척추분리증이 동반된 요추 추간판 탈출증

신병준,김광섭,윤태경,이재철,김경제,김연일 대한척추외과학회 2001 대한척추외과학회지 Vol.8 No.1

연구계획 : 척추분리증이 동반되어 있는 추간판탈출증의 수술적 치료에 관한 후 후향적 연구이다. 연구목적 : 본 연구의 목적은 추간판탈출증 환자 중 척추분리증이 동반되어 있는 빈도를 알아보고, 추간판탈출증을 단순히 수핵제거술 만으로 치료한 경우에 단순한 추간판탈출증의 치료에 비하여 예후에 차이가 있는지를 비교하고자 하였다. 대상 및 방법 : 1989년 3월부터 1999년 2월까지 수핵제거술을 시행받은 환자 273명 중 척추분리증이 있으나, 척추불안정이 없고, 1년 이상 추시 관찰이 가능하였던 9명을 대상으로 하였다. 남자가 5명, 여자가 4명이었고, 평균 연령은 42.7세(30세 64세)였고, 평균 추시 기간은 54.6개월(15개월 114개월)이었다. 추간판탈출의 형태, 척추분리증이 있는 부위 등을 조사하였고 환자들의 이환 기간, 증상의 정도 및 양상, 신경학적 소견 등을 술 전 및 추시 시의 결과를 Kim등의 평가기준에 따라 평가하였다. 결과 : 척추분리증이 동반된 추간판탈출증의 비율은 3.7%로 나타났다. 임상적 증상을 보면 동통은 7례(78%)에서 양성이었는데, visual analogue scale에 의한 통증평가의 평균은 술전 2.1(0 8), 최종 2.1(0 5)이었고, 방사등 9례(100%)모두에서 나타났으며 통증평가의 평균은 술전 7.6(4 10)에서 최종 0.8(0 3)로 호전되었다. 하지 직거상 검사상 7례(78%)에서 양성 소견을 보였고 7명 모두에서 증상의 호전이 있었다. 근력의 약화는 6례(67%)에서 관찰되었는데 6례모두 증상의 호전이 있었다. 감각의 저하는 8례(89%)에서 나타났으며 ?M 우 7례는 증상의 호전을 보였다. 심부 건반사의 이상은 5례(56%)에서나타났으며 2례에서 증상의 호전을 보였다. 임상적 결과는 탁월 2명, 우수 6명, 양호가 1명이었다 결론 : 추간판탈출증에서 척추분리증이 동반된 비율은 3.7%로 일반적인 척추분리증의 빈도와 큰 차이는 없었다. 술후 임상증상의 회복율이나 동통지수의 변화를 볼 때 척추분리증이 동반된 추간판탈출증환자들의 수술결과도 일반적으로 추간판탈출증만이 있는 환자를 치료한 결과와 큰 차이가 없는 것으로 보아 척추분리증이 동반되었다고 하여 척추고정술을 고려하는 등 추간판탈출증 자체의 수술방법을 변경할 필요는 없다고 판단된다. Study Design : This is a retrospective study determining the surgical result of lumbar HlVD associated with spondylolysis. Objectives : To analyze the incidence of lumbar HlVD associated with spondylolysis and to compare the results of open discectomy for lumbar HlVD associated with spondylolysis to simple lumbar HlVD. Summary of Literature Review : Lumbar HlVD associated with spondylolysis need be treated by spinal fusion. Materials and Methods : Nine patients(5 males and 4 females) who had lumbar HlVD with spondylolysis, no instability. follow-up period of 1yr were identified out of 273 patients with lumbar HlVD, treated by open discectomy from March 1989 to Feb. 1999. The type of HlVD and level of spondylolysis were evaluated, the clinical symptoms and signs including SLR. motor deficit, sensory deficit, change of DTR and severity of radiating pain were periodically followed up on the predesigned protocoL Results : The incidence of lumbar HlVD associated with spondylolysis is 3.7%. The recovery of back pain was 2.1 to 2.1 by visual analogue scale, radiating pain was 7.6 to 0.8. The recovery rate of SLR was 100%, motor deficit; 100%. sensory deficit: 85%, change of DTR 4O%. The clinical evaluation was excellent(2), good(6). fair(1). Conclusions : According to the recovery rate of the clinical symptoms, the results of open discectomy for lumbar HlVD associated with spondylolysis without spinal instability and simple HIVD was not different. Therefore, we conclude that lumbar HlVD associated with spondylolysis need not be treated by spinal fusion.

흉부외상 없이 발생한 흉부대동맥 절단증의 조기 진단 : 2례 보고 Two Cases Report

한승백,전영진,백광제,김준식,김정택,김광호,선경 大韓應急醫學會 1998 대한응급의학회지 Vol.9 No.4

Aortic transection or interruption is a rare condition which developed after an acute deceleration injury. Its occurrence depends on the location and direction of the force applied and is usually from motor vehicle accident or falling down. The exact incidence of aortic transection in trauma is not known but, when develops, only about 10-15% of the victims can survive and be transported to the hospital. Even in the survivors, majority of them will be fatal within a few days if a prompt diagnosis and surgical treatments are not made. Aggressive diagnostic work-up is recommended for the patients with high suspicious index, which would salvage the victims with this fatal condition. We report the experience of two cases of aortic transection or interruption following motor vehicle accidents.

난소절제후 Estrogen을 투여한 흰쥐 대동맥에서 Protein Kinase C-α와 Fas 발현의 변화

이왕수,이상엽,안지현,송영빈,김학진,이광재,유재격,김상욱,김태호,김치정,류왕성 중앙대학교 의과대학 의과학연구소 2001 中央醫大誌 Vol.26 No.3

Estrogen is believed to decrease coronary artery disease. Protein kinase C-α(PKCα)appear to be important in signal conduction pathways. Estrogen treatment increases catalytic activity of PKCα,and activation of PKCαcan modulate estrogen receptor levels and responsiveness. And it was reported that activation of PKC can protect cells from apoptosis induced by Fas ligation. But the beneficial effect of estrogen on PKCαwas not clearly demonstrated. The objective of this study was to evaluate the role of PKCαafter ovariectomy and estrogen therapy in rat aorta. The results were summarized as below: 1. The significant pathological changes were not observed in the rat aorta irrelevant to ovariectomy and estrogen therapy. 2. The expression of Fas was decreased in the aorta of estrogen-treated rats than that of ovariectomized rats without estrogen therapy. 3. Increased expression of PKCαwas more marked in the aprta of estrogen-treated rats than that of ovariectomized rat without estrogen therapy. In conclusion,PKCαmay be important in signal conduation pathway on the effect of estrogen. Activation of PKCαby estrogen reduced Fas expression, suggesting that PKCαactivation may play a role in protection against atherasclerosis. Further studies are needed to elucidate the role of PKCαafter estrogen therapy.

강유전체박막/반도체 구조의 형성 및 특성

김광호,김제덕 청주대학교 산업과학연구소 1995 産業科學硏究 Vol.13 No.-

Use of a rapid thermal annealing(RTA) technique is shown to improve the properties of metal-ferroelectric BaMgF_(4)-silicon structures The fluoride film was deposited in an ultra-high vacuum system at a substrate temperature of 300℃. A post-deposition annealing was conducted for 10 seconds at 600℃ in a vacuum of 0.1 Torr, using a home-made RTA apparatus. The results were found out to increase the resistivity of the ferroelectric BaMgF_(4) film from a typical value of 1-2×10^(11) Ω · cm before the annealing to about 5×10^(13) Ω · cm and reduce the interface state density of the BaMgF_(4)/Si interface to about 8×10^(10) /cm^(2) ·eV. Ferroelectric hysteresis measurements using a Sawyer-Tower circuit yielded remanent polarization and coercive field values of about 0.5 μC/cm^(2) and 80㎸/cm, respectively. The typical remanent polarization of the BaMgF_(4) films on the (100) amd (111) orientated silicon wafers were 0.5-0.6 μC/cm^(2) and that of the films on the (110) wafers was 1.2 μC/cm^(2).

진달래 꽃에 의한 Grayanotoxin 중독 3 례

김아진,김준식,신동운,백광제,한승백,이용주 대한응급의학회 2000 대한응급의학회지 Vol.11 No.3

Traditionally, the Rhododendron species has been used in gastrointestinal disorder or hypertension. Grayanotoxin exists in honey, flowers, pollen, and the nectar of the Rhododenron species. We experienced 3 cases of Grayanotoxin intoxication. The symptoms of intoxication were nausea, vomiting, hypotension, bradycardia, diplopia, dizziness, and chest discomfort. Generally, the treatment for Grayanotoxin intoxication is fluid resuscitation and injection of atropine sulfate. The patients who were intoxicated with Grayanotoxin were discharged without complication after supportive care.

소양호의 DOC와 POC의 분포

김범철,최광순,김철구,이유희,김동섭,박제철 江原大學校 附設 環境硏究所 1998 環境硏究 Vol.15 No.-

Seasonal and vertical distributions of dissolved and particulate organic carbon were investigated from May 1995 to March 1997 in n deep mesotrophic reservoir, Lake Soyang, POC contentrations at the dam site ranged from 0.1 to 1.8 mgC/L and DOC concentrations ranged from 1.4 to 4.9 mgC/L. POC concentrations in the surface layer were higher in the season of cyanobacterial bloom, July to September. High POC was observed at the depth of 30 to 60m after storm runoff in summer monsoon season. Turbid storm runoff formed intermediate current laden with much particulate materials from terrestrial sources. The vertical and seasonal variation of DOC was smaller than POC. Higher DOC was observed near the lake bottom which implies sedimentation and degradation of much organic detritus at the bottom. The ratio of DOC : POC varied from 2 to 60, and the ratio was lowest in September 1995 when algal density was highest. DOC : POC ratio of the main inflowing river, the Soyang River, varied from 1 to 10, and the ratio was low in storm runoff when the POC concentration was high.

페이스트 오펙 제조에 관한 연구 : Ⅱ. 페이스트 오펙 포세린의 금속과의 결합강도 비교 Ⅱ. Comparison on the Bond Strength of Paste Opaque Porcelain to Metal

고제만,고대진,김사학,김광만 大韓齒科器材學會 2002 대한치과재료학회지 Vol.29 No.2

Metal-ceramic system has been widely using for aesthetic dental prosthesis. Opaque porcelain is used fore the masking of the metallic color of coping and the enhancing of the bond strength between metal and porcelain for PFM system. Paste opaque is a new type of opaque porcelain to easily apply onto metal coping and to get uniform thickness and good bonding characteristics to metal. The paste opaque was prepared by mixing of powder opaque with organic substances for this study. Three kinds of paste opaque which are in market were selected to compare the particle size distribution and bond strength with the paste opaque prepared in this study. The particle size distributions of all paste opaques were measured by particle size analyser, and the bond strengths were examined by using universal testing machine. This study shows that the maximum size of all samples is under 50㎛ and Ceramco has the finest mean particle size. The bond strength of the prepared paste opaque is about 35 MPa, and it is satisfied with ISO standard(25MPa).

성인성 호흡부전증(ARDS)의 호흡역학 개선을 위한 실험연구

백광제,김준식 大韓應急醫學會 1997 대한응급의학회지 Vol.8 No.1

The acute respiratory distress syndrome (ARDS) is a disorder of diffuse lung injury secondary to a wide variety of clinical insults including sepsis. It is manifested by impaired oxygenation, pulmonary edema, decreased static and dynamic compliance of lung, and increased airway resistance. Reduced lung compliance together with increased airway resistance is a hallmark of the syndrome and has generally been considered as the primary abnormality of lung mechanics. The study was designed to reproduce an ARDS condition in an animal model with acute lung injury and to determine whether these changes are reversed by inhalation of aerosolized bronchodilator such as salbutamol or nicorandil. Six adult mongrel dogs were exposed to intravenous oleic acid (0.08 ml/kg) mixed into a same amount of pure enthanol. We defined a condition of PaO2 less than 60 mmHg in FiO2 0.6 as an acute diffuse lung injury. Lung mechanics were deteriorated after oleic acid injection, from 27.33±2.73 to 17.50±7.47 cmH2O/1/sec in compliance and from 14.55±4.46 to 26.33±6.02 ml/cmH2O in airway resistance. Salbutamol or Nicorandil inhalation significantly improved lung compliance to 30.67±11.30 or 36.33±9.00 cmH2O/1/sec and airway resistance to 16.77±7.47 or 19.55±5.45 ml/cmH2O. From above data, we carefully concluded that compromized lung mechanics in adult respiratory distress syndrome could be effectively managed by inhalation of aerolized bronchodilator.

Helicobacter pylori와 대장균의 Shuttle Vector 개발

조명제,이우곤,이상룡,김경희,안영숙,김성희,김현주,류복덕,최여정,윤영혜,백승철,전영석,이광호 경상대학교 유전공학연구소 1997 遺傳工學硏究所報 Vol.16 No.-

In this study, a vehicle vector using cryptic plasmids was constructed for gene transfer in Helicobacter pylori. pHP51(3.9 kb) and pHP489(1.2 kb) were selected for constructing vectors from cryptic plasmid of H. pylori isolates in Korea. The HindⅢ-digestedDNA fragment(1.2kb) of pHP489 and 1.6kb DNA fragment of pHP51 were ligated with a kanamycin resistance gene(aph3'-Ⅲ) from C. jejuni to produce the recombinant plasmids pHP489K and pHP51K, respectively. Transformation frequency of pHP51K by electroporation was low. But pHP489K could be effectively transformed into various H. pylori strains. In order to design an intermdiate vehicle vector for gene transfer into H. pylori, pBlueHP489K was prepared by recloning pHP489K DNA into pBluescript and pTZ19R vector. This vector permitted the DNA fragment containing pHP489 sequence, aph3'-Ⅲ, and cloned DNA to be cut and self-ligated in the SacⅠ site after cloning. ureA and ureB gene were inserted into pBlueHP489K, resulting in pBlueHP489K/AB. The DNA fragment containing pHP489, kanamycin resistance gene(aph3'-Ⅲ), and urease structural gene was cut away from pBlueHP489K/AB and self-ligated to generate pBlueHP489K/AB. pBlueHP489K/AB made urease-negative H. pylori strains restore their urease activity. By this experiment, pBlueHP489K was confirmed to be the vehicle system for transferring H. pylori genes.

허혈 조건부여가 심근기능의 회복에 미치는 영향 : 적출 심장모델을 이용한 실험연구 Isolated heart experimental study

백광제,김준식,한승백,전영진,이인성 大韓應急醫學會 1999 대한응급의학회지 Vol.10 No.2

Background: Brief episode of coronary artery occlusion(i.e.,ischemic preconditioning) makes the heart more resistant to injury from a subsequent ischemic insult. Although a great deal of effort has been made in studying ischemic preconditioning, the underlying mechanism of ischemic preconditioning and its effect on hypothermic insult has not been elucidated. This study was performed to see whether ischemic preconditioning protects against the depression of cardiac contractility induced by hypothermic cardioplegic arrest/reperfusion. And recently, adenosine was known to have some correlation with the mechanism of preconditioning. If so, does this effect remain after the blockade of adenosine receptor by 8-phenyl theophyline? Method: Twenty-four Sprague-Dawley rat weighed 250-350g were used and divided into three groups. Rat hearts were removed rapidly, and each isolated heart paced with a rate of 180/min was perfused by modified Krebs-Hensleit buffer(KHB) solution on a Langendorff apparatus for an hour. After obtaining baseline data including left ventricular pressure(LVP), dp/dt, and coronary flow, cardiac arrest was induced by perfusion of 0℃ crystalloid cardioplegic(St Thomas) solution. After that, all hearts were stored in the same St Thomas solution at same temperature for 2 hours. In group Ⅰ(control group), the heart was reperfused by KHB solution. In group Ⅱ(preconditioning group), the heart was subjected to two 2-minute episode of global ischemia followed by 5 minute reperfusion with KHB solution(preconditioning) before cardiac arrest. In group Ⅲ(phenyl theophylline group), the heart was subjected to preconditioning procedure and 8-phenyl theophylline at 10μM in concentration was added to KHB solution at time of reperfusion. Observing parameter was obtained in each group at 10, 20, 40 and 60 minutes after starting reperfusion and compared statistically by use of one way ANOVA test(STASTICA, release 4.5). p-value less than 0.05 was considered significant. Results: Although depressed LVP, dp/dt, and coronary flow were seen in all groups during the reperfusion period, the preconditioned group showed more effective recovery of LVP than that of the control group, especially at 10, 20 and 40 minutes(p<.05). We failed to demonstrate the difference between the phenyl theophylline group and the control group(p=NS). Conclusion: These results suggest that ischemic preconditioning has protective effect on recovery state of hypothemic cardioplegic arrest/reperfusion. Its protective effect was limited during early reperfusion stage and was blocked by adenosine blocker.