayed serologic test was done and his serum IgG4 concentration was 45 mg/dL. The final diagnosis was probable IgG4RD on the basis of serological, imaging, histopathological findings. After 6 weeks of oral prednisolone treatment, patient’s back pain improved dramatically. IgG4RD is very rare systemic disease and its paraspinal soft tissue like pleura involvement with vertebra body invasion was absent until now. Our experience indicated that surrounding soft tissue biopsy would be helpful when a percutaneous vertebra bone biopsy mismatched with the image studies, even though vertebra body was main pathological lesion considering the possibility of IgG4RD