• 대한방사선치료학회지
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• 제31권1호
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• pp.33-41
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• 2019

목 적: 식도암 방사선치료 시 세기조절방사선치료(Intensity Modulated Radiation Therapy, IMRT) 및 용적세기조절회전치료(Volumetric Modulated Arc Therapy, VMAT)에서 Jaw-Tracking 기법 유 무에 따라 저선량 영역에 대한 주변 정상장기의 용적선량을 분석하여 그 유용성을 평가하고자 한다. 대상 및 방법: 본 원에서 사용하고 있는 선형가속기 VitalBeamTM(Varian Medical System, U.S.A)으로 식도암 방사선치료를 받은 27명을 대상으로 하였으며, 치료계획은 Eclipse(Ver. 13.6 Varian, U.S.A)를 이용하여 Jaw-Tracking(JT)을 사용한 치료계획과 Non Jaw-Tracking(NJT) 치료계획을 수립하였으며, 치료계획용적(Planning Target Volume, PTV)에 빗장위림프절(Supraclavicular Lymph Nodes, SCL)이 포함되어 있는 T자형 PTV를 가진 환자를 대상으로 하였다. 조사범위에 대한 영향을 확인하기 위해 복강(Celiac) 포함 여부로 비교군을 나누었다. 수립된 치료계획의 비교를 위해 손상위험장기는 양측 폐, 심장, 척수를 비교하였으며 Conformity Index(CI), Homogeneity Index(HI)를 비교하였다. 임상적용 검증을 위해 전자포탈영상장치(Electronic Portal Imaging Device, EPID)를 이용하여 Portal Dosimetry를 실시하였고, 선량 영역의 임계치(Threshold)를 10 %, 5 %, 0 %로 매개변수로 설정하여 감마분석을 실시하였다. 결 과: 모든 치료계획은 3 mm / 3 %, 감마통과율 95 % 기준에 대해 Threshold 10 %의 경우 95 % 이상으로 JT, NJT 모두 통과하였으며, IMRT는 Threshold가 5 %, 0 %로 줄어들수록 JT보다 NJT의 값이 1 % 이상 줄어 들었다. IMRT에서 양측 폐의 $V_5$와 $V_{10}$은 JT에서 Celiac을 포함하지 않을 때 최대 14.7 %, 평균 8.5 %, 5.3 % 만큼 감소했고, $D_{mean}$은 $72.3{\pm}51cGy$ 감소하였으며, Celiac을 포함할 때 JT에서 선량감소가 증가하였다. 심장의 $D_{mean}$은 $68.9{\pm}38.5cGy$, 척수의 $D_{max}$는 $39.7{\pm]30.1cGy$만큼 감소하였다. VMAT은 JT기법 사용 시 폐에서 $V_5$ 평균 2.5 % 감소하였고, 심장 및 척수에서 소량 감소하였으며, Celiac 포함 시 JT의 선량감소가 증가하였다. 결 론: 식도암 치료계획에서 IMRT가 JT 사용 시 양측 폐의 $V_5$, $V_{10}$에서 유의미한 감소가 나타났고, 저 선량영역에서 조사범위가 클수록 선량감소가 크게 나타났다. 따라서 식도암 방사선치료에는 IMRT가 VMAT보다 JT 적용 시 더 효과적이며, 저 선량영역에서의 MLC 누설 및 투과선량으로부터 정상장기를 보호할 수 있다.

• Investigative Magnetic Resonance Imaging
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• 제13권1호
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• pp.40-46
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• 2009

목적 : 기능적 뇌 자기공명영상 (fMRI)과 확산텐서영상(DTI) 합성기법을 이용하여 피질척수로의 여러 부위에서 정량적 특성을 연구하고자 하였다. 대상 및 방법 : 신경학적 이상이 없는 정상인 10명 (남: 8, 여: 2, 평균연령: 30세, 연령분포 : 22 -38세)을 대상으로 하였다. fMRI는 1.5T를 이용하였으며, 손의 쥐기 펴기를 수행하였다. fMRI와 확산텐서섬유로(DTT)의 합성이 가능한 DtiStudio 프로그램을 이용하여 피질척수로를 3차원 영상화하였다. 이때, 시작 관심영역은 2차원 분할 비등방성(fractional anisotropy, FA) 색지도(color map)에서 fMRI의 운동 수행 시 활성부위가 가장 많은 곳으로, 목표 관심영역은 하부 전방 뇌교의 피질척수 부위로 설정하였다. 정량적 분석을 위하여 관심영역을 부채살부터 연수까지 좌우 각각 5곳에 설정하여 분할 비등방성과 현성 확산계수(ADC)를 측정하였다. 결과 : 모든 대상자는 fMRI에서 일차 감각운동 영역이 주로 활성화되었다. 확산텐서 영상에서 피질척수로의 경로는 일차 감각운동 영역부터 연수까지 주행하였다. 피질척수로의 FA 값은 모든 대상자에서 중뇌와 내측 섬유띠의 후지가 타 부위보다 높았다. 결론 : fMRI와 DTT의 합성기법은 피질척수로 상태의 3차원 영상화 및 각 부위에서 FA와 ADC값을 이용한 정량적 분석이 가능하였다. 앞으로, fMRI와 DTT 합성기법은 뇌손상 환자에서 피질척수로의 명확한 상태를 연구하는 데 유용하게 이용될 것으로 사료된다.

• 한국식품영양과학회지
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• 제35권9호
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• pp.1139-1145
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• 2006

본 연구에서는 제주 연안에 서식하는 갈조류 중 감태의 줄기와 잎의 항산화활성을 비교하기 위하여 감태 줄기와 잎으로부터 효소적 가수분해와 메탄올을 이용하여 각각의 추출물을 제조한 후 이들로부터 활성산소종의 소거활성 및 세포의 산화적 손상 억제활성을 포함하는 항산화활성에 대한 차이를 비교 검토하였다. 여기에서 효소적 가수분해를 이용하여 제조된 감태의 효소적 추출물은 메탄올 추출물에 비하여 폴리페놀 함량은 낮았으나, 수율은 약 30% 이상 높게 나타났다. 감태는 줄기와 잎의 모든 부분에서 항산화활성이 우수하게 나타났으며, 두 부위 간의 유의적인 차이는 없었으나, 대체로 잎의 추출물이 줄기의 추출물보다 약간 우수한 항산화효과를 나타내었다. 이러한 결과는 감태의 잎 뿐만 아니라 줄기 또한 마찬가지로 우수한 생리활성 재료임을 확인할 수 있었다. 그리고 메탄올 추출물에 비해 효소적 추출물은 hydroxyl radical 소거활성을 제외한 전반적인 항산화효과 분석에 있어서 더 유용한 경향을 보였다. 이와 같은 결과는 여러 가지 효소들이 복합되어진 효소가 세포벽에 있는 섬유질이나 당단백질 혹은 알긴산 고분자물질 등을 분해시키는 작용을 하여 활성물질들이 원활히 추출될 수 있도록 유도해 주는 작용을 하였기 때문이라고 사료된다. 그리고 높은 수율을 바탕으로 한 수용성의 추출물이기 때문에 그들이 가지고 있는 생리활성물질을 식품산업에 쉽게 응용시킬 수 있으며, 유기용매와 같은 화학약품을 사용하였을 때에 발생할 수도 있는 안전성에 대한 문제도 해결할 수 있을 것이다. 이상의 결과로 감태는 잎 뿐만 아니라 줄기도 잠재적 의약품 소재 및 기능성식품 소재로서의 가능성이 충분하다고 판단된다.의 서로 반대되는 위치에서 온도차가 13.7도에서 -8.3도까지 차이가 나는 것으로 관찰되었으며, 미디어 높이 위치의 변화에 따라서도 21도에서 2도가지 차이를 나타냈다. 바이오필터 함수비는 실험기간 동안 지속적으로 변화가 발생하였는데, 스팀이 제공되는 동안에는 미디어 함수비가 훨씬 빠른 속도로 증가됨이 관찰되어 졌다.EX>$4.9{\sim}5.1^{\circ}Brix$ 수준이었으며, 소형과와 기형과는 S-3에서 많이 나왔다. 이상 연구결과에서 입도분포가 1.2-5mm인 것이 바람직한 것으로 나타났다.omopolysaccharides로 확인되었다. EPS 생성량이 가장 좋은 Leu. kimchii GJ2의 평균 분자량은 360,606 Da이었으며, 나머지 두 균주에 대해서는 생성 EPS 형태와 점도의 차이로 미루어 보아 생성 EPS의 분자구조와 분자량이 서로 다른 것으로 판단하였다.TEX>개로 통계학적으로 유의한 차이가 없었다. Heat shock protein-70 (HSP70)과 neuronal nitric oxide synthase (nNOS)에 대한 면역조직화학검사에서 실험군 Cs2군의 신경세포가 대조군 12군에 비해 HSP70과 nNOS의 과발현을 보였으며, 이는 통계학적으로 유의한 차이를 보였다(p<0.05). nNOS와 HSP70의 발현은 강한 연관성을 보였고(상관계수 0.91, p=0.000), nNOS를 발현하는 세포가 동시에 HSP70도 발현함을 확인할 수 있었다. 결론: 우리는 cyclosporin A가 토끼의 25분간의 척수허혈에 대해 척수보호 효과가 있었으며 이는 HSP70의 과발현과 연관이 있으리라 생각한다.

• Clinical and Experimental Reproductive Medicine
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• 제19권1호
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• pp.87-94
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• 1992

From December 1991 to March 1992, 34 anejacuratory patients with spinal cord injury underwent 90 of electric stimulations with Seager NRH model 12. The average patient age was 43.5 years with a range of 23 to 48 years. The level of cord injury was cervical in 7, thoracic in 6, lumbar in 11, lumbosacral in 7 and conus medullaris in 3. The average number of electric stimulation per a patient was 2.65 with a range of 1 to 4. The average voltage and amplitude per a stimulation were 17.72 volts and 309. 89 mAmp with ranges of 5 to 25 volts and 50 to 500 mAmp. The total and motile sperm number were evaluated microscopically and analyzed statistically by paired t-test according to the frequency of electroejaculation, level of cord injury and voiding pattern. The results were obtained as follows. 1. An overall success rate of electroejaculation was 85.3% among 34 patients and 82.2% among 90 electric stimulations. 2. The total and motile sperm number per a stimulation were not correlated the frequency of electric stimulation, level of cord injury and voiding pattern. 3. Complications occured in 10 cases; severe low abdominal pain in 5, hypertension in 2, sweating in 1, headache in 1 and neck stiffness in 1. All the copmlications subsided spontaneously within 5 to 10 minutes after transient interruption of the electric stimulation. In summary, rectal probe electroejaculation is an accepted safe means of procuring sperm from spinal cord injury patients with ejaculatory incompetence. However very poor sperm motility was found and it was not related with the frequency of electroejaculation, level of cord injury and voiding pattern. Further investigation would be needed to conclude and to identify the reasons for impaired sperm motility.

• 동의생리병리학회지
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• 제16권1호
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• pp.150-153
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• 2002

To elucidate the toxic effect of oxygen free radicals on cultured mouse spinal motor neurons damaged by hydrogen peroxide(H₂O₂)-induced neurotoxicity, we examined the neurotoxicity induced by oxygen radicals by NR assay when cultured spinal motor neurons were grown in the medium containing various concentrations of H₂O₂ for 6 hours. In addition, neuroprotective effects of herb extracts such Rhizoma Gastrodiae(RG), on H₂O₂-induced neurotoxicity in cultured spinal motor neurons were evaluated after cultured spinal motor neurons were preincubated with various concentrations of herb extract, RG for 2 hours before 50uM H₂O₂ for 6 hours. H₂O₂ decreased remarkably cell viability in dose-and time-dependent manner in these cultures, and also herb extract, RG increased cell viability of spinal motor neurons damaged by H₂O₂ in these cultures. From the above results, it is suggested that H₂O₂ was toxic in cultured spinal motor neurons derived from mouse, and RG was effective in blocking the neurotoxicity induced by oxidative stress in these cultures.

• 한방재활의학과학회지
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• 제20권4호
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• pp.1-15
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• 2010

Objectives : This study was performed to evaluate the effects of Hwangryunhaedok-tang(Huanglianjiedu-tang HHT) water extract on locomotor dysfunction induced by spinal cord injury(SCI) in rats. Methods : SCI was induced by mechanical contusion following laminectomy of 10th thoracic vertebra in Sprague-Dawley rats. HHT was orally given once a day for 14 days after SCI. Neurological behavior was examined with the Basso-Beattie-Bresnahan locomotor rating scale. Tissue damage and nerve fiber degeneration were examined with cresyl violet and luxol fast blue staining. Using immunohistochemisty, cellular damage to neurons and nerve fibers were examined against Bax and MAP-2. As inflammatory response markers, iNOS and COX-2 expressions were also examined. Results : 1. HHT ameliorated the locomotor dysfunction of the SCI-induced rats. 2. HHT attenuated the reduction of motor neurons in the ventral horn of the SCI-induced rat spinal cord. 3. HHT significantly reduced the number of Bax positive cells in the peri-lesion of the SCI-induced rat spinal cord. 4. HHT attenuated the reduction of MAP-2 positive cells in the peri-lesion of the SCI-induced rat spinal cord. 5. HHT significantly reduced the number of iNOS and COX-2 positive cells in the peri-lesion of the SCI-induced rat spinal cord. Conclusions : These results suggest that HHT improves the locomotor dysfunction of SCI by protecting motor neurons from cell death through anti-inflammatory effect.

• 한국전문물리치료학회지
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• 제6권2호
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• pp.56-66
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• 1999

The purpose of this study focused how to show physiological responses comparing exercise group and non exercise group for progressive maximal wheelchair ergometer exercise loading in complete paraplegia. It also examined the various factors which would be influenced physiological responses. Sixteen subjects have been investigated in this study, and the subjects are divided into two groups as follows: 1) exercise group (7 subjects) 2) non exercise group (9 subjects). Each test was terminated by physical exhaustion and/or an inability to maintain a flywheel velocity. The results were as follows: 1) No difference was noted in pulmonary function test between two groups. 2) $\dot{v}$ Emax value during maximal exercise was significantly different between the groups (p<0.05). The mean $\dot{v}$ Emax of exercise group was $69.67{\ell}/min$, non exercise group was $41.47{\ell}/min$. 3) $\dot{v}$ $O_2max$(${\ell}/min$) value during maximal exercise was significantly different between the groups (p<0.05). The mean $\dot{v}$ $O_2max$(${\ell}/min$) of exercise group was $1.72{\ell}/min$, non exercise group was $1.15{\ell}/min$. 4) $\dot{v}$ $O_2$ max(ml/kg/min) value during maximal exercise was significantly different between the groups (p<0.05). The mean $\dot{v}$ $O_2max$($ml/kg{\cdot}min$) of exercise group was $25.99ml/kg{\cdot}min$, non exercise group was $18.61{\ell}/min$. 5) Maximal heart rate(HRmax) value during maximal exercise was significantly different between the groups (p<0.05). The mean HRmax of exercise group was 180.43 beats/min, non exercise group was 175.00 beats/min. 6) $\dot{v}\;E/\dot{v}\;O_2$ value during maximal exercise was not significantly different between the groups (p>0.05). The mean $\dot{v}\;E/\dot{v}\;O_2$ of exercise group was $36.36{\ell}/{\ell}\;O_2$, non exercise group was $45.46{\ell}/{\ell}\;O_2$. Considering the results which explore the exercise group with paraplegia has shown the maximal aerobic power compared with non exercise group, regular and consistent physical training is highly assumed as a main factor to improve cardiopulmonary fitness.

• Archives of Plastic Surgery
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• 제35권3호
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• pp.235-242
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• 2008

Purpose: Due to increasing interest in the treatment of spinal cord injuries, many histopathological studies have been conducted to prove that many neurotrophic factors including growth hormone are important for regeneration of the injured spinal cord. Growth hormone has to be given everyday, however, and this negatively affects compliance in clinical trials. Recently, the invention of sustained release growth hormone (SRGH) that can be given just once a week may both help the regeneration of injured spinal cord and, at the same time, be more compliant and convenient for clinical patients. Methods: In this study, thirty 7-week-old female Spraque-Dawley rats were subjected to a weight-driven impact spinal cord injury. They were divided into 3 groups and Group I and II were injected with SRGH once a week for 4 weeks; Group I were injected into the injured spinal cord area, while Group II were injected into the peritoneal cavity. Meanwhile, Group III were injected with normal saline solution. The functional outcome was evaluated using the Basso-Beattie-Bresnahan motor rating score and the inclined plane test was done 4 weeks after the first injection. Histopathological examination was performed at the same time and the amount of residual white matter was measured in all groups. Results: After 4 weeks, Groups I and II showed greater improvement than Group III(the control group) in the functional test. In the control group, invasion of atypical phagocytes, axonal degeneration, edema and cavity formation in the posterior site of spinal cord gray matter was observed in histopatholgical examination. The rate of residual white matter in Group III was less than in the other groups. Conclusion: Data showed significant functional and histopathological improvement in the groups treated with SRGH into the spinal and peritoneal cavity compared with the control group. SRGH is therefore beneficial because it helps with regeneration of the injured spinal cord and improves the compliance and convenience of patients.

• The Korean Journal of Pain
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• 제19권1호
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• pp.33-44
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• 2006

Background: Peripheral nerve injury leads to neuropathic pain, including mechanical hyperalgesia (MH). Nerve discharges produced by an injury to the primary afferents cause the release of glutamate from both central and peripheral terminals. While the role of centrally released glutamate in MH has been well studied, relatively little is known about its peripheral role. This study was carried out to determine if the peripherally conducting nerve impulses and peripheral glutamate receptors contribute to the generation of neuropathic pain. Methods: Rats that had previously received a left L5 dorsal rhizotomy were subjected to a spinal nerve lesion (SNL) or brief electrical stimulation (ES, 4 Hz pulses for 5 min) of the left L5 spinal nerve. The paw withdrawal threshold (PWT) to von Frey filaments was measured. The effects of an intraplantar (i.pl.) injection of a glutamate receptor (GluR) antagonist or agonist on the changes in the SNL- or ES-produced PWT was investigated. Results: SNL produced MH, as evidenced by decrease in the PWT, which lasted for more than 42 days. ES also produced MH lasting for 7 days. MK-801 (NMDAR antagonist), DL-AP3 (group-I mGluR antagonist), and APDC (group-II mGluR agonist) delayed the onset of MH when an i.pl. injection was given before SNL. The same application blocked the onset of ES-induced MH. NBQX (AMPA receptor antagonist) had no effect on either the SNL- or ES-induced onset of MH. When drugs were given after SNL or ES, MK-801 reversed the MH, whereas NBQX, DL-AP3, and APDC had no effect. Conclusions: Peripherally conducting impulses play an important role in the generation of neuropathic pain, which is mediated by the peripheral glutamate receptors.

• 대한물리치료과학회지
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• 제4권2호
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• pp.405-419
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• 1997

This research has been conducted to provide the spinal cord injured patients with comprehensive necessity of and backup data for their rehabilitation in the community and make the aware of importance of overall community support to patients. The data was collected through questionnaire made to 83 patients charged to general hospital in Jeonbuk Province between 1 and 31 March 1997 to analyse the patients ability on activities of daily living through the research on general characteristics and Modified Barthel Index(MBI). As a result the outcome of the research was as follows : 1. Sexual distribution represented that 57 male (68.7%) and 26 female(31.3%) and in the age distribution majority group was 36 thirties (43.4 %) most active in social activities. 2. Analysis on occupation of patients showed majority group was in technicians, 21 people representing 25.4 % and the major cause of injury was traffic accident, 45people representing 54.2%, fall down, 17 people representing 20.5% and industrial accident, 13 people representing 15.7%, respectively. 3. In the multiple choice questionnaire on complications, the rate of appealing pain was highest and spasticity, pressure sore, contracture, depression which restrict the patients from activities of daily living ability were also appeared. 4. The theoretical points in MBI Should lie between 1 and 115 and the average point be 58 but the average point of the MBI among 83 patients was 63. 5. The MBI point by the level of injured represented statistically critical difference(P<0.001) and the MBI points tested by Duncan's Multiple Area Testing in lumbar(80.1) and in thoracic (65.8) represented critically higher than the one in cervical(42.5). 6. In the distribution of the method of Urination after spine injury, the intermittent catheterization represented highest numbar of 34(41.1 %). Testing by Duncan's Multiple Area Testing, as we found the critical difference in the analysis on MBI points(P<0.001), the point in independent self voiding patients ($90.87{\pm}29.34$) was higher than the one in other self voiding patients(P<0.05). 7. In th category of social activities after spine injury, the number of people classified in others, 41 people representing 49.5% was highest and in the MBI points of the spinal cord injured people in religious activity, hobby activity, private club, occupation was critically higher than the people classified in miscellancous(P<0.01) who are the spinal cord injured people and mostly depend on their family's assistance at home in their daily activities.