간질의 분류법에 대한 동서의학적 문헌고찰 및 새로운 제안

손광현,김문주,Son, Kwang-Hyun,Kim, Moon-Ju 대한예방한의학회 2010 대한예방한의학회지 Vol.14 No.2

The major purpose of this study is to evaluate the classification of epileptic seizure types and epilepsy described in the literatures of both Western and East Asian medicine, especially based on the two criteria- a theoretical and a practical aspect of the classification systems. Currently, the 1981 classification of epileptic seizure types, and the 1989 classification of epilepsy syndromes and epilepsies which were proposed and approved by the International League Against Epilepsy(ILAE) have been generally accepted worldwide, although a variety of modifications have been consistently suggested. A large proportion of epilepsy cases cannot be easily classified as either 'focal' or 'generalized' or as either 'symptomatic' or 'idiopathic', so they fail to be precisely fallen into any of the ILAE categories. Terms and concepts used in the East Asian medicine are also inadequate to identify epileptic seizure types and epilepsy syndromes as discrete diagnostic entities because of ambiguities in definition and use. Therefore, this article suggests an alternative approach not only more helpful in understanding mechanism of epilepsy but also more easily applicable and effective in clinical value.

미세골절술 후 생체막 덮개가 연골 재생에 미치는 영향 : 고식적인 미세골절술과의 전향적 비교 연구

손광현,김진호,곽규성,박장원,윤경호,민병현,Son, Kwang-Hyun,Kim, Jin-Ho,Kwak, Kyu-Sung,Park, Jang-Won,Yoon, Kyoung Ho,Min, Byoung-Hyun 대한관절경학회 2011 대한관절경학회지 Vol.15 No.2

목적: 슬관절의 연골 결손에 대한 미세골절술 후 병변을 덮는 생체막을 이용한 환자들의 치료 결과를 비교, 분석하고자 한다. 대상 및 방법: 2008년 1월부터 2010년 1월까지 관절경 검사로 확인된 슬관절 연골의 국소적 전층 결손이 있으며, 골관절염을 보이지 않는 53명(총 59례)의 환자를 대상으로 하였다. 무작위로 선정된 36명(42례)은 미세골절술 후 생체막으로 병변을 덮어주었고(실험군), 나머지 17명(17례)은 고식적인 미세골절술만을 시행받았다(대조군). 모든 환자는 수술 후 6개월째에 임상적 결과를 IKDC 설문지와 통증, 만족도에 대한 VAS 점수를 이용하여 비교하였고, 자기공명영상 촬영을 통해 골연골 병변의 회복 상태를 비교하였다. 결과: 임상 결과(IKDC, 통증 VAS, 만족도 VAS)에서 실험군이 대체로 더 우수하였으며 IKDC에서는 두 군 간의 통계적으로 유의한 차이를 보였다. (IKDC, p=0.047, 통증 VAS, p=0.074; 만족도 VAS, p=0.001). MRI 추시결과에서 실험군의 33명(78.6%)에서 우수한 결손 치유(67~100%)를 보이고, 5명(11.9%)만이 불량한 치유 소견을 보인 반면, 대조군에서는 4명(23.5%)의 환자에서 양호한 결손 치유가 관찰되고 9명(52.9%)의 환자들에서 결손 치유가 불량하였다(p=0.001). 실험군에서 35명(83.3%), 대조군 중 6명(35.3%)에서 변연부 결합부에서 간격이 관찰되지 않았다(p=0.001). 생체막 사용과 관련하여 심각한 부작용은 발견되지 않았다. 결론: 슬관절의 연골 결손 병변에 대해 미세골절술 후 생체막으로 도포한 군에서 단기 추시 임상적 결과 및 MRI를 이용한 영상학적 결과에서 결손부의 연골재생이 잘 된 것을 확인하였고, 미세골절술 후 ArtiFilm$^{TM}$을 함께 사용했던 군에서 연골 치유가 더 잘되는 경향이 있음을 시사한다. Purpose: Microfracture has been used as a first-line treatment to repair articular cartilage defects. In this study, a new technique using an extracelluar matrix biomembrane to cover the cartilage lesions after microfracture was evaluated in terms of cartilage repairability and clinical outcome compared with conventional microfracture technique in a prospective randomized trial. Materials and Methods: A total of 53 patients (59 cases) without osteoarthritis who had focal full thickness articular cartilage lesions were randomly assigned in two group. Seventeen patients (17 cases) underwent conventional microfracture procedure (control group) and thirty-six patients (42 cases) received microfracture and placing biomembrane cover (ArtiFilm$^{TM}$) concomitantly (experimental group). Clinical assessment was done through 6 months postoperatively using the subjective International Knee Documentation Committee IKDC questionnaire, and visual analog scale (VAS) for pain and satisfaction. Magnetic resonance imaging (MRI) was performed at 6 months after the operation in all patients. Results: In clinical outcomes, the significant difference was observed between both groups in IKDC, but not in VAS for pain and for satisfaction (final outcomes of IKDC, p=0.001; VAS for pain, p=0.074; VAS for satisfaction, p=0.194). The MRI showed good to complete defect fill (67 to 100%) in 33 patients (78.6%) of experimental group and 4 patients (23.5%) of control group, respectively. In control group, 9 of 17 patients (52.9%) showed poor defect fill (less than 33%), whereas 5 (11.9%) in experimental group (p=0.001). Assessment of peripheral integration revealed no gap formation in 35 patients (83.3%) in experimental group and 6 patients (35.3%) in control group (p=0.001). No serious complications or adverse effects related to the biomembrane were found. Conclusion: Good short-term follow-up clinical results were obtained in the group whose cartilage defects in the knee joint were covered with biomembrane after the microfracture, with the MRI findings confirming the excellent regeneration of the defective cartilage area. This suggests that the surgery to cover the defective area with biomembrane (ArtiFilm$^{TM}$) after the microfracture procedure is a safe, more effective treatment to induce cartilage regeneration.

Bacillus subtilis로부터 항진균 리포펩타이드 물질 Iturin의 생산

손광현(Kwang-Hyun Son),이항우(Hang-Woo Lee),김성욱(Sung-Uk Kim),복성해(Sung-Hae Bok),김정회(Jung-Hoe Kim) 한국생물공학회 1994 KSBB Journal Vol.9 No.2

고립성 폐결절상을 보인 콕시디오이데스진균증

양현숙 ( Hyun Suk Yang ),이재천 ( Jae Chun Lee ),임채만 ( Chae Man Lim ),이상도 ( Sang Do Lee ),고윤석 ( Youn Suck Koh ),김우성 ( Woo Sung Kim ),김동순 ( Dong Soon Kim ),김원동 ( Won Dong Kim ),손광현 ( Kwang Hyun Son ),심태선 ( T 대한결핵 및 호흡기학회 1999 Tuberculosis and Respiratory Diseases Vol.46 No.2

飛行錯覺(Spatial Disorientation) 防止를 爲한 訓練裝置 考察

朴景華,損光鉉,李甲祥 공군본부 의무감실 1965 항공의학 Vol.13 No.1

騷音이 胃內容物 排出時間에 미치는 影響

趙勝鉉,朴景華,孫光鉉,金勇植 공군본부 의무감실 1965 항공의학 Vol.13 No.1

둔상에 의한 외상성 횡격막파열

김종욱,김동관,김진천,육정환,박승일,김성철,손광현,정관호 대한외상학회 1996 大韓外傷學會誌 Vol.9 No.1

A Retrospective study of 42 patients with diaphragm injuries from blunt trauma during the past five years was undertaken. Twenty six patients (61%) had left diaphragm injuries, and thirteen patients (31%) had right diaphragm injuries. Bilateral diaphragm injuries were found in three patients. Early diagnosis was made in 36 patients by chest X-ray, diagnostic peritoneal lavage, CT scan, or clinical examination. Chest X-ray was the most common method of diagnosis (17 patients), followed by discovery at laparotomy triggered by positive diagnostic peritoneal lavage (12 patients). No right diaphragm injury was identified on chest X-ray, but chest X-ray was diagnostic in 17/26 patients (65%) with left diaphragm injuries. Right diaphragm injuries were associated with more severe trauma (lower GCS and RTS, higher ISS). Virtually all patients had associated injuries, with abdomen being the most common body region involved (71%). We conclude that blunt diaphragm injury is itself rarely a cause of death, but rather a marker of severe injury.

식도 파열 : 병인에 따른 10예의 임상분석 A clinical analysis of 10 patients in respect to pathogenesis

이문규,김병식,김진천,황원영,박건춘,육정환,박승일,손광현 대한외상학회 1994 大韓外傷學會誌 Vol.7 No.2

Despite recent advance in surgical techniques and nutrition with the availability of powerfu1 and selective antibiotics and better postoperative care, esophageal rupture continues to be associated with significant mortality and morbidity. This mortality and morbidity is directly related to delay in diagnosis and treatment. Retrospective analysis of 10 cases admitted at the Surgery and Thoracic Surgery between January 1992 and July 1994 was performed in respect to clinical course and outcome. The range of age was from 25 to 73 years, and male to female ratio was 9:I. The most common cause of rupture was spontaneous rupture. Chief complaints were dyspnea, chest pain and epigastric pain. Diagnosis was made by plain chest X-ray and esophagogram in most cases. The most frequent site of rupture was thoracic esophagus. Therapeutic modalities were variable according to time interval and condition nf patients. The most frequent complication was pneumonia. We concluded that we could improve the morbidity and mortality by early diagnosis and adequate treatment considering cause of rupture, time interval, tissue status and condition of patients.

수술적 방법으로 제거한 식도 이물 3례

박재영,서일원,김영기,우훈영,함태영,손광현 인제대학교 1990 仁濟醫學 Vol.11 No.4

내시경하에서 적출할 수 없어 수술적 방법으로 제거한 식도 이물 3례를 치험하였기에 문헌 고찰과 함께 보고하는 바이다. Esophageal foreign bodies can be easily removed under endocopy, but sometimes this non-invasive extraction technique foils. So, we redmoved them by surgically. The most difficult foreign bodies to extract by endoscopy are the sharp, pointed or big ones. The way of approach depends on the level of impacted body and possible complications. The authors experienced the three cases of esophageal forign bodies which were removed by external approach due to the danger. We report them with brief review of literature.