본태성 수전증 환자의 미토콘드리아 DNA 분석

이언,유영미,유찬종,Lee, Uhn,Yoo, Young Mi,Yoo, Chan Jong 대한신경외과학회 2000 Journal of Korean neurosurgical society Vol.29 No.2

Objective : Essential tremor(ET) is the most common movement disorder, however, there has been little agreement in the neurologic literature regarding diagnostic criteria for ET. Familial ET is an autosomal dominant disorder presenting as an isolated postural tremor. The main feature of ET is postural tremor of the arms with later involvement of the head, voice, or legs. In previous studies, it was reported that ET susceptibility was inherited in an autosomal dominant inheritance. As previous results, it would suggest that ET might be associated with defect of mitochondrial or nuclear DNA. Recent studies are focusing on molecular genetic detection of movement disorders, such as essential tremor and restless legs syndrome. Moreover, authors have analysed mitochondrial DNA(mtDNA) from the blood cell of positive control(PC) and ET patients via long and accurate polymerase chain reaction(LA PCR). Materials & Methods : Blood samples were collected from PC and 9 ET patients. Total DNA was extracted twice with phenol followed by chloroform : isoamylalcohol. For the analysis of mtDNA, LA PCR was performed by mitochondrial specific primers. Results : With this technique, deletions of large quantities were detected within several regions of mtDNA in ET patients except for D-loop and CO I regions. Conclusion : The authors believe that ET is a genentic disorder with deficiency of mitochondrial DNA multicomplexes and mitochondiral dysfunction could be one of major causative factors of ET. Mitochondrial dysfunction may play an important role in the pathogenesis and possibility of disease progression among familial group with ET patients.

심한 요통과 급성 양하지 마비증상으로 나타난 복부 대동맥 폐쇄증 - 증 례 보 고 -

김래상,한기수,이언,박철완,김영보,이상구,김우경,유찬종,Kim, Rae Sang,Han, Ki Soo,Lee, Uhn,Park, Chol Wan,Kim, Young Bo,Lee, Sang Gu,Kim, Woo Kyung,Yoo, Chan Jong 대한신경외과학회 2001 Journal of Korean neurosurgical society Vol.30 No.1

Acute intraabdominal aortic obstruction ends in progressive fatal course or severe permanent disability unless it is diagnosed and treated promptly. However, the incidence of such disease is very rare, so there is very little chance for a neurosurgeon to encounter a patient with acute intraabdominal aortic obstruction. The authors present a case of 62-year-old man with severe low back pain and acute paraplegia caused by acute intraabdominal aortic obstruction.

경막내 요추 추간반 탈출증 - 증례보고 -

정주호,이상구,유찬종,한기수,김우경,김영보,박철완,이언,Jeong, Ju-Ho,Lee, Sang-Gu,Yoo, Chan-Jong,Han, Ki-Soo,Kim, Woo-Kyung,Kim, Young-Bo,Park, Cheol-Wan,Lee, Uhn 대한신경외과학회 2001 Journal of Korean neurosurgical society Vol.30 No.10

The intradural lumbar disc herniation which was first described by Dandy in 1942 is unusual. The pathogenesis is obscure and preoperative diagnosis is not easy. The patient usually have more severe neurologic deficits than those found in the much more common extradural disc herniations. We experienced two cases of the intradural lumbar disc herniation who had previous disc operations and the symptoms and neurologic signs were improved after removal of the intradural sequestration of disc fragments.

척추 결핵의 전방유합술시 Titanium Mesh Cage의 효과

정주호,이상구,유찬종,한기수,김우경,김영보,박철완,이언,Jeong, Ju-Ho,Lee, Sang-Gu,Yoo, Chan-Jong,Han, Ki-Soo,Kim, Woo-Kyung,Kim, Young-Bo,Park, Cheol-Wan,Lee, Uhn 대한신경외과학회 2001 Journal of Korean neurosurgical society Vol.30 No.8

Objective : The maintenance of the correction of kyphotic deformity is one of the difficult problem in tuberculous spondylitis after anterior debriment and fusion with tricortical bone graft. The goal of this study is to find out the efficacy of titanium mesh cage impacted with autogenous bone chip in tuberculous spondylitis treated with anterior intervertebral fusion. Materials and Method : Twelve patients were treated with anterior intervertebral fusion using titanium mesh cage for tuberculous spondylitis from January 1996 to June 1999. We analized the changes in the correction of kyphotic deformity, changes of ESR and CRP, fusion state and recurrence after anterior intervertebral fusion with titanium mesh cage. Results : Clinical symptoms were improved in all twelve patients without any neurologic complications. The mean kyphotic angle corrected was 7.3 degrees immediately after operation, but the loss of correction of kyphotic angle was 2.2 degrees after 3 months and 2.6 degrees after 6 months. We found that the loss of correction of kyphotic deformity occurred mainly within the first 3 months after surgery. Only one patient, suffered from acute hepatic failure after first operation and had an insufficient anti-tuberculous medication therapy, showed recurrence of tuberculous spondylitis after 6 months. The patient underwent a second operation with posterior fixation procedure with good outcome. The changes of ESR and CRP were not specifically important factor to reveal recurrence of tuberculosis of the spine in our series. Conclusion : The surgical procedure of tuberculous spondylitis using titanium mesh cage with bone chip seems to be an effective procedure to minimize loss of the correction of kyphotic deformity without any aggravating inflammatory change and recurrence with titanium mesh cage, when sufficient debridement and anti-tuberculous chemotherapy are achieved.

본태성 수전증과 파킨슨병 환자에서 미토콘드리아 DNA 비교 분석

김래상,유찬종,이상구,김우경,한기수,김영보,박철완,이언,Kim, Rae Sang,Yoo, Chan Jong,Lee, Sang-Gu,Kim, Woo-Kyung,Han, Ki-Soo,Kim, Young-Bo,Park, Cheol-Wan,Lee, Uhn 대한신경외과학회 2000 Journal of Korean neurosurgical society Vol.29 No.11

Essential tremor(ET) is the most common movement disorder however there has been little agreement in the neurologic literature regarding diagnostic criteria for ET. Familial ET is an autosomal dominant disorder presenting as an isolated postural tremor. The main feature of ET is postural tremor of the arms with later involvement of the head, voice, or legs. In previous studies, it was reported that ET susceptibility was inherited in an autosomal dominant inheritance. As with previous results, it would suggest that ET might be associated with defect of mitochondrial or nuclear DNA. Recent studies are focusing molecular genetic detection of movement disorders, such as essential tremor and restless legs syndrome. Parkinson's disease(PD) is a neurodegenerative disease involving mainly the loss of dopaminergic neurons in substantia nigra by several factors. The cause of dopaminergic cell death is unknown. Recently, it has been suggested that Parkinson's disease many result from mitochondrial dysfunction. The authors have analysed mitochondrial DNA(mtDNA) from the blood cell of PD and ET patients via long and accurate polymerase chain reaction(LA PCR). Blood samples were collected from 9 PD and 9 ET patients. Total DNA was extracted twice with phenol followed by chloroform : isoamylalcohol. For the analysis of mtDNA, LA PCR was performed by mitochondrial specific primers. With LA PCR, 1/3 16s rRNA~1/3 ATPase 6/8 and COI~3/4 ND5 regions were observed in different patterns. But, in the COI~1/3 ATPase 6/8 region, the data of PCR were observed in same pattern. This study supports the data that ET and PD are genentic disorders with deficiency of mitochondrial DNA multicomplexes.

딜레마 토론을 활용한 의과대학 윤리교육 프로그램의 개발 및 적용

김지영(Ji-Young Kim),최승헌(Seung Heon Choi),한상환(Sang-Hwan Han),전교(Gyo Jun),김대성(Dae-Sung Kim),Mark C. Love,김미연(Mi-Yeon Kim),이언(Uhn Lee),고창순(Chang-Soon Koh) 한국의학교육학회 2000 Korean journal of medical education Vol.12 No.1

가천의과대학교에서는 의대생들의 도덕판단력 증진을 위해 의료윤리와 관련된 주제들에 대한 딜레마 토론을 활용한 의과대학 윤리교육 프로그램인‘생명과 사회 Ⅱ’를 개발하여 적용하였다.‘생명과 사회 Ⅱ’는 1998년부터 1999년에 거쳐 임상 및 기초의학 교원 20명이 참여하여 학습목표의 설정, 학습주제의 선정, 수업설계, 학습지도안의 작성 등 4단계를 거쳐 개발되었고, 1999학년도 3월부터 6월까지 의예과 2학년에 재학 중인 41명을 대상으로 적용되었으며, 효과성 평가를 위해 학생대상 설문조사가 실시되었다.‘생명과 사회 Ⅱ’의 학습목표는 문헌조사에 기초하여 설정되었으며, 학습주제는 기초 및 임상교원30명을 대상으로 한 ‘의학입문 교과목 개설을 위한 설문지’ 결과를 기초로 선정되었다. 수업설계는 구체적 수업목표의 설정, 수업방법의 선정, 주제별 수업의 배열, 강사 및 tutor의 선정의 단계를 거쳤으며, 학습지도안 작성은 주제별 학습목표의 설정, 학습내용의 선정, 딜레마 시나리오의 구성, 토론을 위한 질문의 구성의 단계를 거쳤다. 교육 프로그램은 토론의 준비, 토론의 진행, 토론의 평가의 단계로 운영되었으며, 평가는 학생 대상의 설문지를 통해 주제별 수업만족도, 전반적인 수업형태에 대한 만족도, 자유의견 등의 항목에 대해 실시되었다. 응답에 대한 분석 결과 개설목적 달성 여부 및 수업형태에 대한 만족여부에 관련된 문항에서 ‘매우 그렇다’ 또는 ‘그렇다’는 반응이 ‘그렇지않다’ 또는 ‘매우 그렇지 않다’라는 반응보다 높은 비율로 나타났으며, 딜레마 토론을 활용한 수업이 기타 교육방법을 활용한 수업에 비해 만족도가 높은 것으로 나타났다. Gachon Medical School has developed and implemented a medical ethics course entitled, Life and Society II . The course uses dilemma discussion based on medical case studies to allow students to develop their moral reasoning ability in both clinical and hospital settings. The course was developed by the faculty of medicine during the 1998-1999 academic years. The program was designed in a four-stage process: 1) learning objectives were identified, 2) contemporary controversies and relevant ethical issues were chosen based on relevance to modern medical practice, 3) a syllabus was drafted based on the aforementioned ethical issues and teaching methods appropriate for each issue were integrated into the syllabus, and 4) tutorial manuals were produced. The course was taught to 41 second-year premedical students and evaluated by student surveys. The learning goals were identified through both a literature survey of contemporary issues in medical ethics and an in-house survey of important content to teach in a medical ethics course. The curriculum was designed based on the identification of specific learning objectives per ethical issue, selection of appropriate materials and content, organization of dilemma scenarios and formulation of questions for discussion. The course was taught using a variety of teaching formats: dilemma discussions, seminars, tutorials, lectures, assigned readings and student presentations. Positive results were obtained from the student surveys: it was discovered that most students thought that the course s learning objectives were achieved. Furthermore, of all the teaching methods employed, most of our students felt that discussing dilemmas was the most effective method for developing moral reasoning ability.

냉동 보관된 백서태자 중뇌 신경세포의 생존율과 신경돌기 형성율에 대한 연구

이 언,김영보,유영미 대한신경외과학회 1999 Journal of Korean neurosurgical society Vol.28 No.2

기능적 뇌정위 수술시 이용되는 기준점 (Reference Point)에 대한 분석 : 한국인 169인에 대한 계측 통계 Data Analysis from 169 Korean People

이언,김영보,김미훈,안성기,강동수,박철완 대한신경외과학회 1995 Journal of Korean neurosurgical society Vol.24 No.9

During thalamotomy, we have to use the various kinds of brain reference points. From 1989 to 1992, the authors performed streotactic thalamotomy or pallidotomy in 169 patients suffering from tremor. We measured and estimated the important intracerebral reference points. These data were very meaningful for stereotactic functional neurosurgery in the Korean medical community because it is obtained from Korean people. We have also estimated the average location of targets for tremor submission.

태아 중뇌 이식 수술에 대한 윤리 강령

이언,김영보 대한신경외과학회 1994 Journal of Korean neurosurgical society Vol.23 No.3

Research or therapy involving human fetal tissue has been subject of intense political and ethical debate in many country for almost two decades. Especially. Transplantation of cells or tissues from aborted fetuses to treat Parkinson's disease shows great clinical promise but it has some ethical or legal controversy. We can expect that demand of fetal brain tissue is increased explosively near future. So we have to establish our own eithical guidelines urgently. In this article authors report several basic medical or ethical issues which the fetal mesencephalic transplantation brings up inevitably and suggest our own ethical guidelines.

Cosman-Roberts-Wells(C.R.W.) 시스템을 이용, 소뇌를 통한 후두와 병소의 뇌정위적 도달법

이승진,이언,고용,김주승,김대규 대한신경외과학회 1991 Journal of Korean neurosurgical society Vol.20 No.1-3

6 patients underwnet CT-guided stereotactic biopsy or hematoma aspiration procedure for posterior fossa lesions. Trajectory for biopsy or aspiration was transcerebellar approach. The patients were placed under general endotracheal anesthesia and positioned prone or sitting. No complications were encountered in the postoperative period when this technique was used. Stereotaxic transcerebellar multiple biopsy can safely provide tissue conformation of the neoplastic nature of a posterior fossa lesion thought to be a tumor. In addition, hematoma aspiration has been demonstrated to be safe, reliable, and efficient.