• Childhood Kidney Diseases
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• 제13권1호
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• pp.1-13
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• 2009

소아청소년기의 당뇨병은 대부분 제1형 당뇨병이나 최근 우리나라를 포함한 서구 사회에서는 제2형 당뇨병의 빈도가 증가하고 있다. 임상소견 상 제1형 당뇨병은 여러 위험인자에 의하여 비교적 전형적인 단계를 거치면서 미세알부민뇨와 당뇨병성 신병증으로 진행하면서 만성 신질환으로 발전하게 되며, 제2형 당뇨병은 비전형적 임상경과를 거치나 신병증 진행율이 높아서, 실제로 당뇨병성 신병증은 전세계 신장대체요법이 필요한 말기 신질환의 가장 많은 원인이며 국내에서도 꾸준히 원인 질환으로서 증가 중이다. 당뇨병이 사춘기 전에 발생하는 경우보다 사춘기나 그 이후에 발생하는 경우에 혈관합병증의 발생이 증가하므로, 사춘기가 위험인자로 작용하며, 이것은 유병기간과 함께 사춘기 전에 소아 당뇨병성 신병증이 발생하는 경우는 매우 드문 이유이다. 제1형과 제2형 당뇨병에서 신병증은 비슷하게 15-25%에서 발병하며, 당뇨병성 신병증과 만성 신질환으로 진행하는 과정 중에 가장 중요한 표식자인 미세알부민뇨는 위험인자이고 병리학적 소견과 관련이 있다.

• 대한정형외과스포츠의학회지
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• 제9권1호
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• pp.16-21
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• 2010

최근 스포츠 활동 증가로 인한 하지의 과사용증후군인 만성 구획증후군 및 스트레스 골절의 빈도가 늘어가고 있다. 만성구획증후군은 운동 중 근육의 부피 증가와 이로 인한 구획압 증가로 야기된 가역적인 허혈상태로, 보존적 치료로 호전되지 않는 경우 근막절개술 등의 수술적 치료를 고려할 수 있다. 스트레스 골절은 정상적인 골에 비정상적인 스트레스가 가해져서 발생하는 피로 골절과 비정상적인 골에 정상적인 스트레스에 의해서 발생하는 부전골절로 분류할 수 있으며, 대부분의 스트레스 골절은 하지, 특히 경골부에 호발한다. 운동선수에서 피로 골절은 훈련 방법의 변화에 기인할 수 있고 진단은 일차적으로 단순방사선 촬영을 시행하며, 자기공명영상을 통해 확진 할 수 있다. 대부분의 경우 휴식 및 단기간의 고정 등을 통한 보존적 치료만으로 증상의 호전 및 운동 복귀가 가능하나, 경골의 신연부에 발생한 경우 수술적 치료를 요할 수도 있다.

• Childhood Kidney Diseases
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• 제13권2호
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• pp.242-247
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• 2009

소아청소년기의 당뇨병은 대부분 제1형 당뇨병으로, 이 때 발생하는 혈관합병증으로서 당뇨병성 신병증은 소아에서 흔하지 않지만 신부전까지 초래할 수 있는 심각한 합병증이다. 혈당조절이 불량하고 사춘기나 그 이후에 당뇨병이 발생하는 경우에 혈관합병증의 발생이 증가하므로 소아청소년기의 당뇨병이 청소년기에 당뇨병성 신병증으로 발현하는 경우는 드물고, 더욱이 말기 신질환으로 진행하는 경우는 매우 드물다. 저자들은 혈당 조절이 불량했던 제 1형 당뇨병 소아 환자에서 혈뇨와 단백뇨가 관찰되어 조직 검사를 통해 사춘기 전에 발생한 당뇨병성 신병증을 확인하고 사춘기에 말기 신질환으로 진행한 1례를 경험하였기에 문헌고찰과 함께 보고하는 바이다.

• Archives of Plastic Surgery
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• 제32권2호
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• pp.175-182
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• 2005

Skull base tumors have been determined inoperable because it is difficult to accurately diagnose the extent of the involvement and to approach and excise the tumor safely. However, recently, the advent of sophisticated diagnostic tools such as computed tomography and magnetic resonance imaging as well as the craniofacial and neurosurgical advanced techniques enabled an accurate determination of operative plans and safe approach for tumor excision. Resection of these tumors may sometimes result in massive and complex extirpation defects that are not amenable to local tissue closure. The purpose of this study is to analyze experiences of skull base reconstruction and to evaluate long term survival rate and complications. All cranial base reconstructions performed from July 1993 to September 2000 at Department of Plastic and Reconstructive Surgery of the Seoul National University Hospital were observed. The medical records were reviewed and analysed to assess the location of defects, reconstruction method, existence of the dural repair, history of preoperative radiotherapy and chemotherapy, complications and causes of death of the expired patients. There were 12 cases in region II, 8 cases in region I and 1 case in region III according to the Irish classification of skull base. Cranioplasty was performed in 4 patients with a bone graft and microvascular free tissue transfer was selected in 17 patients to reconstruct the cranial base and/or mid-facial defects. Among them, 11 cases were reconstructed with a rectus abdominis musculocutaneous free flap, 2 with a latissimus dorsi muscluocutaneous free flap, 1 with a fibular osteocutaneous free flap, 2 with a scapular osteocutaneous free flap, and 1 with a forearm fasciocutaneous free flap, respectively. During over 3 years follow-up, 5 patients were expired and 8 lesions were relapsed. Infection(3 cases) and partial flap loss(2 cases) were the main complications and multiorgan failure(3 cases) by cancer metastasis and sepsis(2 cases) were causes of death. Statistically 4-years survival rate was 68%. A large complex defects were successfully reconstructed by one-stage operation and, the functional results were also satisfactory with acceptable survival rates.

• Archives of Plastic Surgery
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• 제43권2호
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• pp.145-152
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• 2016

Background Innovation has molded the current landscape of plastic surgery. However, documentation of this process only exists scattered throughout the literature as individual articles. The few attempts made to profile innovation in plastic surgery have been narrative, and therefore qualitative and inherently biased. Through the implementation of a novel innovation metric, this work aims to identify and characterise the most prevalent innovations in plastic surgery over the last 50 years. Methods Patents and publications related to plastic surgery (1960 to 2010) were retrieved from patent and MEDLINE databases, respectively. The most active patent codes were identified and grouped into technology areas, which were subsequently plotted graphically against publication data. Expert-derived technologies outside of the top performing patents areas were additionally explored. Results Between 1960 and 2010, 4,651 patents and 43,118 publications related to plastic surgery were identified. The most active patent codes were grouped under reconstructive prostheses, implants, instruments, non-invasive techniques, and tissue engineering. Of these areas and other expert-derived technologies, those currently undergoing growth include surgical instruments, implants, non-invasive practices, transplantation and breast surgery. Innovations related to microvascular surgery, liposuction, tissue engineering, lasers and prostheses have all plateaued. Conclusions The application of a novel metric for evaluating innovation quantitatively outlines the natural history of technologies fundamental to the evolution of plastic surgery. Analysis of current innovation trends provides some insight into which technology domains are the most active.

• Journal of Microbiology and Biotechnology
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• 제26권5호
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• pp.918-927
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• 2016

Cryptococcus neoformans is a life-threatening pathogenic yeast that causes devastating meningoencephalitis. The mechanism of cryptococcal brain invasion is largely unknown, and recent studies suggest that its extracellular microvesicles may be involved in the invasion process. The 14-3-3 protein is abundant in the extracellular microvesicles of C. neoformans, and the 14-3-3-GFP fusion has been used as the microvesicle's marker. However, the physiological role of 14-3-3 has not been explored. In this report, we have found that C. neoformans contains a single 14-3-3 gene that apparently is an essential gene. To explore the functions of 14-3-3, we substituted the promoter region of the 14-3-3 with the copper-controllable promoter CTR4. The CTR4 regulatory strain showed an enlarged cell size, drastic changes in morphology, and a decrease in the thickness of the capsule under copper-enriched conditions. Furthermore, the mutant cells produced a lower amount of total proteins in their extracellular microvesicles and reduced adhesion to human brain microvascular endothelial cells in vitro. Proteomic analyses of the protein components under 14-3-3-overexpressed and -suppressed conditions revealed that the 14-3-3 function(s) might be associated with the microvesicle biogenesis. Our results support that 14-3-3 has diverse pertinent roles in both physiology and pathogenesis in C. neoformans. Its gene functions are closely relevant to the pathogenesis of this fungus.

• Journal of Microbiology and Biotechnology
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• 제27권1호
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• pp.161-170
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• 2017

Meningitis caused by Streptococcus suis serotype 2 (S. suis 2) is a great threat to the pig industry and human health. Virulence factors associated with the pathogenesis of meningitis have yet to be clearly defined, even though many potential S. suis 2 virulence factors have been identified. This greatly hinders the progress of S. suis 2 meningitis pathogenesis research. In this study, a co-culture blood-brain barrier (BBB) model was established using primary porcine brain microvascular endothelial cells and astrocytes, and the whole genome library of S. suis 2 was constructed using phage display technology. Finally, a total of 14 potential virulence factors contributing to S. suis 2 adherence to and invasion of the BBB were selected by analyzing the interactions between the phage library and the co-culture model. Twelve of these factors have not been previously reported in meningitis-related research. The data provide valuable insight into the pathogenesis of S. suis 2 meningitis and potential targets for the development of drug therapies.

• 대한두경부종양학회지
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• 제27권2호
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• pp.210-214
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• 2011

Background and Objectives : Narrow Band Imaging(NBI) is a novel optical technique that enhances the visualization of superficial microvascular architecture which is commonly increased and founded as an irregular shape in a neoplastic lesion. The aim of this study is the evaluation of the usefulness of NBI in the diagnosis of Head and Neck Cancer. Subjects and Methods : From December 2009 to January 2011, 31 consecutive patients who were diagnosed with head and neck malignancy were enrolled in this prospective study. The malignant findings of NBI were demarcated brownish lesion or increased intraepithelial papillary capillary loops(IPCLs) with or without irregularity. Results : There were 29 cases(93.5%) of well demarcated brownish lesion, 26 cases(83.9%) of increased IPCLs and 4 cases(12.9%) of satellite lesions. Diagnostic accuracy of endoscopic examination was increased from 83.9% to 93.5%, when NBI was applied to the conventional endoscopy(p>0.05). Conclusion : NBI is a powerful and safe screening test, which can be performed in out patient clinic without any supplementary procedure.

• Journal of Yeungnam Medical Science
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• 제9권1호
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• pp.167-174
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• 1992

저자들은 1991년 10월부터 1992년 2월까지 본원 이비인후과를 통해 내원하였던 3명의 환자를 대상으로 경부식도 재건 목적으로 유리전완피판술 2례, 전흉부 축형피판슐 1례를 시행하였으며 다음과 같은 결과를 얻어 이에 문헌고찰과 함께 보고하는 바이다. 1. 유리 전완피판술을 이용하여 피판의 한쪽변을 deepithelization한 후 이중봉합 하였으며, 원위부는 완만한 S자 모양으로 도안하고 하부식도에 틈을 만들어 피판을 삽입함으로서 문제점으로 제기되어온 하부식도문합부 협착, 누공형성등의 합병증을 해결할 수 있었다. 2. 술전 방사선 치료로 수혜부의 혈관을 이용하지 못할때에는 전흉부 축형피판술을 사용하여 만족할 만한 결과를 얻을 수 있었다. 3. 공장 전이술의 합병중인 개복의 번거러움과 수술후 장폐색증, 운동장애, 연하곤란, 음식물의 역류동의 문제점을 해결할 수 있었다.

• Journal of Korean Neurosurgical Society
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• 제29권10호
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• pp.1303-1308
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• 2000

Objectives : It has been known that vascular endothelial growth factor(VEGF), as an endothelial cell-specific mitogen, induces angiogenesis, and possesses vascular permeability and procoagulant properties. Peritumoral brain edema(PTBE) is a common accompaniment of malignant gliomas. It results from microvascular extravasation of plasma and proteins through the interendothelial spaces. The correlation between pathological grading, PTBE, neovascularization, and the expression of VEGF were analyzed in 31 patients with astrocytic tumors. Methods : Astrocytic tumor samples(8 astrocytomas, 14 anaplastic astrocytomas, and 9 glioblastomas) from 31 patients( 21 males and 10 females : average age $37{\pm}24$ years) who underwent surgery were examined retrospectively for the expression of VEGF and CD31(microvasculature) immunohistochemically. The extent of PTBE was examined by using preoperative CT or MRI as an edema index(EI). In addition to VEGF and CD31, several causative factors including tumor size, histologic type were compared with EI. Results : Only one of 8 astrocytomas, and majority of high grade(21 of 23 anaplastic astrocytomas and glioblastomas) tumors demonstrated PTBE(p<0.05). The majority of high grade tumors showed higher expression of VEGF (p<0.01). High grade tumors showed even higher CD31 expression(p<0.05), however, there was no close correlation between expression of VEGF and CD31. The EI was increased significantly, just as VEGF(p<0.01), but CD31 expression was not correlated with high EI. Conclusion : These data suggest that VEGF expression is closely correlated with PTBE and histological grading in astrocytic tumors. Microvasculature(CD31) in tumors is highly correlated with histological grading, however, shows no correlation with the expression of VEGF and PTBE.