임상의를 위한 지방유래세포의 이해

구자혜,한승규 대한미용성형외과학회 2009 Archives of Aesthetic Plastic Surgery Vol.15 No.3

Recent works state that adipose tissue hosts cells which are able to display various differentiation potentials. Moreover, this adult tissue is abundant and easy to sample with no ethic limitation. In addition, the simple isolation procedures provide a clear advantage for tissue engineering. The adipose cells which are used for tissue engineering can be isolated from the stromal vascular fraction (SVF) obtained after adipose tissue digestion that may be used either freshly prepared or after culture. In this last case, cultured cells represent a particular cell subpopulation, which is restricted to the adherent cell fraction of SVF, and termed adipose derived stromal cells(ADSCs). However, there is a confusing inconsistency in the literature in the use of terms to describe multipotent precursor cells from adipose tissue stroma, such as processed lipoasporate cells, ADSCs, preadipocytes, adipose stoma vascular cell fraction, SVF cells, and others. In addition, characteristics of such cells have not clearly been defined and still controversial. The aim of this brief and comprehensive review is to define terminologies for such cells, to describe preparation and isolation procedures for SVF cells and ADSCs, to summarize molecular characterization of SVF cells and ADSCs, and to discuss clinical cases using these cells.

미투 운동 이후 젊은 연극인은 과연 변화했는가?

구자혜 한국연극평론가협회 2018 연극평론 Vol.89 No.-

Zone 5 손목 열상에 대한 임상적 분석

구자혜,정성호,한승규,김우경 대한수부외과학회 2011 대한수부외과학회지 Vol.16 No.4

Purpose: We conduct a comprehensive review of demography, vector and cause of injury and results of zone 5 volar wrist lacerations. Materials and Methods: From July 2001 and June 2010, a total of 170 patients with zone 5 wrist lacerations were reviewed retrospectively. Sex, age, vector and cause of injury, injured structures and results were investigated. The correlations between the wound length, vector, cause of injury and number of injured structures were analyzed statistically. Results: The most common cause of injury is self-inflicted wrist injury followed by incidental accident, industrial accident, and the glass is the most common vector. Thirty six patients underwent primary repair only and 134patients explored then underwent teno-neuro-arteriorraphy. Error rate between the preoperative and intraoperative evaluations was 30.6%, particularly greater than 50% in cases of flexor digitorum profundus and radial artery injuries. The most common injured structure was palmaris longus followed by flexor carpi radialis, flexor carpi ulnaris and median nerve. The cause and vector of injury did not correlate with the number of injured structures. Relationship between the mean length of wounds and the number of injured structures showed weak positive correlation. Conclusion: In zone 5 wrist lacerations, exploration should be performed if the laceration involved over dermis layer. In addition to the surgical treatment, psychological care of these injuries is necessary. 목적: Zone 5 손목 열상 환자에서 나이와 성별 분포, 손상의 원인과 매개체, 결과에대해 분석하고자 하였다. 대상 및 방법: 2001년 7월부터 2010년 6월까지 zone 5 손목 열상 환자 170명을 대상으로 환자의 성별, 연령, 손상 기전과 원인, 손상 구조물 및 결과를 후향적으로 조사하고 손상의 심한 정도와 기전, 원인, 상처 길이를 통계학적으로 분석하였다. 결과: 자해에 의한 손상이 가장 많았으며 단순사고, 산업재해 순이었으며 유리가 가장 흔한 원인이었다. 36명이 1차 봉합술을 시행받았으며 134명이 탐색술을 통해 건-신경-동맥 봉합술을 시행받았다). 술전 검사와 술후 검사를 비교한 결과 평균 30.6%에서 오차가 있었으며 특히 심부 굽힘근(flexor digital profundus), 요골 동맥(radial artery)에서 50% 이상의 오차를 보였다. 손상된 구조물은 긴 수장근, 요골쪽 손목굽힘근, 척골쪽 손목 굽힘근, 정 중 신경 순이었다 기전, 원인은 손상의 심한 정도와통계학적으로 의미 있는 연관성은 없었다. 상처의 길이와 손상된 구조물의 관계는 불완전한 양의 관계를 보였다. 결론: 손목 zone 5 열상 환자에서 진피층 이상의 열상 시에는 반드시 탐색술을 시행하여야 하며 자살 시도, 자해에 의한 수상이 많으므로 수술적 치료와 함께 정신과적관리가 필요하다.

당뇨발 궤양을 가진 환자에서의 창상치유인자에 대한 조사

구자혜,한승규,장현,이병일,김우경 대한성형외과학회 2007 Archives of Plastic Surgery Vol.34 No.5

Purpose: Diabetic foot ulcer is a representative disease of chronic would with multiple defects of wound healing factors. Many nutrition factors have been known to be essential for wound healing, but objective data are lacking. The purpose of this study is to determine those factors essential for wound healing, and to find out which of those factors are lacking in diabetic foot ulcer patients through this pilot study.Methods: We studied 100 patients who visited our clinic from March 2005 to February 2006 for treatment of diabetic foot ulcers with a duration of more than 6 weeks. We checked serum levels of protein, albumin, vitamin A, C, E, iron, magnesium, zinc, copper and hemoglobin by drawing 23cc blood after 8 hours of fasting. Protein, albumin, iron, magnesium levels were measured by colorimetry; hemoglobin levels were measured by auto analysis. Vitamin levels were measured by high performance liquid chromatography (HPLC), copper and zinc levels were measured by Inductively coupled plasma (ICP). They were compared with normal values. The patients were divided by transcutaneous oxygen pressure levels, age and sex to study the effects of these parameters.Results: 76% and 61% of patients had within-normal range serum protein and albumin levels, respectively. Among vitamins, only the level of vitamin C was low in 55% of the patients. Levels of vitamin A, E were normal or high in 93% and 100% of patients. As for trace elements, levels of iron and zinc were low in 63% and 60% of patients, but levels of magnesium and copper were usually normal or high. Levels of vitamin C, iron and zinc were lower in the low-transcutaneous oxygen pressure group. There were no definite differences according to age and sex.Conclusion: Serum levels of Hb, vitamin C, iron, zinc were low in most diabetic foot ulcer patients. The deficit was very severe in the low-transcutaneous oxygen pressure group.

국립극단의 작품 개발 및 창작자 육성 제도 점검

구자혜 한국연극평론가협회 2019 연극평론 Vol.95 No.-

당뇨발 환자의 창상치유예측을 위한 혈중 교원질 농도

구자혜,한승규,김우경 대한성형외과학회 2008 Archives of Plastic Surgery Vol.35 No.5

Purpose: When deciding a treatment plan in diabetic foot ulcer patients, predicting a possibility of healing wounds is important since not a few patients have poor general condition to get successful wound healing. This study was planned to find out if a serum collagen level can be used as a predictor for healing wounds in diabetic foot patients. Methods: Fifty-seven patients, who visited our clinic from January to June, 2007 for treatment of diabetic foot ulcers, were included in this study. Serum levels of type I collagen were checked using carboxy terminal type I propeptide kits. Simultaneously serum levels of vitamin C and iron, cofactors of collagen synthesis, were checked. The patients were divided into two groups; a group of successfully healed wounds and the other of unhealed wounds. Serum levels of the parameters were compared between the 2 groups. Results: The serum level of collagen was 197.65± 86.26ng/ml in a healed group and 87.91±28.76ng/ml in the unhealed group(p<0.05). The serum iron and vitamin C levels were did not show significant differences. Conclusion: The serum collagen level may predict healing or nonhealing wounds in diabetic foot ulcers.

평생학습개념으로서 세종학당 문화 프로그램 운영

구자혜 한국문법교육학회 2019 한국문법교육학회 학술발표논문집 Vol.2019 No.2

광범위한 안와파열골절에서 Titanium Mesh Plate와 Porous Polyethylene (Medpor ®) 동시 사용의 유용성

구자혜,원창훈,동은상,윤을식 대한두개안면성형외과학회 2010 Archives of Craniofacial Surgery Vol.11 No.2

Purpose: The goals of a blow-out fracture reconstruction are to restore the osseous continuity, provide support for the orbital contents and prevent functional and anatomic defects. Over the past several years,a range of autogenous and synthetic implants have been used extensively in orbital reconstructions. None of these implants have any absolute indications or contraindications in certain clinical settings. However,in extensive blow-out fractures, it is difficult to restore support of the orbital contents, which can cause more complications, such as enophthalmos. This study examined the clinical outcomes of extensive or comminuted blow-out fractures that were reconstructed by the simultaneous use of a titanium mesh plate and Medpor . Methods: Eighty six patients with extensive orbital fractures, who were admitted between March 1999and February 2007, were reviewed retrospectively. The patients’ chart and CT were inspected for review. Twenty three patients were operated on with both a titanium mesh plate (Matrix MIDFACE pre-formed orbital plate, Synthes, USA) and Medpor (Porex, GA, USA). The patients underwent pre-operative CT scans to evaluate the fracture site and measure the area of the fracture. A transconjunctival approach was used, and titanium mesh plates were inserted subperiosteally with screw fixation. Medpor was inserted above the titanium mesh plate. The patients were evaluated post-operatively for enophthalmos,diplopia, sensory disturbances and eyeball movement for a period of at least 6 months. Results: No implant-related complications were encountered during the follow-up period. Enophthalmos occurred in 1 patient, 1 patient had permanent sensory disturbance, and 3 patients complained of ocular pain and fatigue, which recovered without treatment. Although there were no significance differences between groups, the use of 2 implants had fewer complications. Therefore, it can be an alternative method for treating blow out fractures. Conclusion: The use of both a titanium mesh plate and Medpor simultaneously may be a safe and acceptable technique in the reconstruction of extensive blow-out fractures. (J Korean Cleft Palate Craniofac Assoc 11: 85, 2010)

[연출노트] 〈commercial, definitely - 마카다미아, 검열, 사과 그리고 맨스플레인〉

구자혜 공연과이론을위한모임 2016 공연과 이론 Vol.- No.62

유방확대술 후 유방보형물의 파열 : 피막내외의 동시 파열에 대한 증례보고

구자혜,정성호 대한미용성형외과학회 2013 Archives of Aesthetic Plastic Surgery Vol.19 No.1

This paper presents the case of a ruptured hydrogel breast implant, along with its clinical, radiologic, and pathologic findings. Breast asymmetry is typically the most common clinical feature of breast implant rupture. In case of a hydrogel breast implant rupture, hydrogel spreads out after implant leakage and the breast is enlarged with swelling and edema. Intracapsular ruptures showed no significant collapse of the implants despite a collection of fluid surrounding the implant inside the capsule. However, extracapsular ruptures showed implant collapse and extensive inflammation or fibrosis extension to the muscle and chest wall. In this case, a large amount of fluid collection with enlarged implants inside the capsule and extracapsular granulomas were showed simultaneously. Since the use of silicone breast implants has been restricted,hydrogel implants have been used for some time as an alternative option for breast implants. However,hydrogel implants have been restricted because of their unpredictability and unreliability. This case report draws attention to an unusual presentation of complications following the insertion of hydrogel breast implants for augmentation mammoplasty.