• Archives of Hand and Microsurgery
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• 제23권4호
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• pp.223-229
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• 2018

목적: 무지 수근중수 관절염(thumb carpometacarpal joint arthritis)에 대한 관절성형술로 대다각골을 제거한 후 중수골을 안정시키는 여러 방법이 소개되어 있다. 현수 봉합 관절성형술은 덜 침습적이면서 술식이 쉬운 장점이 있다. 본 연구는 무지 수근중수 관절염 환자에서 이 술식을 이용하여 수술한 결과를 알아보고자 한다. 방법: 무지 수근중수 관절염으로 진단받고 현수 봉합 관절성형술을 시행한 환자 12명을 대상으로 후향적으로 연구하였다. 시각통증척도, 수술만족도, DASH (disabilities of the arm, shoulder and hand) 점수를 조사하였고, 단순방사선 검사에서 대다각골 공간 비율을 계측하였다. 결과: 평균 추시 기간은 23개월이었다. 수술 전후 통증 점수는 7.0에서 2.9로 유의하게 감소하여 호전을 보였고 (p<0.05), 수술만족도는 평균 6.9였다. 그러나 수술 전후 DASH 점수는 유의한 차이가 없었다(p=0.06). 평균 대다각골 공간 비율은 수술 전 0.45, 수술 직후 0.33, 마지막 추시 시 0.23이었다. 결론: 현수 봉합 관절성형술은 수술 결과가 만족스럽고, 다른 술식과 비교하여 중수골 침강에 의한 대다각골 공간의 감소도 큰 차이가 없어 진행된 무지 수근중수 관절염 환자에서 유용하게 사용될 수 있을 것으로 생각한다.

• 한국의학물리학회지:의학물리
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• 제18권4호
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• pp.226-232
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• 2007

국립암센터에 설치된 양성자 치료기의 빔 전달 시스템에 대하여 Geant4 코드를 이용하여 몬테카를로 전산모사를 수행하였고, 선량검증 도구로써의 이용 가능성에 대하여 연구하였다. 몬테카를로 기술을 기반으로 하는 선량계산은 물질내의 선량분포를 이해하는 데 가장 정확한 방법으로 알려져 있다 외부조사 방사선치료에 있어서 이 방법의 장점을 극대화 하기 위해서는, 빔이 지나가는 곳에 놓여진 노즐 구성요소들의 정확한 모델링과 더불어 초기빔 특성파악은 무엇보다 중요하다. 국립암센터에 설치된 양성자 치료기는 총 3가지 형태-double/single scattering, uniform scanning and pencil-beam scanning-로 치료빔을 조사할 수 있으며, 본 연구진은 Geant4.8.2 코드를 기반으로 double/single scattering 모드를 구성하는 모든 노즐구성요소들에 대하여 모델링 하였다. 특정 치료감이에 대하여 실험치와 일치하는 전산모사의 결과를 얻었다 본 기관에 설치된 양성자치료기에 대한 몬테카를로 전산모사에 대한 기반을 성공적으로 구축하였고, 치료빔에 대하여 정밀한 선량측정에 이용할 수 있다. 치료빔의 전 에너지 영역에 걸쳐 추가적인 커미셔닝을 수행할 것이다.

• Journal of Chest Surgery
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• 제8권1호
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• pp.19-28
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• 1975

The thoracoscopic study was reported on 21 cases of spontaneous pneumothorax requiring surgical management, and clinical values of thoracoscopic examination on spontaneous pneumothorax were also discussed. patients were treated in the Department of .Thoracic Surgery, Hanyang University Hospital for the period of two Years from May 1972 to April 1974. For exact detection of etiologic factors on spontaneous pneumothorax, the thoracoscopic examination in the intrapleural space was performed in parallel with X-ray study. this study, the difference of diagnostic and therapeutic significance between radiological and thoracoscopic findings were observed and compared simultaneously. The results are summerized as follows: Patients age was distributed between 3 and 70 years old with highest incidence in the age group of sixty decade [33. 3%], and sex ratio of male to female was 5:2. The tuberculous processes which developed superficial subpleural layer in the lung parenchyme, on the pulmonary surface could be observed by thoracoscopic examination in a characteristic picture. detection ratio of pulmonary tuberculosis by the radiologic study to that by thoracoscopy was 8:2. The adhesion between the visceral and the parietal pleura which could possibly make a rupture of the alveola and the visceral pleura was found to be localized in a small area of the lung surface. The other part of the lung surface was free of the adhesion and, therefore, the movement of the lung took place completely without any difficulty. The ruptured orifice of the pleura and pathological changes surrounding the orifice can be detected by thoracoscopy, but not by other means such as radiologic examination. A single tuberculous bleb and multiple emphysematous blebs were found on 6 cases out of 21 cases of spontaneous pneumothorax. Among these cases, radiologic Study revealed the bleb only in one patient. On the other hand, the blebs were found in all the six patients by means of thoracoscopic examination. It gives the detection ratio of bleb by radiologic study to that by thoracoscopy was 1:6. By thoracoscopy, the rupture on the lung surface were visualized on the 10 patients out of a total of 21 patients [10 patients of visual rupture]. However, the rupture of the pleura was not observed on the rest of 11 patients even by thoracoscopic examination [11 patients of non visual rupture]. Five patients [50%] out of ten who had the visual rupture on the lung surface was required a surgical operation to remove pneumothorax. For the patients who were detected to have the visual rupture of the pleura by thoracoscopy, be considered in the early stage of closed thoracostomy. of 21 patients, 16 patients [11 patients of non visual rupture of the pleura and 5 patients of visual rupture of the pleura] who received no surgical management, were treated with closed thoracostomy with continuous suction, and the` pneumothorax was healed completely up in each cases. Therapeutic measures for the remaining 5 patients of visual rupture of the pleura who were subjected to surgical approach for radical treatment of spontaneous pneumothorax were accordingly complicated, and the following different procedures were properly indicated case by case, that is, rib resection thoracostomy, simple closure of ruptured visceral pleura, wedged resection of the lung, and lobectomy.

• Journal of Periodontal and Implant Science
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• 제27권1호
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• pp.61-78
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• 1997

PDGF-BB has been recognized as a highly potential growth factor for guided tissue regeneration in periodontal defect. This study carried out histologic and histometric evaluation of $200ng/cm^2$ PDGF-BB loaded bioresorbable membrane made from polyglycolic and polylactic acid. It was tested for its biocompatibility, ability to prevent epithelial downgrowth and amount of periodontal regeneration. Without membrane and PDGF-BB unloaded bioresorbable membrane were used as control. Healthy six beagle dogs were used. Each dog was anesthetized and buccal flaps were reflected in the mandibular and maxillary premolar areas. Buccal alveolar bone between the mesiobuccal and distobuccal line angles was surgically removed on the lower 2nd and 4th premolar in mandible, 2nd premolar in maxilla, to a level 4mm apical to the cementoenamel junction with creating a Class II buccal furcation defect for available space. Care was taken not to remove the root cementum layer and rubber impression materials were placed over each surgically created defect. Flaps were repositioned and sutured. Reconstructive surgery was performed 1 month after defect preparation. PDGF-BB loaded membranes and controls were randomly placed on maxillary 2nd premolars and mandibular 2nd and 4th premolars. Plaque control regimen was instituted with daily brushing with a 0.1% chlorhexidine digluconate during experimental periods. The animals were sacrificed 2 and 5 weeks after surgery and undecalcified specimens were prepared for histologic evaluation. The degree of coronal regrowth of new bone, new cementum and the amonut of new bone areas formed on the defected area of the PDGF-BB loaded membrnae turned superior to without membrane and drug unloaded membrane. Experimental membrane could prevent the epithelial downgrowth irrespective of drug loaded or not and showed good biocompatiblity, These results implicated that PDGF-BB loaded bioresorbable membrane could be highly useful tool for guided tissue regeneration of periodontal defects.

• The Korean Journal of Pain
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• 제33권4호
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• pp.318-325
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• 2020

Background: Chemotherapy-induced peripheral neuropathy (CIPN) is a major side effect of anti-cancer drugs. Neurotensin receptors (NTSRs) are widely distributed within the pain circuits in the central nervous system. The purpose of this study was to determine the role of NTSR1 by examining the effects of an NTSR1 agonist in rats with CIPN and investigate the contribution of spinal serotonin receptors to the antinociceptive effect. Methods: Sprague-Dawley rats (weight 150-180 g) were used in this study. CIPN was induced by injecting cisplatin (2 mg/kg) once a day for 4 days. Intrathecal catheters were placed into the subarachnoid space of the CIPN rats. The antiallodynic effects of intrathecally or intraperitoneally administered PD 149163, an NTSR1 agonist, were evaluated. Furthermore, the levels of serotonin in the spinal cord were measured by high-performance liquid chromatography. Results: Intrathecal or intraperitoneal PD 149163 increased the paw withdrawal threshold in CIPN rats. Intrathecal administration of the NTSR1 antagonist SR 48692 suppressed the antinociceptive effect of PD 149163 given via the intrathecal route, but not the antinociceptive effect of intraperitoneally administered PD 149163. Intrathecal administration of dihydroergocristine, a serotonin receptor antagonist, suppressed the antinociceptive effect of intrathecally administered, but not intraperitoneally administered, PD 149163. Injecting cisplatin diminished the serotonin level in the spinal cord, but intrathecal or intraperitoneal administration of PD 149163 did not affect this reduction. Conclusions: NTSR1 played a critical role in modulating CIPN-related pain. Therefore, NTSR1 agonists may be useful therapeutic agents to treat CIPN. In addition, spinal serotonin receptors may be indirectly involved in the effect of NTSR1 agonist.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제15권2호
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• pp.81-91
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• 1993

Arthrosis of the temporomandibular joint is defined as a disease of a joint with chief complaint of pain, clicking, limited jaw movements. Generally, most patients with the temporomandibular arthrosis can be treated conservatively with muscle relaxation therapy combined with mandibular repositioning prostheses, followed by occlusal equilibration, restorative dentistry and/or orthodontics, and many other forms of treatment. In case prior nonsurgical treatment proved to be ineffective or the disease is chronic and severe, surgical operation is recommended. For patients with arthrosis of the temporomandibular joint, only discectomy as therapeutic method of the surgical treatment should not be applied and the removed articular disc of the temporomandibular joint should be replaced. Allograft such as Proplast-Teflon, Silastic, etc have been used as replacements of removed articular disc. However, these allograft materials have caused complications such as inflammatory changes, foreign body reactions. As a result, a replacement material which is autogenous, space occupying, easy to harvest and less inflammatory change has been developed. Auricular cartilage with perichondrium satisfies many of these requirements. The apparent advantages of autogenous auricular cartilage as an interpositional graft after a discectomy are as follows, (1) the form of the external ear corresponds to joint morphology, (2) a graft of adequate size can be harvested, (3) the form of the external ear remains unchanged after surgery, (4) the graft can be obtained adjacent to the surgical site, (5) biologically acceptable material is used, (6) the additional expense of allogenic graft is avoided. Because we considered autogenous auricular cartilage as a good replacement material, removed articular disc has been replaced with fresh autogenous auricular cartilage in the case of three patients. The result of the treatment is favorable, and the cases being presented here.

• 대한통합의학회지
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• 제3권2호
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• pp.29-37
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• 2015

Purpose: The purpose of this study was to investigate the factors that make the bathroom experience an inconvenient one for stroke patients, including the use of basic materials to provide an effective and individualized bathroom environment. Method: The survey was conducted from May 20 to June 20, 2014 on 81 stroke patients. The questionnaire is composed of the following: general factors of respondents, degree of inconvenience of general bathroom usage, and inconvenient factors. The questions on inconvenient factors of bathroom usage are comprised of 20 questions in a 5-point Likert scale. Result: The degree of inconvenience of bathroom usage results showed that the group of patients using wheelchairs experience more inconvenience than the group of patients without wheelchairs. The inconvenient factors between two groups are shown to have significant differences in the door sill, the location of the mirror, the chair for showering, transferring to the bathtub, slippery floor, the location of cabinets, door width, shower space, the location of shower booth, and the safety handle on the wall and toilet (p<.05). Conclusion: The result of this research shows that the inconvenient factors in the bathroom experience stroke patients vary depending on the use of wheelchair. The result may be utilized as therapeutic basic materials provide an effective bathroom environment to stoke patients in future.

• Journal of Chest Surgery
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• 제30권9호
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• pp.936-940
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• 1997

43세 남자 환자가 기침,각혈 등의 심한 호흡기 증상을 주소로 내원하였다. 술전 단순 흉부 X-선 촬영과 단층 촬영에서 좌폐의 213를 차지하는 공동과 균종(mycetoma)을 발견할 수 있었다. 첫 수술에서 공동벽의 심한 유착과 박리증의 공동벽 파열,술전 환자의 호흡 기능을 감안하여 공동 절개술 (cavemostomy)과 흉곽 성형술(thoracoplasty)을 시행하였고 잔존하는 공간과 기관지 늑막루의 완전한 폐쇄를 흉벽 근육성형술(myoplasty)와 대망 충진술(omentoplasty)를 2차로 시행하여 추적 관찰중 좋은 결과를 보였다. 본 증례로 저자등은 심한 호흡 증상으로 전신 상태가 양호하지 못하고 만성쇠약에 빠진 좌폐의 213이상 차지할 만큼 큰 공동을 가진 폐국균증의 경우 대망이나 근육을 이용한 공동 절개술(cavemostomy)를 충분히 고려해 볼만한 수술적 방법임을 알게 되었다.

• Journal of Korean Neurosurgical Society
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• 제30권8호
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• pp.1004-1012
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• 2001

Objective : The spinal cord tumors(including vertebral tumors) are increasingly diagnosed and operated due to development of refined diagnostic and therapeutic tools. It is necessary to re-evaluate clinical features and surgical results of spinal cord tumors with increasing cases and developing treatment modalities. The authors reviewed the spinal cord tumor cases to evaluate their clinical characteristics. Material and Methods : The retrospective review of 654 cases of spinal cord tumors between 1973 and 1999 was done. The clinical features, pathological analysis and surgical results were analyzed and compared to the literature. The results of the study are analyzed with a more detailed consideration of each of major pathologies : neurogenic tumors, meningeal tumors, neuroepithelial tumors, and metastatic tumors. Results and Conclusion : The spinal cord tumor was most common in the 5th decade of age(145 cases, 22.1%) and 78 cases(11.9%) were found in children under 15 years of age. The ratio of male to female was 1.2 : 1. The pathologic diagnosis was neurogenic tumor in 266 cases(40.7%), neuroepithelial tumor in 131(20.0%), metastatic tumor in 118(18.0%), and meningeal tumor in 94(14.4%) in the order of frequency. The tumor was located most frequently in the thoracic area(36.5%) and in the intradural extramedullary space(38.1%). The most common initial presentation was pain(40.1%) and the mean duration for presentation to operation was 14.8 months. The total or gross total removal was possible in 404 cases(61.7%) and the surgical result on the postoperative one month was recovery or improvement in 424 cases(64.8%), stationary in 188(28.7%), progression in 42(6.4%). As a surgical complication, there was a spinal deformity(12 cases), wound infection(5 cases), aspiration pneumonia(5 cases) etc. Neurogenic tumors and menigiomas showed good surgical results, whereas neuroepithelial tumors(except ependymoma) and metastatic tumors showed relatively poor prognosis.

• The Korean Journal of Pain
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• 제21권3호
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• pp.173-178
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• 2008

Background: The intrathecal (IT) $GABA_A$ receptor antagonist, bicuculline (BIC), results in tactile allodynia (TA) through disinhibition in the spinal cord. Such disinhibition is considered to be an important mechanism for neuropathic pain. Agmatine, an endogenous polyamine, has a neuro-protective effect in the central nervous system. We investigated the analgesic effects and mechanisms of agmatine action on BIC-induced TA. Methods: Male Sprague-Dawley rats, weighting 250-300 g, were subjected to implantations of PE-10 into the lumbar subarachnoid space for IT drug injection. Five days after surgery, either $10{\mu}l$ of normal saline (NS) or agmatine ($30{\mu}g$ or $10{\mu}g$) in $10{\mu}l$ NS were injected 10 min prior to BIC ($10{\mu}g$) or NMDA ($5{\mu}g$). We assessed the degree of TA (graded 0: no response, 1: mild response, 2: moderate response, 3: strong response) every 5 min for 30 min. Areas under curves and degree of TA were expressed as mean ${\pm}$ SEM. Results were analyzed using one-way ANOVA followed by a Tukey test for multiple comparisons. P < 0.05 was considered significant. Results: IT BIC-induced strong TA reached its peak and plateaued between 10 to 15 min. IT NS-NMDA induced mild transient TA for up to 15 min. Preemptive IT AG attenuated IT BIC-induced TA dose dependently and preemptive IT AG10 completely abolished the IT NMDA-induced TA. Conclusions: Preemptive IT AG attenuated the IT BIC-induced TA through inhibitory actions on postsynaptic NMDA receptor activation. AG might be a viable therapeutic option in the treatment of neuropathic pain.