• Tuberculosis and Respiratory Diseases
• /
• 제40권1호
• /
• pp.72-78
• /
• 1993

연구배경 : 원발성 폐암의 전이 병소 발견은 병변 자체와 위험한 합병증을 예방하기 위한 치료 계획의 수립에 중요하다. 원발성 폐암은 임파절, 부신, 뇌, 간장, 뼈로 잘 전이되며 뼈중에서는 주로 두개골, 척추, 늑골 그리고 장골 등을 침범한다. 편평상피암에서의 골전이는 다른 폐암에 비하여 비교적 낮은 빈도로 알려져 있으며 특히 원위부 족지골에의 전이는 매우 드물다. 방법 : 저자등은 연세대학교 의과대학 세브란스병원에서 우측 제 5 원위부 족지골에만 전이 병소가 발견된 폐암 1 예를 경험하였다. 결과 : 처음 편평상피암의 진단시에 T4N3MO의 상태였으며 세 번째 항암제 투여시 처음으로 원격 전이가 제 5 원위부 족지골에 국한되어 발견되었다. 단순 골사진과 전신 골 주사검사상 우측 제 5 원위부 족지골의 국소적 이상 소견이 관찰되었으며 제 5 족지의 절단 조직검사에서 폐의 편평상피암이 전이된 병변임을 병리조직학적으로 확인할 수 있었다. 결론 : 본 증례의 특징은 뼈중에서도 통상적으로 전이가 잘되는 두개골, 철추, 늑골이나 장골이외에 제 5 원위부 족지골에 처음 전이가 된 것이다. 따라서 원발성 폐암 환자에서 이학적 검사상 국소적인 염증같은 이상 소견이 발견되면 가능성은 비록 적더라도 전이성 병변을 의심해 보는 것이 필요하리라고 생각된다.

• 한국전문물리치료학회지
• /
• 제27권4호
• /
• pp.286-291
• /
• 2020

Background: Anterior cruciate ligament reconstruction (ACLR) causes a reduction in the balance of the lower extremities. Static and dynamic balance were evaluated separately to confirm the decrease in balance in patients underwent ACLR. The commonly used methods include the Biodex Balance System (BBS) for static balance and the Y balance test (YBT) for dynamic balance. No study has evaluated whether the static and dynamic balance of the involved side recovers as much as the uninvolved side one year after ACLR. Objects: The purpose of this study was to investigate the recovery of static and dynamic balance between the involved and the uninvolved sides. Methods: The BBS (overall, anteroposterior index, and mediolateral index) and YBT (anterior, posterolateral, and posteromedial) of 58 patients underwent ACLR were measured one year postoperation. Both sides of the BBS and the YBT were compared using the paired t-test. Results: All the index of the BBS showed no difference between the involved and the uninvolved sides, while all the scores of the YBT showed a significant difference in both sides. The YBT anterior result was 54.64 ± 5.62 cm in the involved side and 56.90 ± 5.41 cm in the uninvolved side (p = 0.001). The YBT posterolateral results were 90.12 ± 10.51 cm and 92.34 ± 9.85 cm (p = 0.013). The YBT posteromedial results were 93.72 ± 8.84 cm and 96.14 ± 9.37 cm (p = 0.002). Conclusion: A year after ACLR, the static balance showed no difference, while the dynamic balance showed a significant difference in the involved and the uninvolved sides. The static balance of the involved side recovered as much as the uninvolved side, but the dynamic balance did not. Therefore, dynamic balance training should be considered in the rehabilitation program for patients underwent ACLR.

• 근관절건강학회지
• /
• 제11권2호
• /
• pp.187-198
• /
• 2004

Purpose: The purpose of this study was to identify differences of BMI, pain, depression, self-esteem and self-efficacy between rheumatoid arthritis and osteoarthritis patients. Method: The study subjects were 135 persons having chronic arthritis at rheumatology clinic and the department of orthopedic surgery of the C university hospital in D city. The data were collected from February 19th to April 7th, 2003. The data analysis consisted of $X^{2}-test$, t-test, Pearson Correlation Coefficient, and multiple regression using SPSSWIN 10.0 program. Result: 1. There were significant differences in age(p=0.000), occupation(p=0.015), marriage(p=0.028), duration of illness(p=0.000), BMI(p=0.006) and Self-efficacy(p=0.017) between rheumatoid arthritis and osteoarthritis patients. 2. In rheumatoid arthritis, the BMI and self-esteem(r=-0.239, p=0.05) were significantly correlated and also pain and self-esteem(r=-0.402, p=0.01), pain and self-efficacy(r=-0.455, p=0.01) were significantly negatively correlated. The self-esteem and depression(r=-0.622, p=0.01), self-efficacy and depression(r=-0.729, p=0.01) were significantly negatively correlated and also pain and depression(r=0.432, p=0.01), self-esteem and self-efficacy(r=-0.476, p=0.01) were significantly positively correlated. In osteoarthritis, the pain and self-esteem(r=-0.225, p=0.01) were significantly negatively correlated and also pain and self-efficacy(r=-0.493, p=0.01), self-esteem and depression(r=-0.692, p=0.01), self-efficacy and depression(r=-0.566, p=0.01) were significantly negatively correlated. The pain and depression(r=0.290, p=0.05), self-esteem and self-efficacy(r=0.383, p=0.01) were significantly positively correlated. 3. The factors influenced by the self-efficacy, the depression and age in rheumatoid arthritis explained 56.2%, the depression and pain in osteoarthritis explained 43.9%. The factors influenced by the BMI, the self-esteem in rheumatoid arthritis explained 5.7%, but there was no significantly variable in osteoarthritis. Conclusion: The results support the importance of different nursing intervention focused on BMI and self-efficacy in patients with rheumatoid arthritis and osteoarthritis. There is a need for further studies to identify relation of variables in different diseases related to arthritis.

• 대한한의학회지
• /
• 제27권1호
• /
• pp.184-195
• /
• 2006

Objectives : Betula Platyphylla(BP) is a traditional analgesic, anti-fungal, anti-inflammatory herb used in Chinese 1medicine. However, no information is available to explain its action. In this study. we investigated the anti-inflammatory 1effects of BP to elutidate the molecular pharmacological activity in the ethanol extract of BP(BPE). Methods : We performed WTS assay in lipopolysaccharide (LPS) stimulated RAW264.7 macrophages with BPE. Nitrite was measured by Griess assay, prostaglandin E2 (PGE2) by enzyme-linked immunosorbent assay (ELISA) in LPS induced RAW264.7 macrophages with BPE. Inducible nitric oxide synthase (iNOS) and cyclooxygenase (COX-2) were determined by Western blot. Activation of nuclear factor-kappaB (NF-kB) was measured by electrophoretic mobility shift assay (EMSA). Results : BPE significantly suppressed production of nitric oxide (NO) and PGE2 in LPS-induced RAW264.7 macrophages in a dose-dependent manner. The maximal inhibition rate of NO and PGE2 production by BPE was ca. 88.8% and 93% at the concentration of $100{\mu}g/ml$ (non-cytotoxic concentration), respectively. BPE also decreased iNOS protein and COX-2 protein in LPS-induced RAW264.7 macrophages. EMSA demonstrated that BPE inhibited the DNA binding activity of the NF-kB. Conclusions : These results suggest that BPE inhibits NF-${\kappa}B$-mediated gene expression and downregulates inflammatory mediator production in RAW264.7 macrophages.

• Archives of Plastic Surgery
• /
• 제38권1호
• /
• pp.27-34
• /
• 2011

Purpose: Anterolateral thigh (ALT) perforator free flap is commonly used because of its various benefits. The author reports important factors of preoperative and perioperative ALT perforator free flap and causes of failure. Methods: 84 patients who were treated with ALT perforator free flap from December 2004 to 2008, and February 2010 to April 2010 were studied. 61 patients were male and 23 were female. The mean age of patients was 51.1. The main cause was neoplasm and the main reconstructive areas were head and neck area. The size of flap was various from $3{\times}4$ to $12{\times}18$ cm. 6 patients received split thickness skin graft at donor site. Preoperative angiography was checked to all patients. Results: Among the 84 patients, partial necrosis of flaps occurred in 4 patients because of atherosclerosis, varicose vein, or inattention of patient, etc. And total flap necrosis in 5 patients because of abnormal vessels of recipient area or delay of operation, etc. One case of serous cyst was found as the complication of donor area. Two cases of skin graft on donor site were done because of suspected muscle compartment syndrome, 4 cases of that because of large flap. Septocutaneous perforators were found in 7 cases. The author couldn't find reliable perforator in 3 cases, ipsilateral anteromedial thigh perforator and contralateral ALT perforator and latissimus dorsi musculocutaneous free flap were done instead of ALT. There was no case which needed reoperation because of the impairment of blood supply, and 3 cases were revised by leech because of the burn injury by a lamp or venous congestion. Conclusion: Although ALT perforator free flap is widely used with its various merits, many factors such as preoperative condition of donor or recipient area, morphology of defect and operating time need to consider to prevent flap necrosis. And operators should need careful technique because septocutaneous perforator is uncommon, and musculocutaneous perforator is common but difficult to dissect.

• Archives of Reconstructive Microsurgery
• /
• 제6권1호
• /
• pp.29-38
• /
• 1997

A peripheral nerve when approximation of the ends imparts tension at the anastomosis and with a relatively long segment defect after excision of neuroma and neurofibroma cannnot be repaired by early primary suture. The one of the optimistic reconstruction method of severed peripheral nerves is to restore tension-free continuity at the repair site putting an autogenous nerve graft into the neural gap despite of ancipating motor or sensory deficit of the donor nerve area. To overcome the deficit of the autogenous nerve graft, several other conduits supplying a metabolically active environment which is able to support axon regeneration and progression, providing protection against scar invasion, and guiding the regrowing axons to the distal stump of the nerve have been studied. An author have used ipsilateral femoral vein, ipsilateral femoral vein filled with fresh thigh muscle, and autogenous sciatic nerve for the sciatic nerve defect of around 10 mm in length to observe the regeneration pattern in rat by light and electron microscopy. The results were as follows. 1. Light microscopically regeneration pattern of nerve fibers in the autogenous graft group was more abundant than vein graft and vein filled with muscle group. 2. On ultrastructural findings, the proxial end of the graft in various groups showed similar regenerating features of the axons, myelin sheaths, and Schwann cells. The fascicular arrangement of the myelinated and unmyelinated fibers was same regardless of the type of conduits. There were more or less increasing tendency in the number and the diameter of myelinated fibers correlated with the regeneration time. 3. In the middle of the graft, myelinated nerve fibers of vein filled with muscle group were more in number and myelin sheath was thinner than in the venous graft, but the number of regenerating axons in autogenous nerve graft was superior to that in both groups of the graft. The amount of collagen fibrils and amorphous materials in the endoneurial space was increased to elapsed time. 4. There was no difference in regenerating patterns of the nerve fibers of distal end of the graft. The size and shape of the myelinated nerve fbers were more different than that of proximal and middle portion of the graft. From the above results, the degree of myelination and regenerating activity in autogenous nerve is more effective and active in other types of the graft and there were no morphological differences in either ends of the graft regardless of regeneration time.

• Journal of Yeungnam Medical Science
• /
• 제15권2호
• /
• pp.359-370
• /
• 1998

1987년부터 1998년까지 영남대학교 의과대학 부속병원에서 연골모세포종으로 진단받은 8례를 대상으로 임상병리학적 특정의 분석과 면역조직화학적 검색을 시행하여 다음과 같은 결과를 얻었다. 환자의 연령은 17세에서 38세 사이였고 평균연령은 22.7세였다. 종양의 크기는 1.5cm에서 8.0cm 사이이며 평균 크기는 4.0cm였다. 종양은 대퇴골(3례), 슬개골(2례), 경골(1례), 비골(1례) 및 척골(1례)에서 각각 발생하였다. 육안적으로 종괴는 회백색의 고형성 부위, 암갈색의 출혈, 괴사 및 낭성 변화가 다양한 비율로 섞여 있었고, 조직학적으로 연골성 분화는 8례중 7례 (87.5%)에서 나타났으며, 유사분열은 5례(62.5%), 혈철소 침착은 5례 (62.5%) 그리고 괴사는 3례 (37.5%)에서 각각 발견되었다. 석회화는 3례 (37.5%)에서 관찰되었고, 4례 (50%)에서는 이차성 동맥류성 골낭을 보였으며 1례(12.5%)에서는 혈관침범이 관찰되었다. S-100 단백은 7례 (87.5%)에서 종양세포의 세포질에 양성 반응을 나타내었고, 모든 예에서 cytokeratin에 대하여 음성 반응을 보였다.

• 동아시아식생활학회지
• /
• 제19권5호
• /
• pp.713-722
• /
• 2009

Vitamin D levels have been reported to be associated with diabetes, obesity and metabolic syndrome. There have been studies on the nutritional status of vitamin D in postmenopausal women at Seoul and premenopausal women at Busan, and these studies showed that nearly no relationship between serum vitamin D levels and the obesity index existed. However, there have been no studies that examined about the relationship between serum vitamin D levels and insulin resistance in Korea. In this study, we investigated serum vitamin D levels and the relationship between serum vitamin D levels and insulin resistance (homeostasis model assessment of insulin resistance), obesity index (body mass index, percentage of body fat and waist circumference) in 180 premenopausal women (non-obese women 87.8%, obese women 12.2%) in spring (March~April), fall (September~October) and winter (January~February) at Daejeon. Serum vitamin D levels were lower in winter than in spring-fall, after adjusting for age and the obesity index. The frequency of vitamin D inadequacy (serum vitamin D levels were $\leq$ 20 ng/mL) was 45.5% in winter and, 23.5% in spring-fall, and which showed that vitamin D inadequacy was higher in winter than in spring-fall. Multiple regression analysis showed that serum vitamin D levels had no relationship with the obesity index or insulin resistance. There was no difference in the obesity index or insulin resistance between the vitamin D inadequacy and normal group, and there was no relationship between serum vitamin D levels and the obesity index or insulin resistance in non-obese and obese premenopausal women, respectively. In conclusion, serum vitamin D levels in premenopausal women at Daejeon were lower in winter than in spring-fall, and the frequency of vitamin D inadequacy was higher in winter than in spring-fall. Serum vitamin D levels had no relationship with the obesity index or insulin resistance in premenopausal women, most of whom were not obese.

• Applied Microscopy
• /
• 제31권3호
• /
• pp.287-305
• /
• 2001

태생기 성장골에 출현하는 연골관은 골화와 무관하고 영양분을 공급하는 통로라 하였고 일부 학자들은 연골관 말단부에서 골화가 일어남을 발표하였다. 추체에서 연골관은 골화중심부 출현이전에 나타나 전 태생기동안 존재하기 때문에 연골관과 골화와의 관계를 관찰하는 것은 골화과정을 이해하는데 의의 있는 일이라 사료된다. 본 연구는 연골관이 추체연골부 골화중심부 출현에서부터 골화가 진행하는 과정에 어떠한 역할을 하는가를 전자현미경으로 관찰하여 새로운 지견을 얻었기에 그 결과를 보고하고자 한다. 좌고 60mm(태령 12주)때 추체에 연골관이 출현하기 시작하였고, 80mm(13주)때 추체 중앙부에는 석회화연골세포와 비대연골세포로 구성된 석회화소가 출현하였으며 심연골관이 비대연골세포대에서 관찰되었다. 비대연골세포의 형태는 다양하였고 불규칙하게 배열하고 있었다. 심연골관의 끝부분에는 골형성세포, 골모세포 및 파연골세포들이 관찰되었고 이것이 1차 골화중심부 출현이었다. 비석회화 연골기질은 연골관내에 존재한 혈관주위 결합조직들에 의해 주로 흡수되었고 파연골세포에의한 석회화 연골기질의 흡수는 활발하지 많음을 볼 수 있었다. 120mm(16주)때 추체 연골내골화가 전 후방으로 진행되었고 전 후방 연골막에서 막내골화가 시작되어 막성골층판이 신생되었다. 결론적으로 추체의 골화과정은 장골의 골단연골의 골화과정과 유사하였고, 특히 추체에 출현하는 연골관의 주위에 존재하는 결합조직성 세포들이 골형성세포 및 골모세포로 분화 발육하여 신생골이 형성됨을 알 수 있었다.

• 한국방사선학회논문지
• /
• 제5권6호
• /
• pp.363-367
• /
• 2011

일반적으로 중년여성의 골다공증은 저체중에서 발생률이 높은 것으로 보고되었으나 비만인 경우에도 발생할 수 있다. 따라서 본 연구의 목적은 골밀도 검사에서 골다공증으로 진단받은 중년여성 120명을 대상으로 골다공증과 체질량지수의 상관관계를 비교하고자 하였다. 체질량지수가 18.5 미만을 저체중, 18.5 ~ 22.9를 정상, 23.0 ~ 24.9를 과체중, 25.0 ~ 29.9를 비만, 30.0 이상인 경우를 고도비만으로 하였다. 연구 결과 대상자의 체질량지수 분포는 저체중이 2명(1.7%), 정상이 18명(15.0%), 과체중이 19명(15.8%), 비만이 75명(62.5%), 고도비만이 6명(5.0%) 이었다. 또한 체질량지수와 골다공증의 상관관계는 체질량지수가 정상인 경우 18명 중 13명(72.2%)이 골다공증이었으며 과체중의 경우 19명 중 14명(73.7%), 비만의 경우 75명 중 63명(84%), 고도비만의 경우 6명 중 5명(83.3%)로 나타나 체질량지수가 비만인 경우에서 골다공증 발생률이 높았다. 결론적으로 중년여성의 골다공증은 체질량지수가 비만일수록 골다공증 환자가 많다는 것을 알 수 있었으며 대부분 골감소증보다는 골다공증이 높게 나타남을 알 수 있었다.