Matched Comparison of Fusion Rates between Hydroxyapatite Demineralized Bone Matrix and Autograft in Lumbar Interbody Fusion

Kim, Dae Hwan,Lee, Nam,Shin, Dong Ah,Yi, Seong,Kim, Keung Nyun,Ha, Yoon The Korean Neurosurgical Society 2016 Journal of Korean neurosurgical society Vol.59 No.4

Objective : To compare the fusion rate of a hydroxyapatite demineralized bone matrix (DBM) with post-laminectomy acquired autograft in lumbar interbody fusion surgery and to evaluate the correlation between fusion rate and clinical outcome. Methods : From January 2013 to April 2014, 98 patients underwent lumbar interbody fusion surgery with hydroxyapatite DBM (HA-DBM group) in our institute. Of those patients, 65 received complete CT scans for 12 months postoperatively in order to evaluate fusion status. For comparison with autograft, we selected another 65 patients who underwent lumbar interbody fusion surgery with post-laminectomy acquired autograft (Autograft group) during the same period. Both fusion material groups were matched in terms of age, sex, body mass index (BMI), and bone mineral density (BMD). To evaluate the clinical outcomes, we analyzed the results of visual analogue scale (VAS), Oswestry Disability Index (ODI), and Short Form Health Survey (SF-36). Results : We reviewed the CT scans of 149 fusion levels in 130 patients (HA-DBM group, 75 levels/65 patients; Autograft group, 74 levels/65 patients). Age, sex, BMI, and BMD were not significantly different between the groups (p=0.528, p=0.848, p=0.527, and p=0.610, respectively). The HA-DBM group showed 39 of 75 fused levels (52%), and the Autograft group showed 46 of 74 fused levels (62.2%). This difference was not statistically significant (p=0.21). In the HA-DBM group, older age and low BMD were significantly associated with non-fusion (61.24 vs. 66.68, p=0.027; -1.63 vs. -2.29, p=0.015, respectively). VAS and ODI showed significant improvement after surgery when fusion was successfully achieved in both groups (p=0.004, p=0.002, HA-DBM group; p=0.012, p=0.03, Autograft group). Conclusion : The fusion rates of the hydroxyapatite DBM and Autograft groups were not significantly different. In addition, clinical outcomes were similar between the groups. However, older age and low BMD are risk factors that might induce non-union after surgery with hydroxyapatite DBM.

성인에서 장기간 Furosemide오용과 연관된 신수질 석회화

김윤구,이윤하,이규백,장세호,김대중,오하영,김보현,김미경,조윤숙 대한신장학회 1996 대한신장학회잡지 Vol.15 No.4

정신분열병에 대한 리스페리돈의 효과 및 안정성

이민수,김용구,김영훈,연병길,오병훈,윤도준,윤진상,이철,정희연,강병조,김광수,김동언,김명정,김상훈,김희철,나철,노승호,민경준,박기창,박두병,백기청,백인호,손봉기,손진욱,양병환,양창국,우행원,이정호,이종범,이홍식,임기영,전태연,정영조,정영철,정인과,정인원,지익성,채정호,한상익,한선호,한진희,서광윤 大韓神經精神醫學會 1998 신경정신의학 Vol.37 No.1

연구목적 : 본 시험의 목적은 임상시험 시작전에 연구자들을 대상으로 PANSS Workshop을 통하여 PANSS, ESRS에 대한 국내에서의 표준화 작업을 구축하고 새로운 정신병 치료제인 리스페리돈의 효과와 안정성을 재확인하여 리스페리돈 사용에 대한 적정화를 이루는데 있다. 연구방법 : 1996년 4월부터 1996년 9월까지 국내 39개 대학병원 정신과에 입원중인 혹은 증상이 악화되어 입원하는 정신분열병 환자 377명을 대상으로 다시설 개방 연구를 시행하였다. 1주일간의 약물 배설기간을 가진후, 리스페리돈을 8주간 투여하였고, 기준점, 1주, 2주, 4주, 그리고 8주후에 평가되었다. 용량은 제1일에는 리스페리돈 1mg씩 1일 2회, 제2일에는 2mg씩 1일 2회, 제3∼7일에는 3mg씩 1일 2회 투여하였다. 이후 환자의 임상상태에 따라 임의로 증량할 수 있으며, 최대 일일 16mg을 초과하지 않도록 하였다. 추체외로 증상을 조절하기 위한 투약을 허용하였다. 임상증상 및 부작용의 평가는 PANSS(Positive and Negative Syndrome Scale), CGI(Clinical Global Impression) 그리고 ESRS(Extrapyramidal Symptom Rating Scale)을 사용하였다. 연구결과 : 377명중 343명(91%)이 8주간의 연구를 완결하였다. 치료 종결시점인 8주후 PANSS 총점수가 20% 이상 호전된 경우를 약물 반응군으로 정의할때, 약물반응군은 81.3%였다. 리스페리돈에 반응하는 예측인자로는 발병연령, 이전의 입원 횟수, 유병기간이 관련 있었다. 리스페리돈은 1주후부터 PANSS양성, 음성, 및 일반정신병리 점수상에 유의한 호전을 보여 효과가 빨랐다. CGI의 경우도 기준점에 비해 1주후부터 유의한 감소를 나타내었다. ESRS의 경우, 파킨슨 평가점수는 기준점과 비교해 투여 1주, 2주, 4주후 유의하게 증가되었다가 8주후 기준점과 차이가 없었다. Dystonia 평가점수는 1주후만 유의한 증가를 보였으며, dyskinesia 평가점수는 유의한 차이가 없었다. 혈압, 맥박수의 생명징후 및 일반 혈액학 검사, 생화학적 검사, 심전도 검사에서 유의한 변화는 없었다. 결 론 : 이상의 다시설 개방 임상 연구를 통해 리스페리돈은 정신분열병 환자에서 양성증상뿐만 아니라 음성증상 및 전반적인 증상에도 효과적인 것으로 사료된다. 보다 명확한 평가를 위해서는 다른 항정신병약물과의 이중맹검 연구가 필요할 것으로 생각되며, 또한 장기적 치료에 대한 평가도 함께 이루어져야 하겠다. Objective : The purpose of this study was to investigate the efficacy and safety of risperidone in the treatment of Korean schizophrenic patients. Method : This multicenter open study included 377 schizophrenic patients drawn from 39 university hospitals. After a wash-out period of 1 week, the schizophrenic patients were treated with risperidone for 8 weeks and evaluated at 5 points ; at baseline, and 1, 2, 4 and 8 weeks of treatment. The dose was increased from 2mg/day(1mg twice daily) to 6mg/day(3mg twice daily) during the first week and adjusted to a maximum of 16mg/day over the next 7 weeks according to the patient's clinical response. Medication to control extrapyramidal symptoms was permitted. The psychiatric and neurological status of the patients was assessed by PANSS, CGI, and ESRS scales. Results : 343(91%) of 377 patients completed the 8-week trial period. Clinical improvement, as defined by a 20% or more reduction in total PANSS score at end point, was shown by 81.3% of patients. The predictors of response to risperidone were associated older age, shorter duration of illness, fewer previous hospitalization. Risperidone had rapid onset of action ; a significant decrease of the total PANSS and three PANSS factor(positive, negative, general), and CGI was already noticed at the end of first week. For the ESRS, parkinsonism rating scores were significantly increased until week 4 comparing with baseline. Dystonia rating scores were significantly increased until week 1, and dyskinesia rating scores were not significantly changed during the study. Laboratory parameters including vital sign, EKG, hematological, and biochemical values showed no significant changes during the trial. Conclusions : This study suggests that risperidone is generally safe and effective against both the positive and negative symptoms in our group of patients.

HAZARD ANALYSIS USING MULTI-COMPONENT ANALYSIS IN CHEMICAL PROCESSES

Kim,Ku-Hwoi,Lee,Dong-Eon n,Kim,Yonhg-Ha,Yoon,En-Sup 한국화재소방학회 2001 한국화재소방학회 학술대회 논문집 Vol.2001 No.추계

Alendronate의 뼈모세포를 통한 뼈파괴세포 형성 억제 기전

김현진,김민석,김태성,이은주,박하옥,김백윤,김선헌 대한해부학회 2003 Anatomy & Cell Biology Vol.36 No.6

The HBV DNA Amounts in Serum Have No relationship with ALT level and Hetergeneous Population Coexits in Chronic Hepatitis B Virus Infection

Chun, Yoon-Keun,Ha, Joo-hun,Hong-Jung-Woo,Oh, Soo-Myung,Kim, Sung-Soo 경희대학교 동서의학연구소 1999 INTERNATIONAL SYMPOSIUM ON EAST-WEST MEDICINE Vol.1999 No.1

Yoon-Keun Chun¹,Joohun Ha□Hong-Jung Woo□, Soo Myung Oh□,Sung Soo Kim□ ¹Department of Molecular Biology, College of Medicine,²Department of Surgery, college of Medicine,³Department of Internal Medicine, College of Oriental Medicine,and ⁴East-Weat Medical Reserch Institute,Kyung Hee University, Seoul, Korea. The HBV DNA Amounts in Serum Have No relationship with ALT level and Hetergeneous Population Coexits in Chronic Hepatitis B Virus Infection. Proceedings of International Symposium on East-West Medicine, Seoul. 212-230, 1999. -Hepatitis B is caused by hepadnavirus. Hepatitis B virus replicates through 3.5kb pregenomic RNA intermediate which is regulated by core promoter. Pathogenesis of hepatitis B virus has been bilieved the result of host immune response. But recently many studies have reported that high level of viral replication caused by mutation in core promoter might result in severs hepatitis. But these studies were performed in vitro, not in vivo. So there is yet debate about which factor, viral of host factor, is more important in pathogenesis of hepatitis B virus. So we measured real viral replication level in 204 chronic hepatitis B patients by quantifying HBV DNA from sera by our novel PCR-based more sensitive method, and compared these results with ALT level measured from same sera, which indicates liver cell damage. Surprisingly there are no significant correlation between HBV DNA quantity and ALT level. Then we cloned core promoter region. In SSCP, we found that many viral mutants coexist in one patient. Base on SSCP result, we chose main viral core promoter type in each patients, which is thought to determine overall viral replication level in this patient. Main type of core promoter region of each 41 patients were directly sequenced. And with these we measured promoter activity by luciferase assay system and compared promoter activity with on another. We found tha there were some differences in promoter activity according to core promoter sequences. And we constructed replication-competent viral constructs with core promoter from 41 patients and Transfected these into HepG2 cell and measured HBV DNA by southern blot. There were also differences in HBV DNA quantity according to core promoter sequences. On these all results we investigated correlation between the effect of HBV core promoter on viral replication in vitro and HBN DNA quantity, ALT level from sera of each patients. We found there is no significant correlation among them. As a result, we concluded that in determining severity chronic hepatitis B patients, host factors of each patient is more important rather than replicative activity of virus itself.

淸陰 金尙憲의 疏箚 考察

김하윤(Ha-yoon, Kim) 어문연구학회 2012 어문연구 Vol.72 No.-

淸陰 金尙憲은 선조에서 인조대에 이르기까지 조선시대 사란(壬辰ㆍ丁酉ㆍ丁卯ㆍ丙子)의 소용돌이를 모두 경험한 관료문인이다. 그는 대표적 척화대신으로 국론을 이끌어 조선후기 사회의 국가대의로 기능한 北伐論의 기초를 놓았다고 평가받으며, 명분과 의리를 중시하여 후세에 節操의 상징으로 높이 평가되고 있다. 그의 문장과 節義는 正祖와 桐溪 鄭蘊에게 극찬을 받았고, 청나라 사람들에게까지도 경외의 대상이 되었다. 본고는 조선 중기 淸陰 金尙憲의 疏箚중에서 당시의 실상과 청음의 시대인식을 엿볼 수 있는 時弊疏와 諫諍疏를 통하여, 청음 소차의 槪況과 內容을 파악하였다. 청음의 소차는 모두 140편인데, 上疏와 箚子가 거의 5:5의 동일한 비율로 창작되었고, 諫長에 제배된 1624년을 기점으로 창작이 집중되는 현상을 보인다. 諫長으로서의 책임감을 다하고자 했던 그는 소차에서도 왕에 대한 直諫의 정도를 강하게 표출하였다. 그리고 여러 자리에서 진퇴를 반복하다 보니 전반적으로 辭免疏와 請願疏가 많은 비중을 차지하게 되었던 것이다. 청음은 왕권의 정통성을 확립하여 백성을 안정시키고, 時弊의 匡正을 위해서는 言路가 중요하다고 주장하였다. 君臣간의 의사 전달 창구가 언로인데, 언로의 開閉는 곧 나라의 存亡까지 이어지는 원인이 될 수 있으므로, 언로의 원활한 소통이 잘 이루어져야 한다고 하였다. 그리고 언로의 수직적인 소통에 이어서 보편적으로 통용되는 公道가 시행되야 함도 강조하였다. 賢才를 기용하고, 近臣들의 直言을 귀담아 들으며, 백성들을 위하는 爲民政治의 모범을 보이는 것이 公道라 할 수 있다. 그러나 청음 당대의 현실은 私情에 치우쳐 公道政治가 제대로 이루어지지 않고 있음을 力說하고 있다. 또한 上下의 言路가 소통되어 바른 도리인 공도가 회복된다면, 당대의 弊政은 자연스럽게 개혁되고 실추된 민심이 회복되어 人心도 돌아올 것이라고 보았다. 결국 국가가 扶持되는 원동력은 人心이고, 인심은 곧 하늘의 뜻인 것이다. 청음은 자신이 겪었던 당대의 폐정을 疏箚라는 형식을 빌어 임금께 직언하고 정치에 반영하여 세상을 匡正하고자 하였던 것이다. 그래서 임금의 뜻이 백성들의 마음에 순응하게 되면 하늘도 자연스럽게 왕에게 民治의 정당성을 부여해 준다고 본 것이다. From King Seonjo to King Injo, Cheongeum Sanghyeon Kim was caught up in a political vortex in the Joseon dynasty as a bureaucratic literacy man, experiencing massacre of scholars of Imjin, Jeongyu, Jeongmyo, and Byeongja. His reputation in the late Joseon Dynasty included that he was a representative minister who rejected peace and he established base of sending an expedition to conquer the north which served as a country representative. Also, he was highly praised as his image of integrity, putting high value on moral obligations and loyalty. In addition, his writings and moral obligations won rave reviews from Donggyeo Jeongon and even Ching people admired him with great awe. The purpose of this study was to investigate Cheongeum’s appeals focusing on its overall condition and contents to explore real condition and recognition of the times through looking at the letters of correcting corruptness of the times (Sipyeoso) and that of begging (Ganjaengso). Total number of Cheongeum’s appeals is 140, created in the ratio of 5: 5 between appeals and simple form of appeals (Chaja). The period of creation was focused on 1624 when he was appointed as a chair of appeals; he strongly expressed his appeals to King directly in his appeals to fulfill his duty as a chair of appeals and his repeated appointment in various positions brought many letters of begging and appeals in general. He argued that the press was highly important to secure King’s legitimacy, to stabilize people’s livelihood, and to correct corruptness of the times. According to what he asserted, it was the press that could make communication clearly and effectively between king and servant. He believed the opening and closing could cause one nation failed by emphasizing good communication of the press. On top of that, he put a stress on implementing path of justice that could be used in common in addition to vertical communication of the press. What he suggested as a path of justice was employing a man of knowledge and wise, listening to plain speaking, and showing exemplary politics for the people. In spite of his idea of a path of justice, situation of the time was, paradoxically, too much biased by personal feeling to implement it. With regaining a fair path through effective communication in the press up and down, he believed negative effects of the politics could be renovated and people’s alienated mind would be recovered naturally, bringing people’s mind back; driving force of a nation is the mind of the people and the mind of the people is the mind of heaven. Fit into a pattern of appeals, Cheongeum spoke plainly the negative effects of politics he had experienced and sought to reflect them on politics for correctness. In this way, authority of legitimacy he believed would follow naturally and endow king to rule over the people from the heaven when king’s mind conformed the mind of the people.

상지 단순반복작업 근로자의 수근관 증후군 유병률에 관한 조사

손지언,장태원,김윤규,홍영습,정갑열,김동일,이강진,하남진,김상범,김준연 대한산업의학회 2001 대한직업환경의학회지 Vol.13 No.3

목적 : 본 연구는 수근관 증후군의 발생위험이 높은 작업형태에 종사하는 상지 단순반복작업근로자로서 육류 및 어류 가공 사업장과 목재소 근로자에서 근전도검사를 이용하여 수근관 증후군의 유병률을 조사하고자 하였다. 방법 : 상지 단순반복작업근로자로서 육류 및 어류 가공 사업장 근로자 69명과 목재소 근로자 17명을 실험군으로, 관리직, 경리, 경비등 상지의 단순반복작업이 없는 근로자 28명을 대조군으로 선정하여, 작업적 및 병력조사, 이학적 검사와 근전도검사를 통해 수근관 증후군의 유병률을 조사하였다. 결과 : 수근관 증후군의 유병률은 육류 및 어류 가공 사업장과 목재소에서 각각 26.09 % (18명)와 29.41 %(5명)로 조사되었으며, 육류 및 어류가공사업장과 목재소 근로자를 '7년 이상과 미만의 작업기간'으로 층화하여 비교한 결과 '상지부위의 통증 호소 유무', 'Visual Analogue Scale(VAS: 총 10점) 4점 이상 여부', 'Tinel teat 양성 유무', 'Phalen test 양성 유무'는 모두 단기 작업근로자군에서 양성의 빈도가 증가되었고 '수근관 증후군 유무'는 장기작업근로자군에서 양성의 빈도가 증가되었다. 결론 : 육류 및 어류 가공 사업장과 목재소의 수근관 증후군 유병률은 각각 26.09 %와 29.41 %로 육류 및 어류 가공 사업장과 목재소는 1996년 OSHA가 지정한 바와 같이 위험한 작업요인이 있는 작업장으로 분류하여 관리되어야 할 것으로 생각된다. Objectives : This study was carried out to survey on the prevalence of Carpal Tunnel Syndrome(CTS) in high risk jobs(meat and fish processing plant and wood plant), by application of Nerve Conduction Study(NCS), a confirmatory diagnostic method. Methods : Experimental group was 69 workers sampled from meat and fish processing plants and 17 workers sampled from wood plants, who were simple, repetitive workers using upper extremities and control group was 28 workers sampled from managers, secretaries and keepers. All employees were examined through work history, physical examination and NCS. Results : 18 workers(26.09%) in meat and fish processing plants, and 5 workers(29.41%) in wood plants had compatible findings to NIOSH diagnostic criteria for CTS. The experimental group had more symptoms (complaint of upper extremities, Visual Analogue Scale ≥4(VAS: total 10 point)), signs(Tinel and Phalen test) and prevalence of CTS than control group(p<0.05). The prevalence of symptoms and signs were higher in short term workers(<7 years), but the prevalence of CTS was higher in long term workers(≥7 years). Conclusions : The prevalence of CTS in meat and fish processing plant and wood plant were 26.09% and 29.41% respectively. Authors propose that meat and fish processing and wood plants should be managed as a risk job category which were designated by OSHA in 1996

Recombinant Human HAPLN1 Mitigates Pulmonary Emphysema by Increasing TGF-β Receptor I and Sirtuins Levels in Human Alveolar Epithelial Cells

김대경,Yongwei Piao,So Yoon Yun,Zhicheng Fu,Ji Min Jang,Moon Jung Back,Ha Hyung Kim 한국분자세포생물학회 2023 Molecules and cells Vol.46 No.9

Chronic obstructive pulmonary disease (COPD) will be the third leading cause of death worldwide by 2030. One of its components, emphysema, has been defined as a lung disease that irreversibly damages the lungs’ alveoli. Treatment is currently unavailable for emphysema symptoms and complete cure of the disease. Hyaluronan (HA) and proteoglycan link protein 1 (HAPLN1), an HA-binding protein linking HA in the extracellular matrix to stabilize the proteoglycan structure, forms a bulky hydrogel-like aggregate. Studies on the biological role of the full-length HAPLN1, a simple structure-stabilizing protein, are limited. Here, we demonstrated for the first time that treating human alveolar epithelial type 2 cells with recombinant human HAPLN1 (rhHAPLN1) increased TGF-β receptor 1 (TGF-β RI) protein levels, but not TGF-β RII, in a CD44-dependent manner with concurrent enhancement of the phosphorylated Smad3 (p-Smad3), but not p-Smad2, upon TGF-β1 stimulation. Furthermore, rhHAPLN1 significantly increased sirtuins levels (i.e., SIRT1/2/6) without TGF-β1 and inhibited acetylated p300 levels that were increased by TGF-β1. rhHAPLN1 is crucial in regulating cellular senescence, including p53, p21, and p16, and inflammation markers such as p-NF-κB and Nrf2. Both senile emphysema mouse model induced via intraperitoneal rhHAPLN1 injections and porcine pancreatic elastase (PPE)-induced COPD mouse model generated via rhHAPLN1-containing aerosols inhalations showed a significantly potent efficacy in reducing alveolar spaces enlargement. Preclinical trials are underway to investigate the effects of inhaled rhHAPLN1-containing aerosols on several COPD animal models.

자궁내 발육지연이 있는 출생체중 2,500 g 이상인 환아의 주산기 예후에 관한 연구

송태복,조명숙,하진아,윤대석,김철홍,김윤하,최영륜 全南大醫大 2004 전남의대학술지 Vol.40 No.1