Cortisol Awakening Response and Nighttime Salivary Cortisol Levels in Healthy Working Korean Subjects

신일영,안련섭,전세일,이영진,김민수,이채관,성시몬 연세대학교의과대학 2011 Yonsei medical journal Vol.52 No.3

Cortisol awakening response (CAR) and nighttime cortisol levels have been used as indices of adrenocortical activity. However, population-based statistical information regarding these indices has not been provided in healthy subjects. This study was carried out to provide basic statistical information regarding these indices. Materials and Methods: Cortisol levels were measured in saliva samples collected immediately upon awakening (0 min), 30 min after awakening and in the nighttime on two consecutive days in 133 healthy subjects. Results: We determined the mean [standard deviation (SD)], median (interquartile range) and 5th-95th percentile range for each measure and auxiliary indices for CAR, i.e., the secreted cortisol concentration within 30 min of awakening (CARscc) and absolute and relative increases in cortisol level within 30 min of awakening (CARi and CARi%, respectively). We also determined these values for auxiliary indices derived from nighttime cortisol level, i.e., the ratio of cortisol level 30 min after awakening (CA_30 min) to nighttime level (CA_30 min/NC), as well as absolute and relative decreases in cortisol levels from CA_30 min to nighttime (DCd and DCd%, respectively). We found no significant differences in cortisol level for any time point or in auxiliary indices between collection days, genders and ages. Conclusion: The provided descriptive information and statistics on the CAR and nighttime cortisol level will be helpful to medical specialists and researchers involved in hypothalamus-pituitary-adrenal axis assessment.

경막하 수외로 전이된 척수암 1례 - 증 례 보 고 -

신일영,도재원,윤석만,이경석,배학근,윤일규,최순관,변박장,Shin, Il-Young,Doh, Jae-Won,Yoon, Seok-Mann,Lee, Kyeong-Seok,Bae, Hack-Gun,Yun, Il-Gyu,Choi, Soon-Kwan,Byun, Bark-Jang 대한신경외과학회 2000 Journal of Korean neurosurgical society Vol.29 No.8

Spinal intradural extramedullary metastasis are very rare. The authors report a case of spinal metastasis at the T5 level in the intradural extramedullary space in a 76-year-old man who presented with paraparesis and sciatica. Preoper-ative neuroradiologic imaging studies were highly suggestive of intradural mass lesion with compressive myelopathy. Pathology revealed metastatic squamous cell carcinoma. We describle the mechanism of tumor spread in intradural spinal metastasis.

자발성 뇌지주막하 출혈 환자에서 최초 뇌실 크기의 임상적 의의

신일영,윤일규,윤석만,도재원,이경석,배학근,최순관,변박장 순천향의학연구소 2001 Journal of Soonchunhyang Medical Science Vol.7 No.1

The purpose of this study is to invesetigate the clinical significance of initial enlargement of ventricle in the patients who had aneurysmal SAH. Of the total 821 patients with aneursmal SAH who were registerd in SAH data bank system between 1989-1999, 307 patients who had been already measured in the size of ventricle at the time of admission, were studied retrospectively. The size of ventricle was calculated by bifrontal index. Normal size of ventricle was defined as 30% or less, mild enlargement was defined as 31 to 39%, and moderate enlargement of vertricle was defined as more than 39% in bifrontal index. The sizes of ventricle using bifrontal index were analysed according to the age, sex, blood pressure, consciousness at admission, medical history of hypertension, location of ruptured aneurysm, Fisher's grade on CT(computerized tomography) scan at the time of admission, cerebral vasospasm, intraventricular hemorrhage (IVH), performance of external ventricular drainage (EVD), and prognosis at discherge. Chi-square test and ANONA were used in the statistical evaluation. The results were as follows : 1) Of the 307 patients, 235(76.5%) had a mild to moderate enlargement of ventricle at the time of admission (more than 30% in bifrontal index). 2) The size of ventricle was enlarged according to the increase of age (p<0.05). 3) In the patients who had ruptured aneurysm on anterior cerebral artery, the size of ventricle significantly increased and showed a higher incidence in mild enlargement compared with moderate enlargement of ventricle (p<0.05). 4) The size of ventricle increased in th patients who had IVH and the EVD was more frequently performed in th patients who had the enlarged ventricle associated with IVH (p<0.05). 5) In the patients who had high Fisher's grade, the size of ventricle had a tendency to increase, but there was no statistical significance. 6) In the patients who had poor prognosis, the size of ventricle had a tendency to increase, but there was no statistical significance. Conclusively, the initial size of ventricle was enlarged in th aged patients, ruptured aneurysm on anterior communicating artery, high FIsher's grade, patients associated with IVH. Considering those factors, prediction for the enlargement of ventricle size may help to treat the patients suffering aneurysmal SAH.

임상 : 성인 두개인두종의 근치적 적출술후 초기 결과

신일영 ( Il Young Shin ),김정훈 ( Jeong Hoon Kim ),김창진 ( Chang Jin Kim ),이정교 ( Jung Kyo Lee ) 대한뇌종양학회 2005 대한뇌종양학회지 Vol.4 No.2

Objective￡ºCraniopharyngioma is a histologically benign tumor but difficult to resect completely. Even with the complete resection, it has been known for high rate of recurrence. The authors report our clinical experiences and early results of radical resection of craniopharyngiomas. Methods￡º36 cases of craniopharyngioma were treated during the period between Oct, 1996 and Apr 2003, Ages of the patients ranged from 17 to 65(mean 40.3 yrs), and male to female ratio was 25￡º11. The mean maximum diameter of the tumors was 36.3mm(18-75mm), All the tumors were resected by transcranial excision attempting radical excision with maximally preserving surrounding neurovascular structures. Follow-up period was from 6 months to 87 months(mean 41.4 months). Results￡ºComplete excision was done in 34 out of 36 patients(92%) and subtotal removal was done in 2 patients. In the operative field, pituitary stalk was preserved in 17 cases. Histologically, 30 patients were adamantinomatous subtype and 6 were papillary subtype. Hypopituitarism was noted in all cases immediately after surgery except two cases, and five patients normalized their pituitary function in follow-up. Diabetes insipitus was noted in 27 cases. Among 26 patients with preopertive visual deficits, 8 patients improved their vision, seventeen did not changed and one worsened. The tumor recurred in 2 patients, at 9 months and 23 months postoperation. Recurred cases were managed by repeated craniotomy and tumor removal, they were recurrences at 36 and 40 months after 2nd operation each. Conclusions￡ºCraniopharyngioma is a benign tumor, therefore, complete excision is the only method to increase the possibility of cure. The authors recommend that complete radical excision should be attempted in every case. However, longer follow up with more patients is needed.

안와의 흑색종 방사선치료후 발생한 골육종

신일영(Il-Young Shin),박동혁(Dong Hyuk Park),정용구(Yong Gu Chung),정광윤(Kwang Yoon Jung) 대한두개저학회 2007 대한두개저학회지 Vol.2 No.1

Introduction Postirradiation osteosarcoma arising after nasopharyngeal cancer is rare and not frequently reported. Case presentation We report irradiation induced osteosarcoma involving the orbit, ethmoid, maxilla and mandible following treatment of melanoma in 45-years-old woman who presented with foul discharge in previous operation site. We present the clinical history, physical findings, imaging studies, and pathologic findings in a patient found to have osteogenic sarcoma of the maxillary sinus and peri-orbit after radiation therapy for a maxillary melanoma. Conclusion Osteogenic sarcoma is a rare and late complication of radiation treatment. Although radiotherapy remains an effective adjuvent treatment in patients with tumor, particularly those with residual or recurrent tumor, potential complications must be acknowledged.

A STUDY ON THE EFFECTS OF THE ELECTROACUPUNCTURE STIMULATION AFFECTING THE PAIN CONDUCTION FROM ORO-FACIAL REGION

Shin, Il Young,Lee, Jong Heun 대한구강생물학회 1984 International Journal of Oral Biology Vol.8 No.1

동통의 조절은 많은 연구 노력에도 불구하고 현대의학의 큰 난제중의 하나로 남아있다.1970년대에 진통마취제를 사용하지 않고 전기침 자극으로 수술중의 동통을 조절하였다는 보고가 있는 이래, Toda등 (1979, 1980, 1981), Pomeranz(1979) 그리고 Andersen등(1970)은 실험동물의 치수자극으로 야기되는 동통반응의 하나인 개구반사시의 악이복근 활성도를 이용하여 동통에 대한 전기침 자극의 영향을 조사한 바 있다. 본 실험에서는 하치조신경을 자극 할 때의 악이복근 활성도에 합곡, 협거 및 하관점의 전기침 자극이 미치는 영향과 morphine 및 naloxone의 영향에 관하여 관할하였다. 전기침 자극군의 악이복근 활성도는 자극시작후 약 15분 후에 최대 35.5%로 억제되었고, morphine 투여시에는 약 40분후 28.5%까지 억제되었다. 15분후 전기침 자극을 중단하면 급격히 정상 수준으로 회복되었고, morphine 투여시에는 약 120분 후에도 약 80.5% 정도의 회복에 불과하였다. 전기침 자극군과 morphine 투여군에서 악이복근 활성도가 최대로 억제되었을 때 naloxone을 투여한 바, 전기침 자극 중단 또는 morphine 투여시의 회복보다 급격히 정상수준으로 회복되는 양상을 보였다.

Capsaicin과 Paradol이 구강내 유해자극에 의한 개구반사와 신경흥분 전달에 미치는 영향

최동주,신일영,김중수,이종흔 대한구강생물학회 1988 International Journal of Oral Biology Vol.12 No.2

This study was performed to elucidate the analgesic mechanism of paradol and to compare effects of paradol with those of dihidrocapscaicin(DHC). Rabbits(2-2.5kg both sexes) were anesthetized with pentobarbital sodium(30mg/kg I.V.), and cannulated in trachea and external jugular vein. To observe effects on jaw opening reflex, inferior alveolar nerve(IAN) of both sides were exposed for drug application, and wire electrodes were inserted in anterior belly of digastric muscle for recording of EMGs of anterior belly of digastric muscle(dEMG) and in oral mucosa covering mental foramen for applying noxious stimulation. dEMGs evoked by noxious stimulation with double intensity of threshold for digastric EMG were recorded in magnetic tape recorder. To observe effects on action potential, saphenous nerve were exposed, and three tissue pools were made from surrounding tissue. The most distal pool was used for applying stimulation, the most proximal one for recording of action potentials, and the other on for drug application. Action potentials evoked by 200 folds intensity of threshold for most sensitive fiber were recorded in magnetic tape recorder. One side of IAN and saphenous nerves were used for DHC or paradol applications, the other side of nerves for control experiments(only vehicle application). Vehicle consisted of 10% Tween 80, 10% ethanol and 80% physiological saline(v/v), and drugs were solubilized in vehicle for 1.5% concentration(w/v). dEMGs and action potentials were recorded before drug application, immediate after 30 minutes drug application, at 30 and 60 minutes after drug had been washed out. DHC application on IAN could not influence on dEMG, but paradol application decreased the amplitude of dEMG. In action potential experiments, DHC decreased amplitude and conduction velocity of only C fiber, while paradol did those of C-fiber and Aδ-fiber.

Simultaneous Multiple Basal Ganglia and Cerebellar Hemorrhage: Case Report

이호준,신일영,황형식 대한뇌혈관외과학회 2013 Journal of Cerebrovascular and Endovascular Neuros Vol.15 No.4

A 35-year-old man presented with simultaneous multiple intracranial hematomas in the right cerebellar dentate nucleus and left basal ganglia. The hematomas were visible by computed tomography performed within two hours of the patient's arrival. The initial computed tomography showed acute hemorrhage in the left basal ganglia and dentate nucleus in cerebellum. The patient then experienced a change of consciousness due to newly developed hydrocephalus, and emergent extra-ventricular drainage was performed. By discharge, fortunately, the patient was fully recovered.

흰쥐 악하선 선포세포의 막전위와 주입저항에 미치는 바륨, 스트론튬과 코발트의 효과

박경표,신일영 대한구강생물학회 1988 International Journal of Oral Biology Vol.12 No.2

This experiment was performed to elucidate the role of calcium and the effect of barium, strontium and cobalt on the membrane potential and input resistance of salivary acinar cells in submaxillary gland of rats. Segments of submaxillary gland were isolated and superfused with physiological salt solution which contain Tris aminomethan buffer. pH was adjusted to 7.4 at 37℃ with hydrochloric acid. Membrane potential and input resistance were measured with glass microelectrode filled with 3M KCl, having a tip resistance of 10-30MΩ. Resting membrane potential(RMP) and input resistance(IR) of submaxillary gland cells were -31.1mV and 12.8MΩ, respectively and acetylcholine(Ach) evoked hyperpolarization by 13.0mV in Tris buffered solution. In calcium free solution which contain EGTA(10^-4M), RMP and IR were both decreased and Ach evoked no change in membrane potential(MP) and IR. In Tris buffered solution containing barium, RMP was increased and IR was enhanced, Acd evoked depolarization by 9.0mV and reduction in input resistance from 25.8MΩ to 20.8MΩ. Strontium also increased RMP and enhanced IR and Ach evoked hyperpolarization by 6.3mV and reduction in IR from 18.7MΩ to 12.7MΩ. In Tris buffered solution containing cobalt, RMP and IR were also decreased but Ach evoked hyperpolarization by 6.8mV.

소뇌의 급성기 뇌졸중 환자에서 부분적 두개골 피판을 이용한 후두와 감압적 두개절개술과 두개절제술의 추적관찰 결과 비교

박승섭,신일영 대한두개저학회 2022 대한두개저학회지 Vol.17 No.2

Background : In patients with severe cerebellar hemorrhage or infarction, life-threatening complications may occur. It is generally known that early decompressive craniectomy is superior to craniotomy, but there is no clear guideline for the procedure. Materials and Methods : From April 2014 to April 2021, patients who underwent suboccipital decompressive craniectomy for cerebellar stroke were treated surgically and followed up. Since September 2020, we have performed craniotomy with obtuse angled partial bone flap in 6 patients. We compared the results of 6 months follow-up in these patients with 9 patients who had previously had only decompressive craniectomy. Results : There were no deaths during 6 months in either group. Preoperative modified Rankin Scale (mRS) (P = 0.659), 1 month (P = 0.659), 3 months (P = 0.713), and 6 months (P > 0.545) postoperative mRS showed no significant difference between them. Conclusions : The results were not inferior to those who underwent suboccipital craniotomy with obtuse-angled partial bone flap and those who underwent craniectomy.