• 대한소아치과학회지
• /
• 제45권2호
• /
• pp.257-264
• /
• 2018

골화석증은 파골세포의 기능 장애 및 증가된 골 밀도를 보이는 질환으로 그 중 유아기형 골화석증은 심각한 유형이다. 전신의 골경화와 범혈구감소증, 두개 신경 협착, 높은 감염위험성, 두부와 안모의 변형 등 다양한 증상을 유발한다. 대부분의 유아기 골화석증 환자는 발달 지연과 왜소증을 보이며, 조기에 사망에 이를 수 있다. 14개월의 여성 환아가 유전치부위에 초기 우식병소를 주소로 전남대학교 치과병원 소아치과에 내원하였다. 환아는 4세에 재 내원 하였으며 interferon-gamma, erythropoietin 치료를 받고 있었다. 성장 지연, 골격 변형, 좁은 상악궁, 총생, 선천적 영구치 결손, 우식증을 보였다. 소아과 의사와 협진하여 예방적 항생제 투여와 진정요법 후 치과 치료를 진행하였다. 이후 감염이 발생한 다수 유구치를 발치 후 상악에 가철성 연성 의치를 이용하여 구강 재건(rehabilitation)을 시행하였다. 골화석증 환자의 경우, 저하된 면역기능으로 인해 감염에 매우 취약하며, 출혈이나 발치와 연관된 골수염이나 패혈증이 유발될 수 있으므로 소아과 의료진의 협조와 예방적 항생제의 사용에 관한 고려가 간단한 치과시술 시에도 필수적이다. 또한, 당분섭취 제한 및 구강위생관리를 위한 의료진의 적극적인 개입이 필요하다.

• 생명과학회지
• /
• 제11권2호
• /
• pp.181-189
• /
• 2001

Cytokines are hormone-like proteins which mediate and regulast inflammatory and immune responses. Transforming growth factor -$\beta$1(TGF-$\beta$) plays an important role in the control of the immune response and wound healing, and in the development o various tissues and organs, Nitric oxide(NO) is major messenger molecule regulating immune function and blood vessel dilation and serving as a neurotransmitter in the brain and peripheral nervous system. Also, NO is to be a potent mutagen that cause mutation in the p53 tumor suppressor gene in early phases of human gastric carcinogenesis. The purpose of this study was to investigate the effect of Helicobacter phlori lystes, lipopolysaccharide (LPS), and Staphylococcus enterotoxin B(SEB) on production of TGF-$\beta$1 and NO by human fibroblasts. Primary cultured human fibroblasts were incubated with H. pylori lysates(Hp), LPs, SEB, Hp+LPS, Hp+SEB, Hp+LPS+SEB. Cultured supernatants that were collected at 24, 48 and 72 hr were assessed for TGF-$\beta$1 by enzyme-linked immunosorbent assay and NO production by quantification of nitrite ion. TGF-$\beta$1 production in fibroblasts exposed with Hp, LPS or SEB for 48 hrs was enhanced, but for 72 hrs inhibited. Its production by doble exposure such as Hp+LPS, Hp+SEB, Hp+LPS+SEB was lowered in comparison with single exposure of Hp in cases of 24 and 48 hrs incubation, but for 72 hrs decreased in Hp vaculoating toxin(+), increased in Hp vacuolating toxin(-). No production in fibroblasts increaed at all doses of LPS. But its production by exposure of SEB increased or decreased according to dose and incubation time. Also, NO production by Hp vacuolating toxin(+) increased at all doses, but its production by Hp vacuolating toxin(-) decreased. Its production by doble exposure such as Hp+LPS, Hp+SEB, Hp+LPS+SEB decreased in comparison with single exposure Hp Therefore, quantities pf TGB-$\beta$1 and NO released by human fibroblasts shows differences according to kinds of stimulants. Also, in care stimulated with same kinds of stimulants, its productions exhibit quantitative differences according to exposure times. These results suggest that the decreased of TGF-$\beta$1 in fibroblasts by mixed exposure with Hp producing vacuolating toxin and bacterial toxins such as LPS and SEB may effect negatively in healing of host tissue and increased of NO by infection oh H. pylori may related to the increased susceptibility for human gastric carcinogenesis.

• 대한화장품학회지
• /
• 제40권1호
• /
• pp.29-36
• /
• 2014

철피석곡은 중국에서 전통의약식물로 잘 알려진 난과 식물 중 하나이다. 본 연구에서는 생물반응장치를 이용하여 조직 배양된 철피석곡에 대하여 화장품 성분으로써 응용 가치를 평가하였다. 이미 몇몇 보고된 논문에서 철피석곡은 항암, 상처 치유 그리고 면역기능증진 등의 약리학적 활성에 대한 연구가 진행되었다. 본 연구에서는 생물반응장치를 이용하여 조직 배양된 철피석곡의 원괴체상구체 및 다신초에 대하여 화장품 성분으로서 효능, 효과를 자연에서 자란 철피석곡과 비교 평가하였다. 항산화 활성 비교 실험 결과 철피석곡의 원괴체상구체는 조직배양된 다신초 및 철피석곡 지하부 및 지상부보다 항산화 효과가 우수하였다. 조직배양된 원괴체상구체의 총 페놀 및 총 플라보노이드 성분 또한 다른 다신초나 자연에서 자란 철피석곡 추출물보다 함유량이 높음을 알 수 있었다. 다른 한편으로는 피부 미백과 관련한 효과를 비교 조사한 결과, 조직 배양된 다신초가 자연에서 자란 철피석곡 지상부, 지하부 및 조직 배양된 원괴체상구체보다 타이로 시네이즈 활성 억제 및 멜라닌 생성 억제 효과가 우수하였다. 이러한 결과들은 피부개선을 위한 화장품 성분으로서 조직배양체의 부분별 응용 가능성을 제공할 수 있을 것으로 사료된다.

• Advances in pediatric surgery
• /
• 제12권2호
• /
• pp.167-174
• /
• 2006

Central venous catheter (CVC) for long-term venous access is indispensable for various reasons including hyperalimentation, frequent blood sampling, frequent IV drug use in pediatric patients. We report clinical experience of surgical neonates in whom CVC was inserted primarily via great saphenous vein into suprarenal inferior vena cava. From March 2004 to March 2006, we performed CVC insertion via saphenous vein - contralateral side to main wound - into suprarenal inferior vena cava in surgeries of neonates. 2.7Fr or 4.2Fr, single lumen, tunneled Broviac catheters (Bard Access system, Inc, Salt Lake City, Utah) were used. Skin exit site of tunneled catheter was located in ipsilateral flank area just below edge lower rib. At the end of the procedure, location of the catheter tip was confirmed by plain radiography of abdomen. We retrospectively reviewed the admission records of the patients including nursing staff charts. Nine (50.0 %) patients were male and nine (50.0%) were female. Median gestational age was 38 weeks (range, 29-42 weeks) and median birth weight was 3,105 gm (range, 1,040-3,720 gm). Median age at catheter insertion was 38.5 days (range, 1-236 days). The purpose of CVC insertion was short-and long-term hyperalimentation in nine (50.0 %) patients. CVC insertion was performed in operation room under general anesthesia in sixteen (88.9 %) patients (in these cases, CVC insertion was performed just prior to concurrent operation) and neonatal intensive care unit (NICU) under local anesthesia with adequate sedation in two (11.2%). During the admission period (total catheter-indwelling time: 553 days), CVC functioned well without any significant side effects. Transient swelling of the ipsilateral leg (n=1, 5.6 %) and transient migration of catheter tip (n=1, 5.6 %) were noted, which did not affect function of the indwelled CVC. Mean catheter-indwelling time was 30.7days (range, 3-72 days). All catheters were removed electively except two mortality case. Complications, such as thrombosis, infection, kinking or extravasation of drugs, were not observed in our study period. Tunneled trans-great saphenous vein inferior vena cava catheters are not only comparable to cervical CVCs in terms of function and complication rates, but also very beneficial in selected patients, especially those in whom cervical approach is technically impossible or contraindicated.

• Clinical and Experimental Pediatrics
• /
• 제50권7호
• /
• pp.665-671
• /
• 2007

목 적 : 최근 신생아기에 심장 수술을 받은 환아들의 임상적 특징 및 수술 성적에 대해 알아보고자 하였다. 방 법 : 2000년 3월부터 2006년 2월까지 6년간 경북대학교 병원에서 신생아기에 수술을 받은 82명에 대해 이들의 수술 당시 나이 및 체중, 심기형의 종류, 수술 전 상태, 수술 내용 및 결과, 합병증 등을 검토하였다. 결 과 : 대상 환아 82명 중 남아는 41명이었으며 수술 당시 평균 나이는 12일, 평균 몸무게는 3,200 g이었다. 주된 심기형은 완전대혈관전위, 활로씨사징, 심실중격이 온전한 폐동맥판폐쇄, 기능적 단심실이 다수를 차지하였다. 수술 방법으로 인공심폐기를 사용한 경우가 57례였고, 54례에서 완전 교정수술이 시행되었다. 수술 종류로 완전 교정수술로는 동맥전환수술이, 고식 수술로는 변형 B-T 단락술이 가장 많이 시행되었다. 총 사망은 9례(10.9%)였으며 이 중 조기 사망은 6례, 만기 사망은 3례였다. 수술 후 합병증은 급성 신기능 부전, 지연 흉골 봉합, 상처감염, 수술 후 부정맥, 뇌실내 또는 뇌내출혈 등이 발생하여 내과적 치료를 필요로 하였다. 결 론 : 최근 6년간 본원에서 신생아기의 선천성 심장병에 대한 수술적 치료는 수술 전 처치, 수술 방법, 체외 순환법 그리고 수술 후 집중 치료의 발달을 통해서 많은 향상을 보였다.

• Journal of Trauma and Injury
• /
• 제26권3호
• /
• pp.111-124
• /
• 2013

Purpose: We should prepare proper medical service for disaster control as South Korea is not free from terrorism and war, as we experienced through the two naval battles of the Yeonpyeong, one in 1999 and the other in 2002, the sinking of Cheonan in 2010, and the attack against the border island of Yeonpyeong in 2010. Moreover, North Korea's increasingly bellicose rhetoric and mounting military threats against the world demand instant action to address the issue. The aim of this article is to describe our experience with three patients with combat-related gunshot and explosive injuries to their extremities and to establish useful methods for the management of patients with combat-related injuries. Methods: Three personnel who had been injured by gunshot or explosion during either the second naval battle of the Yeonpyeong in 2002 or the attack against the border island of Yeonpyeong in 2010 were included in our retrospective analysis. There were one case of gunshot injury and two cases of explosive injuries to the extremities, and the injured regions were the left hand, the right foot, and the right humerus. In one case, the patient had accompanying abdominal injuries, and his vital signs were unstable. He recovered after early initial management and appropriate emergency surgery. Results: All patients underwent emergent surgical debridement and temporary fixation surgery in the same military hospital immediately after their evacuations from the combat area. After that, continuous administration of antibiotics and wound care were performed, and definite reconstructions were carried out in a delayed manner. In the two cases in which flap operations for soft tissue coverage were required, one operation was performed 5 weeks after the injury, and the other operation was performed 7 weeks after the injury. Definite procedures for osteosynthesis were performed at 3 months in all cases. Complete union and adequate functional recovery were achieved in all cases. Conclusion: The patient should be stabilized and any life-threatening injuries must first be evaluated and treated with damage control surgery. Staged treatment and strict adherence to traditional principles for open fractures are recommended for combat-related gunshot and explosive injuries to the extremities.

• Journal of Chest Surgery
• /
• 제45권2호
• /
• pp.110-115
• /
• 2012

Background: Pneumonectomy remains the ultimate curative treatment modality for destroyed lung caused by tuberculosis despite multiple risks involved in the procedure. We retrospectively evaluated patients who underwent pneumonectomy for treatment of sequelae of pulmonary tuberculosis to determine the risk factors of early and long-term outcomes. Materials and Methods: Between January 1980 and December 2008, pneumonectomy or pleuropneumonectomy was performed in 73 consecutive patients with destroyed lung caused by tuberculosis. There were 48 patients with empyema (12 with bronchopleural fistula [BPF]), 11 with aspergilloma and 7 with multidrug resistant tuberculosis. Results: There were 5 operative mortalities (6.8%). One patient had intraoperative uncontrolled arrhythmia, one had a postoperative cardiac arrest, and three had postoperative respiratory failure. A total of 29 patients (39.7%) suffered from postoperative complications. Twelve patients (16.7%) were found to have postpneumonectomy empyema (PPE), 4 patients had wound infections (5.6%), and 7 patients required re-exploration due to postoperative bleeding (9.7%). The prevalence of PPE increased in patients with preoperative empyema (p=0.019). There were five patients with postoperative BPF, four of which occurred in right-side operation. The only risk factor for BPF was the right-side operation (p=0.023). The 5- and 10-year survival rates were 88.9% and 76.2%, respectively. The risk factors for late deaths were old age (${\geq}50$ years, p=0.02) and low predicted postoperative forced expiratory volume in one second (FEV1) (< 1.2 L, p=0.02). Conclusion: Although PPE increases in patients with preoperative empyema and postoperative BPF increases in right-side operation, the mortality rates and long-term survival rates were found to be satisfactory. However, the follow-up care for patients with low predicted postoperative FEV1 should continue for prevention and early detection of pulmonary complication related to impaired pulmonary function.

• Archives of Plastic Surgery
• /
• 제38권2호
• /
• pp.199-202
• /
• 2011

Purpose: Hyoid bone is a U-shaped bone in the anterior of the neck. Hyoid bone fractures are exceedingly rare and represent only 0.002% of all fractures because of its protective position relative to the mandible and its suspension by elastic musculature. We report a patient who presented hyoid bone fracture associated with hypoglossal nerve palsy. We also discuss the possible complication and treatment. Methods: A 69-year-old man was transferred from another institution because of persistent purulent discharge from the left chin. He had a history of trauma in which a knuckle crane grabbed his face and neck in the construction site. A CT scan at the time of the accident demonstrated a comminuted fracture of the right side of the mandible and hyoid bone fracture at the junction between body and right greater cornua. The displaced fracture of hyoid bone and fullness in the pre-epiglottic space were noted, probably indicating some edema. The patient was transferred into ICU after treatment of emergency tracheostomy because the patient showed respiratory distress rapidly. When the patient was hospitalized in our emergency room, he complained of dysphagia and pain when swallowing. On examination of oral cavity, the presence of muscle wasting with fasciculation of the tongue was noted and the tongue deviates to the left side on protruding from the mouth. Pharyngolarygoscopy was performed to make sure that there was no evidence of progressive swelling and pharyngeal laceration. Results: The patient underwent surgical removal of dead and infected tissue from the wound and reconstruction of mandibular bony defect by iliac bone grafting. Hyoid bone fracture was managed conservatively with oral analgesics, soft diet and restricted movement. Hypoglossal nerve palsy was resolved within 7 weeks after trauma without complications. Conclusion: Closed hyoid bone fracture is usually uncomplicated and thus it can be treated conservatively. Surgical intervention for hyoid bone fracture is recommended for patient with airway compromise, pharyngeal perforation and painful symptoms which show no response to conservative care. Furthermore, since respiratory distress syndrome may develop quickly, close observation is required. Besides, hypoglossal nerve palsy is a rarely recognized complication of hyoid bone fracture.

• 대한방사선기술학회지:방사선기술과학
• /
• 제39권3호
• /
• pp.399-406
• /
• 2016

비전리-방사선의 일종인 근적외선은 비침습적이고, 비전리성을 가지며, 생체 내 높은 투과성을 가지는 전자기파로, 진단을 위한 의료영상분야에 전 세계적으로 관심이 증가하여 그 활용 가능성이 활발히 연구되어지고 있다. 그러나 현재 국내에서 근적외선 의료영상의 활용은 극히 제한되어 있으며, 큰 관심을 가지고 있지 못하여, 새롭게 형성되는 근적외선 기반 의료영상 분야의 방사선사의 대응 역량의 강화가 필요시 된다. 본 연구에서는 근적외선의 특징 및 영상화 원리를 간략히 소개하고, 이를 이용한 최신의 연구 주제 및 세계적인 연구 동향을 소개함으로서 국내 방사선사의 역량을 강화하고자 한다. 특히, 임상적 활용 가능성이 매우 높은 상처 및 당뇨발등의 연구 주제에 대해서 소개하여, 이 분야의 발전을 가속화 시키는데 기여하고자 한다.

• Journal of Trauma and Injury
• /
• 제23권2호
• /
• pp.102-106
• /
• 2010

Purpose: With the increasing numbers of foreign residents in Korea, the need for an emergency medical care system for foreign patients seems to be growing. Sometimes, a foreigner admitted to an emergency room is not treated sufficiently due to the absence of insurance, facility in the Korean language, and a guardian. The management of a foreigner with trauma in the ER is difficult due to various problems such as social and economic status. The purpose of this study was to investigate the current management status of foreigners with penetrating wounds in the emergency room. Methods: This study is an analysis of 580 patients that were diagnosed with penetrating wounds in one teaching Hospital from Jan. 1, 2008 to Dec. 31, 2008. We analyzed results according to nationality, alcohol ingestion, intentional or accidental trauma, trauma mechanism, injury severity, management time in the ER, and outcome in the ER. Results: Of the total 580 patients, 486 patients (83.8%) were native Koreans and 94 patients (16.2%) were foreigners. According to the Revised Trauma Score, the average score of native Korean patients was 7.808, and the average score of foreign patients was 7.638. Of native Korean patients, 22.6% had knife wounds while 38.3% of foreign patients did. Of native Korean patients, 17.3% experienced intentional trauma while 33.0% of the foreign patients did. Of native Korean patients, 22.5% had ingested alcohol while 49.4% of the foreigners had. Of native Korean patients, 10.5% were admitted while 7.6% of the foreign patients were. Of native Korean patients, 14.2% were discharged against medical advice (DAMA), while 18.5% of foreign patients were. Of native Korean patients, 1.2% ran away while 8.7% of the foreign patients did. Conclusion: Stabbing was the most common cause of penetrating wounds in foreigner patients in this study. Intentional trauma was more common in foreigners with penetrating wounds than in native Koreans. The severity was higher in foreigners with penetrating wounds than it was in native Koreans, and patients who ran away or were discharged against medical advice were more commonly foreigners with penetrating wounds. Social insurance or policy is needed for the management of foreigners with penetrating wounds.