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      • 생체분해성 망막압정을 이용한 망막고정에 대한 실험적 연구

        김용백,민병무,김창식,박근성,김승영,길숙종,조항진,이성복,노승무,송규상,강대영,조준식,양준묵,정경수,최선웅,이진호,김학용,인현빈 충남대학교 의과대학 지역사회의학연구소 1998 충남의대잡지 Vol.25 No.1

        Biodegradable retinal fixation devices obtain mechnical fixation of the retina with desirable chorioretinal scarring and with the potential for local, sustained release of antimetabolites and steroids to inhibit proliferative vitreoretinopathy. We manufactured a biodegradable retinal tack with barb that was designed in order to prevent intrusion from implantation of retinal tacks. This study was carried to evaluate the efficacy for retinal fixation and the capability for sustained release of drugs with a newly designed biodegradable retinal tack Biodegradable retinal tacks were made of polymers of glycolic acids and were designed with barbs in a shape to prevent the disinsertion. Biodegradale retinal tacks are divided into 3 parts, a conical portion that is inserted into the sclera, a cylinder portion that remains in the vitreous, and a neck portion between the pin and the cylinder. The tapered conical end was manufactured to allow easy insertion through the retina and choroid into the sclera. A cylinder portion was manufactured with a tapered angle that fixes firmly into the orifice of 19 gauge spinal needle. A neck portion, 0.4 mm in diameter, was designed to prevent disinsertion from following implantation of retinal tack. The applicator was a 19 gauge spinal needle and its orifice was prepared to 15°angle to accept the tapered cylinder portion of the retinal tack. The retinal tacks, secured in the needles, were passed through the formed vitreous and inserted into the retina, choroid, and sclera and were released by pushing the internal needle, usually within 2-3mm of the medullary ray of the posterior rabbit retina A retinal tack was placed in each of 8 pigmented rabbit eyes. Slit-lamp biomicroscopy, indirect ophthalmoscopy and fundus photography were performed periodically from 1 day to 8 weeks after surgery. Eight eyes were enucleated and studied by light microscopy at 8 weeks. Biomicroscopic evaluation of the animals revealed edemas adjacent to the retinal surfaces immediately after insertion of the biodegradable retinal tacks in all the animals. These edemas disappeared after 1 week. The first noticeable change in the size of retinal tacks was shown after 2weeks. The size of the retinal tacks gradually got smaller, decreasing to about one-half at 4 weeks and about one-third at 8 weeks. All retinal tacks remained in inserted places without any movement for an 8 week period. On light microscopy, epiretinal proliferations were seen to extend into the vitreous cavity. Cellular capsules that lined the inner aspect of the scleral defect caused by tack insertion were found. However the adjacent retina had a normal cytologic appearance and architecture in all specimens. We manufactured a biodegradable retinal tack that is designed to prevent intrusion from implantation of retinal tacks. All biodegradable retinal tacks reduce in size with time, but no retinal tacks extruded from the inserted place. The newly designed biodegradable retinal tack can be used for retinal fixation and may be used as a vehicle for the introduction of pharmacologic agents to prevent the cellular events that promote proliferative vitreoretinopathy.

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        요추 수술 예정 환자에서 실시한 선택적 신경근 차단술의 5년 추시 결과

        심대무(Dae Moo Shim),김태균(Tae Kyun Kim),오성균(Sung Kyun Oh),최윤홍(Yun Hong Choi),이석중(Suk Jung Lee) 대한정형외과학회 2009 대한정형외과학회지 Vol.44 No.1

        목적: 하지 방사통을 호소하는 환자의 수술 준비 과정에서 선택적 척추 신경근 차단술을 실시하고, 그 효과가 얼마나 오래 유지되는지를 알아 보고자 5년 이상 추시된 환자를 대상으로 분석하여 그 결과를 보고 하고자 한다. 대상 및 방법: 2000년 1월에서 2000년 12월까지 하지 방사통으로 타 병원 혹은 본원에서 수술적 치료를 권유받은 환자 중 수술 준비 과정에서 진단 및 치료 목적으로 선택적 척추 신경근 차단술을 시행한 환자를 대상으로 하였으며, 이중 5년 이상 추시가 가능하였던 69예를 대상으로 하였다. 결과분석은 진료기록부와 전화 인터뷰를 통해 하였으며. 신경차단술 시행군과 수술을 시행한 군의 치료결과 분석은 Kim's criteria (김의 평가기준), VAS(Visual analog scale) score를 이용하였다. 결과: 연구 대상 환자 69예 중 37예에서는 차단술 후에 증상 호전이 없어 수술을 시행하였고, 32예에서는 신경차단술 만으로 증상호전 되었다. 젊은 사람(60세 미만)에서 보존적 요법보다는 수술을 하는 경향이 많았으며, 이환 기간이 길수록(6개월 이상) 신경근 차단술 보다는 수술하는 경우가 높았다. 차단술 만으로도 호전된 32예의 환자 추시 결과상 다른 치료 없이 증상 호전이 지속되었던 환자는 17예(24.6%)였고 증상이 재발하여 추가 치료를 필요로 한 환자는 15예이었다. 이중 4예는 수술적 치료를 시행하였다. 결론: 수술이 예정된 하지 방사통 환자를 대상으로 수술 준비 기간 동안에 신경근 차단술을 시행하여 그 중 일부에서는 장기 추시에서도 증상 호전이 지속 되었다. 따라서 신경차단술은 수술 전에 한번 시도해 볼 만한 방법 중의 하나로 사료된다. Purpose: To evaluate the effectiveness of a selective nerve root block (SNRB) in patients with sciatica before surgery through a more than 5 year follow up. Materials and Methods: Between January 2000 and December 2000, patients with sciatica, who were recommended to undergo surgery to diagnose and treat sciatica by other clinics or at our hospital, were selected to undergo SNRB before surgery. Among them, 69 patients were followed up for 5 years. The analysis was based on the patients' medical records and telephone interviews, and the treatment results in the SNRB group and operation group were analyzed using Kim's criteria and the Visual Analog Scale score. Results: Among the 69 patients, there was no improvement in symptoms in 37 patients after SNRB. Therefore, they underwent surgery. The symptoms of the remaining 32 patients were improved by SNRB. Overall, younger patients and those with a longer symptom duration required surgery. Conclusion: SNRB was performed on patients with sciatica who were scheduled to undergo surgery. Some patients showed improvement in their symptoms in the long term. Therefore, SNRB should be considered as a treatment option prior to surgery.

      • 생체분해성 고분자를 이용한 사시수술용 제형개발 및 효용성에 대한 연구

        민병무,김용백,김승영,김창식,박근성,길숙종,조항진,이성복,노승무,송규상,강대영,조준식,양준묵,정경수,최선웅,이진호,김학용,인현빈 충남대학교 의과대학 지역사회의학연구소 1998 충남의대잡지 Vol.25 No.1

        A new device, muscle clamping system was developed to facilitate exact quatifying technique A strabismus surgery, and reduce the risk of complications. The device is composed of a lower fixing body with three jaws and an upper supporting body. They are used to clip an extraocular muscle and fix it to the sclera with a single bite. Superior rectus recession on 16 rabbit eyes were performed with this new device. Conjunctival injection, muscle adhesion strength, and light microscopic findings were examined at 1, 2, 4 and 8 weeks postoperatively. The Conjunctival injection were minimal, adhesion power ranged from 420 to 600 gram gravity, which is sufficient in withstand the normal pull of human extraocular muscle. In microscopic exam, some Inflammatory cells and fibrosis were found. The new device was technically easy, fast, and accurate, so it may be useful in stabismus surgery.

      • 다발성 대장암 간전이 환자의 간절제를 위한 새로운 시도

        주종우,김형철,임철완,신응진,조규석,유기원,송옥평,홍대식,박성진,조준희,이혜경,김희경,권계원,고은석 순천향의학연구소;Soonchunhyang Medical Research Institute 2004 Journal of Soonchunhyang Medical Science Vol.10 No.2

        Multiple bilobar liver matastases (MBLM) are the main cause of low resectability in the colon cancer liver metastases. The authors experienced one case of initially non-resectable colon cancer liver metastases. He was curatively and safely treated with a two-stage hepatectomy using the new method of future remnant liver volume growing. A 54-year-old man was referred to our department with the sigmoid colon cancer combined with MBLM, which were checked in two small metastatic lesions in the left lobe and five large sized lesions in the right lobe in the computed tomogram (CT). A laparoscopic assisted anterior resection was primarily performed. We performed the 1^(st) stage hepatectomy 3 weeks after the colon resection. Intra-operative Ultrasonogram (US) found 9 small superficial metastatic lesions in the left lobe. All that lesions were completely removed by non-anatomical wedge resection. An occlusion ballon catheter was placed in the right portal vein through a small branch of the inferior mesenteric vein at that time. The future remnant liver volume was sufficiently increased 3 weeks after the 1^(st) hepatectomy. A right hepatectomy was safely performed 22 days after the 1^(st) hepatectomy. The patient received a regional chemotherapy (interleukin2 based immuno-chemotherapy through hepatic artery) for 4 months, then received 9 cycles of systemic chemotherapy (biweekly Oxaliplation, leucovorin, plus 5-fluorouracil) without any recurrence evidence.

      • 대장수술 후에 발생한 급성신부전의 위험인자

        이혜미,황창재,김재황,김흥대,박대팔,서일숙,송선옥,김세연,이덕희,지대림 영남대학교 의과대학 2007 Yeungnam University Journal of Medicine Vol.24 No.2

        연구 배경 : 급성 신부전은 술 후 발생할 수 있는 합병증 중에서 사망률은 큰 영향을 줄 수 있으므로 이 연구를 통해 위험인자를 알아보려고 한다. 재료 및 방법 : 2004년 1월부터 2006년 12월까지 3년간 영남대학교 의과대학 부속병원에서 대장 수술을 받은 570명의 환자들을 대상으로 하였다. 환자들의 성별과 연령, 미국 마취과학회 신체등급, 동반질환, 수술의 종류, 응급수술의 여부, 수술 시간, 재수술의 여부, 술 중의 투약 상황, 술 후에 자가 통증 조절기에 사용한 약제, 술 중에 저혈압의 유무, 수혈 여부, 술 후 기계적 환기를 시행한 경우를 비교하였다. 결과 : 비교 결과에서 성별과 수술의 종류, 응급 수술의 여부, 개복여부 등에는 유의한 차이를 보이지 않았다. 반면 환자의 나이와 수술 시간, 재수술의 여부, 술중에 이뇨제 등을 사용한 경우, 술 중에 저혈압의 유무, 술 후에 기계적 환기를 시행한 경우 등에는 유의한 차이를 보였다. 결론 : 이상의 결과로 급성신부전의 원인은 어느 한 가지라고 하기 보다는 위험인자에 얼마나 노출되어 있는가가 결정하는 것 같고, 그 원인들이 모여서 상승효과를 내는 것 같다. 그러므로 수술 전부터 많은 위험에 노출된 환자는 술 중 더 적극적인 감시를 시행하여 수술 후의 합병증 발생을 줄이는 노력을 기울여야 하겠다. Background : Acute renal failure is one of the leading causes of postoperative morbidity and mortality. The purpose of this study was to determine the risk factors that are associated with acute renal failure after colorectal surgery. Materials and Methods : Five hundred seventy patients who operated colorectal surgery at the Yeungnam University Medical Center over three years from 2004 to 2006 were enrolled in this study. The effects of gender, age, ASA classification, concomitant disease, surgery type and duration, reoperation, urogenital manipulation, medication, hypotension, hypovolemia, transfusion, and postoperative ventilatory care on the occurrence of acute renal failure after colorectal surgery were studied. Results : The major risk factors of acute renal failure after colorectal surgery were age of patients (P=0.003), ASA classification (P<0.001), concomitant disease (P<0.001), duration of the time surgery (P=0.034), reoperation (P=0.001), use of intraoperative diuretics (P=0.005), use of postoperative diuretics (P<0.001), intraoperative hypotension (P=0.018), intraoperative transfusion (P<0.001), postoperative transfusion (P<0.001), and postoperative ventilatory care (P=0.001). Conclusion : Multiple factors cause synergistic effects on the development of acute renal failure after colorectal surgery. Therefore, efforts to reduce the risk factors associated with acute renal failure are needed. In addition, intensive postoperative care should be provided to all patients.

      • 이온주입이 금속의 일함수에 미치는 영향(Ⅰ)

        김현경,강석태,황정남,이철주,최대선,정병두 연세대학교 자연과학연구소 1984 學術論文集 Vol.13 No.-

        이온 주입이 일함수 차이에 미치는 영향을 연구하기 위하여 낮은 에너지 이온 가속기, 전자총과 기타 일함수 차이를 측정하기 위한 장치를 설계, 제작하였다. 제작된 이온 가속기의 집속 특성은 이론적인 값과 일치하였다. 즉, 집속 렌즈의 확대율이 이론값은 2.0인데 비하여 1.2로 상당히 작은 값이었다. 또한 집속 렌즈의 전압 V_L과 추출 전압 V_e에 의한 집속 특성 역시 이론값과 매우 잘 일치하였다 . 제작된 장치를 사용하여 다결정 Cu와 Ni의 일함수 차이를 측정한 결과 0.45eV임을 알았다. 그리고 전자선을 이용하여 억제 전위차로 일함수를 측정할때 입사 전자의 반사율을 고려해야 함을 알았다. Low energy ion accelerator, electron gun, and apparatus for measuring work function difference are designed and constructed in order to study the effect of ion implantation on the work function. The focusing properties of accelerator is coincided with theoretical results; the magnification of Einzel lens is found to be 1.2, while theoretical value is 2.0, and the focal properties as a function of V_L/V_e are in good agreement with theory. Using these systems, the work function difference between polycrystalline Cu and Ni is found to be 0.45eV, and the experimental retarding potential plots indicate close agreement with the theoretical values modified by electron reflection.

      • 국내 가사노동 연구의 동향 분석 (I) : 생활시간, 태도 및 만족도, 가사분담 연구를 중심으로 with focus on the literatures of the time studies, the attiudes toward and satisfaction with household tasks, and the division of household tasks

        김대년,이연숙 카톨릭 대학교 생활과학 연구소 1990 생활과학연구논집 Vol.10 No.1

        The purposes of this study are to analyze the trends of household task studies and to identify the common variables affecting each topic. The results of review of the literature were as follows: ①The variables affecting the attitudes toward, value perception about and satisfaction with the household tasks were the education level and age of wife, income, employment status of wife, and length of marriage. The psychological factors were found to be the variables affecting the level of satisfaction with household tasks. ②The age of children, employment status of wife, income, and the presense of house keeper were found to be as factors affecting the amount of time spenton household tasks. ③Compared with other studies, the variables affecting the aspects of household task division were found not to differ among studies. The impacting variables were the employment status of wife, the age of wife, socio-economic status of the family, structure of house, and income.

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