Sodium Nitroprusside(SNP)를 사용한 유도 저혈압 마취시 Renin 활성치, Aldosterone, Epinephrine, Norepinephrine의 변동

강기택,구영권,우성,조강희,백세민 인제대학교 1991 仁濟醫學 Vol.12 No.3

악안면 성형재건술 환자 10명을 대상으로한 sodium nitroprusside(SNP) 유도 저혈압 마취에서 SNP를 주입한 후에 체내의 renin-angiotensin-aldosterone system과 sympathoadrenal system이 활성화되었음을 관찰할 수 있었다. Sodium Nitroprusside (SNP) is used during induced hypotension to decrease bleeding in operation site by direct relaxation of vascular smooth muscle. It is known that the infusion of SNP increases plasma renin activity and this activation of remain-angiotensin system is one physiologic mechanism opposing the hypotensive action of SNP. The purpose of this study was to determine plasma renin activity and activation of sympathoadrenal system following infusion of SNP for hypotensive anesthesia in 10 patients needed maxillofacial reconstructive surgery. Blood samples for analysis were drawn according the time sequence of SNP infusion ; Stage 1; After the induction and before SNP infusion, Stage 2 ; 30 min after when mean arterial pressure maintained 60-70 torr and within 30 min after SNP infusion, Stage 3;Before slopping of SNP, Stage4; 30 min after stopping of SNP. The results were as followings, 1) The duration of anesthesia and infusion of SNP were 197.7±131.3 Min and 100.2±40.3 min. 2) Total doses of 0.01% SNP solution were 115.2±36.4 ml through hypotensive anesthesia 3) PRA in stage 2,3 and 4 (25.3±7.6, 26.2±7.2 and 24.5±8.2 ng/dl/hr respectively) were significantly increased compared with the value of stage 1 (8.9±7.0ng/dl/hr) and the level of aldosterone in stage 2, 3, 4 (28.4±12.7, 33.6±20.0 and 32.9±18.0 mg/dl respectively) were significantly increased compared with the value of stage 1 (13.4±9.1 ng/dl). The increased values of PRA and aldosterone fowllowing infusion of SNP were continued eyen after the time of stopping SNP. 4) Norepinephrine in stage 2, 3(545±157.5, 347.7±115.0 pg/ml respectively) and epinephrine in stage 2,3 (178.4±58.7, 132±55.7 pg/ml respectively) were significantly increased compared with the values of stage 1(norepinephrine ; 236.2±107.3, epinephrine ; 111.8±73.9 pg/ml) and they were returned to the control value after slopping of SNP infusion 5) Sodium potassium and chloride were not changed significantly during SNP induced hypotensive anesthesia. In summary, the activity of renin-angiotesin-aldostprone system and sympathoadrenal system were increased following infusion of SNP during SNP induced hypotensive anesthesia.

제 3형 구상돌기 골절의 수술적 치료

전인호,민우기,오창욱,경희수,박병철,김풍택,인주철,이정엽 대한골절학회 2004 대한골절학회지 Vol.17 No.4

목적: 8례의 제 3형 척골 구상돌기 골절에 대해 수술적 치료 후 임상적 방사선학적 결과를 보고하고자 한다. 대상 및 방법 : 8명의 구상돌기 골절에 대한 후향적 연구를 시행하였다. 대상은 모두 남자였으며 평균 나이는 33세였다. 3례에서 척골 구상돌기 단독 골절이었으며 2례에서 주관절 탈구가, 2례에서 요골 두 및 경부 골절이, 1례에서 내측 측부인대 손상이 동반되었다. 전례에서 전방 도달법을 통해 유관나사를 이용한 관혈적 정복 및 내고정이 시행되었다. 평균 추시 기간은 31개월 이었으며 (24~60개월), Mayo Elbow Performance Score로 임상적 결과를 판정하였다. 결과 : 최근 추시에서 평균의 능동적 주관절 가동범위는 105°였다. 평균의 Mayo Elbow Performance Score는 76.9점이었다(50~95). 1례에서 최우수, 4례에서 우수, 2례에서 양호, 1례에서 불량의 결과를 보였다. 결론 : 제 3형의 척골 구상돌기 골절에서 조기의 관혈적 정복 및 안정적인 내고정으로 신뢰할 만한 치료를 제공하였으며, 손상 주관절의 동반된 인대손상과 복합골절은 중요한 예후인자로 간주되었다. Purpose: To review the clinical results of eight cases of typeⅢ coronoid process fractures which were treated operatively. Materials and Methods : Eight patients with coronoid type Ⅲ were reviewed retrospectively. All were men with an average age of 33. There were three isolated fractures, two elbow dislocations, two radial head and neck fractures, and one medial collateral ligament rupture. Open reduction and internal fixation through anterior approach with canulated screws was used. The patients were followed up for a mean of 31 months(24 to 60). Results: Average active elbow joint motion at the most recent follow up was 105°. The average Mayo Elbow Performance Score was 76.9 (50 to 95). There was one excellent result, four good, two fair, and one poor. Conclusion: Early open reduction and stable internal fixation provided a reliable method for the treatment of typeⅢ coronoid process fractures. Any associated ligament injuries to the elbow and fracture comninution were considered as important prognostic factors.

Biomechanical advantage of lengthening of the femur with an external fixator over an intramedullary nail

Min, Woo-Kie,Min, Byung-Guk,Oh, Chang-Wug,Song, Hae-Ryong,Oh, Jong-Keon,Ahn, Hyung-Soo,Park, Byung-Chul,Kim, Poong-Taek Lippincott Williams Wilkins, Inc. 2007 JOURNAL OF PEDIATRIC ORTHOPAEDICS PART B Vol.16 No.1

The present experimental study investigated biomechanical differences in methods of femoral lengthening using a monolateral external fixator only and using an external fixator over an intramedullary nail. Three materials, namely polyvinyl chloride rods, composite synthetic bone, and cadaver-bone, were tested using the MTS machine. We evaluated the differences of axial stiffness according to the presence of a nail or the numbers of half-pins (two or three half-pins) that were fixed at each side of osteotomy. The addition of a nail may increase the axial stiffness of the frame of monolateral external fixator for limb lengthening. Additionally, it is enough to distract the femur with fixing two half-pins at each side, when using the technique of lengthening over a nail.

Proliferation and osteoblastic differentiation of bone marrow stem cells: comparison of vertebral body and iliac crest

Min, Woo-Kie,Bae, Jae-Sung,Park, Byung-Chul,Jeon, In-Ho,Jin, Hee Kyung,Son, Min-Jung,Park, Eui Kyun,Kim, Shin-Yoon Springer-Verlag 2010 European spine journal Vol.19 No.10

근위 상완골 골절 치료 중 경험한 LCP 금속판의 고정 실패

민우기 ( Woo Kie Min ),신상진 ( Sang Jin Sin ),전인호 ( In Ho Jeon ),차기봉 ( Ki Bong Cha ),오창욱 ( Chang Wuk Oh ),김풍택 ( Poong Taek Kim ),천상호 ( Sang Ho Cheon ) 대한골절학회 2006 대한골절학회지 Vol.19 No.2

목적: 근위 상완골 골절에서 잠김 압박 금속판을 이용한 내고정술 후 발생한 치료 실패를 경험하고 그 원인인자에 대해 분석, 보고하고자 한다. 대상 및 방법: 2003년 10월부터 2005년 7월까지 6명의 환자 6예를 대상으로 하였으며 평균 연령은 54.6세(범위: 38~70)였다. 손상의 원인으로는 교통사고가 4예, 실족이 1예, 낙상이 1예였고 Neer 분류상 이분 골절이 4예, 3분 골절과 4분 골절이 각 1예였으며 전예에서 관혈적 정복술 및 잠김 압박 금속판을 이용한 금속판 내고정술을 시행하였다. 결과: 전체 6예 중 금속판과 나사못이 철퇴되면서 골절 정복이 소설된 경우가 5예, 금속판 부전이 1예였다. 전예에서 술 전 내측 피질골의 분쇄상 및 골 결손을 보였으며 수술시 골이식 및 대결절에 긴장대 강선은 시행하지 않았다. 술 후 3예에서 해부학적 정복을 얻었으나 3예에서는 골절부의 전위 및 각형성을 보이는 비해부학적 정복을 얻었다. 결론: 근위 상완골 골절의 관혈적 정복술 및 잠김 압박 금속판을 이용한 고정술 시 내측 골 지지의 회복 및 해부학적 정복의 실패, 골두의 짧은 나사못 고정, 대결절 골절의 불충분한 고정 등이 위험 인자로 생각되었으며 이러한 합병증을 피하기 위해서 잠김 압박 금속판의 근위 상완골 골절 고정시 충분한 술 전 준비와 추가적인 고정과 골 이식술 등을 고려해야 한다. Purpose: To evaluate the causative factors in the catastrophic failure of LCP in the proximal humerus fracture. Materials and Methods: Six patients (6 cases) were collected between October 2003 and July 2005. The mean age was 55.6 years (range: 38~70). The cause of injury was road traffic accident in four, fall down in one and slip down in one. According to the Neer classification, four were 2 part fractures, each one in 3 part fracture and 4 part fracture. Results: Fixation failure occurred due to back-out of the plate and screw in five and plate breakage in one. Analysis of the preoperative radiographs revealed medial cortical defect in all and no bone graft and tension band wiring in the greater tuberosity fragment were carried out. Postoperative radiographs showed the anatomical reduction in three and non-anatomical in three. Conclusion: Non-anatomical reduction, insufficient medial bony buttress, inadequate screw length to the head and the neglect for the greater tuberosity fragment were the contributing factors to the failure of LCP. Knowledge of these factors will enable the surgeon to avoid failure of the LCP. Augmentation fixation and bone graft procedures with careful preoperative planning are necessary for successful fixation of LCP.

Neuropeptide Y regulates the hematopoietic stem cell microenvironment and prevents nerve injury in the bone marrow

Park, Min Hee,Jin, Hee Kyung,Min, Woo‐,Kie,Lee, Won Woo,Lee, Jeong Eun,Akiyama, Haruhiko,Herzog, Herbert,Enikolopov, Grigori N,Schuchman, Edward H,Bae, Jae‐,sung EMBO 2015 The EMBO journal Vol.34 No.12

<P>Many reports have revealed the importance of the sympathetic nervous system (SNS) in the control of the bone marrow environment. However, the specific role of neuropeptide Y (NPY) in this process has not been systematically studied. Here we show that NPY-deficient mice have significantly reduced hematopoietic stem cell (HSC) numbers and impaired regeneration in bone marrow due to apoptotic destruction of SNS fibers and/or endothelial cells. Furthermore, pharmacological elevation of NPY prevented bone marrow impairments in a mouse model of chemotherapy-induced SNS injury, while NPY injection into conditional knockout mice lacking the Y1 receptor in macrophages did not relieve bone marrow dysfunction. These results indicate that NPY promotes neuroprotection and restores bone marrow dysfunction from chemotherapy-induced SNS injury through the Y1 receptor in macrophages. They also reveal a new role of NPY as a regulator of the bone marrow microenvironment and highlight the potential therapeutic value of this neuropeptide.</P>

40세 이상 재발성 견관절 탈구 환자에서 관절내 병변에 대한 관절경적 연구

민우기(Woo-Kie Min),김주은(Ju-Eun Kim),조환성(Hwan-Seong Cho),김풍택(Poong-Taek Kim),전인호(In-Ho Jeon) 대한견주관절의학회 2009 대한견주관절학회지 Vol.12 No.2

목적: 40대 이상의 환자의 외상성 견관절 재발성 전방 탈구에서 관절 내 병변 구조물을 조사하고, 그 발병 기전 및 향후 치료 방침을 정하는데 임상적 의의를 제공하고자 한다. 대상 및 방법: 2001년 1월부터 2009년 5월까지 재발성 견관절 전방 탈구로 본원에서 수술적 치료를 받은 환자 중 수술 당시 나이가 40세 이상인 16명의 환자 (평균 나이 52.7세)를 조사하였다. 모든 환자에서 관절경을 이용하여, 관절와 순, 관절막, 회전근 개, 골병변 등의 관절 내 구조물에 대한 관절경적 소견을 조사하였다. 결과: 조사한 16례의 모든 환자들에서 상완 골두의 Hill-Sachs 병변이 보였으며, 골성 Bankart 병변 3례 (19%), 관절와 순 파열 6례 (38%), 관절막 파열은 15례 (94%)에서 발견 되었다. 12례 (75%)의 환자에서 극상건 파열이 발견되었고, 견갑하근 파열은 5례 (31%)에서 발견되었다. SLAP 병변은 1례 (6%)에서 관찰되었다. 결론: 40세 이상 견관절 재발성 탈구 환자에서는 관절막 및 회전근 개 파열의 빈도가 상대적으로 많이 나타났다. 따라서 청소년기와 달리, 장년층 이상의 환자에서는 관절막 및 회전근 개 손상에 대한 수술 전 대비가 요구된다. Purpose: This study is to analyze the prevalence of various intra-articular lesions in patients with traumatic recurrent anterior dislocation of shoulder over 40 years and suggest clinical implications for treatment. Materials and Methods: We retrospectively studied 16 cases that underwent surgical treatment for recurrent anterior dislocation of shoulder from January 2001 to May 2009. There were 9 males and 7 females, and the mean age was 52.7years. We carried out arthroscopic exam for all patients based on standard protocol, which included labrum, capular lesion, cuff, bony lesions. Results: All 16 cases showed Hill-Sachs lesion, 3 patients (19%) had bony Bankart lesion, 6 patients (38%) had labral tear. Capsular tear were found 15 patients (94%). Twelve (75%) had ruptured supraspinatus and 5 (31%) had subscapularis tear. Only one (6%) had SLAP lesion. Conclusion: There was relatively higher incidence of capsular and rotator cuff tears in patients over age 40 years. Preoperative planning to address these lesions is highly recommended.

Neuropeptide Y improves cisplatin-induced bone marrow dysfunction without blocking chemotherapeutic efficacy in a cancer mouse model

( Min Hee Park ),( In Kyung Jung ),( Woo-kie Min ),( Jin Ho Choi ),( Gyu Man Kim ),( Hee Kyung Jin ),( Jae-sung Bae ) 생화학분자생물학회(구 한국생화학분자생물학회) 2017 BMB Reports Vol.50 No.8

Cisplatin is the most effective and widely used chemotherapeutic agent for many types of cancer. Unfortunately, its clinical use is limited by its adverse effects, notably bone marrow suppression leading to abnormal hematopoiesis. We previously revealed that neuropeptide Y (NPY) is responsible for the maintenance of hematopoietic stem cell (HSC) function by protecting the sympathetic nervous system (SNS) fibers survival from chemotherapy-induced bone marrow impairment. Here, we show the NPY-mediated protective effect against bone marrow dysfunction due to cisplatin in an ovarian cancer mouse model. During chemotherapy, NPY mitigates reduction in HSC abundance and destruction of SNS fibers in the bone marrow without blocking the anticancer efficacy of cisplatin, and it results in the restoration of blood cells and amelioration of sensory neuropathy. Therefore, these results suggest that NPY can be used as a potentially effective agent to improve bone marrow dysfunction during cisplatin-based cancer therapy. [BMB Reports 2017; 50(8): 417-422]

Perspective : Role of neuropeptide Y in the bone marrow hematopoietic stem cell microenvironment

( Min Hee Park ),( Woo Kie Min ),( Hee Kyung Jin ),( Jae Sung Bae ) 생화학분자생물학회(구 한국생화학분자생물학회) 2015 BMB Reports Vol.48 No.12

The sympathetic nervous system (SNS) or neurotransmitters in the bone marrow microenvironment has been known to regulate hematopoietic stem cell (HSC) functions such as self-renewal, proliferation and differentiation. However, the specific role of neuropeptide Y (NPY) in this process remains relatively unexplored. In this study, we demonstrated that NPY deficient mice have significantly reduced HSC numbers and impaired bone marrow regeneration due to apoptotic destruction of SNS fibers and/or endothelial cells. Moreover, NPY treatment prevented bone marrow impairments in a mouse model of chemotherapy- induced SNS injury, while conditional knockout mice lacking the Y1 receptor in macrophages did not restore bone marrow dysfunction in spite of NPY injection. Transforming growth factor-beta (TGF-β) secreted by NPY-mediated Y1 receptor stimulation in macrophages plays a key role in neuroprotection and HSC survival in the bone marrow. Therefore, this study reveals a new role of NPY in bone marrow HSC microenvironment, and provides an insight into the therapeutic application of this neuropeptide. [BMB Reports 2015; 48(12): 645-646]

On-chip quantum emitter of a single quantum dot integrated with silicon nitride photonic circuits

Min-Ho Choi,Seonghun Ahn,Seongmoon Jun,Hyun-Gyu Song,Hwan-Seop Yeo,Kie Young Woo,Yong-Hoon Cho 한국진공학회 2019 한국진공학회 학술발표회초록집 Vol.2019 No.2