신경인성 과반사성 배뇨근에 대한 배뇨근 내보툴리눔 독소 A 주사

고현윤,신용범,손현주,장재혁,이경미,문혜정,하용훈 부산대학교 병원 암연구소 2008 부산대병원학술지 Vol.- No.23

Local injections of botulinum toxin A have been reported in the treatment of neurogenic bladder dysfunctions including detrusor sphincter dyssynergia and detrusor overactivity. We reports a case of intradetrusor injection of botulinum toxin type A in acervical cord injured patient with neurogenic overactive detrusor refractory to high dose anticholinergic medication. Botulinum toxin A (200 units) was injected cystoscopically into the detrusor in 40 sites over the bladder with sparing the trigone. Urodynamic studies were performed at baseline, and eight days, four weeks, and eight weeks after intradetrusor injection. There was marked improvement of the urodynamic parameters including maximum cystometric capacity and maximum detrusor pressure after intradetrusor botulinum toxin injection.

장루 보유자의 생활 만족도 조사

서현석,이석환,고영관,오수명,윤충,주흥재,이기형 대한대장항문학회 1998 Annals of Coloproctolgy Vol.14 No.3

마미증후군 환자의 요천추 신청근 손상 및 회복양상

손현주,김경민,한지의,장재혁,신용범,고현윤 부산대학교 병원 암연구소 2007 부산대병원학술지 Vol.- No.21

Purpose: Numbers and severity of the injured segments and neurological recovery patterns are both vague and confused following cauda equina syndrome (CES). We evaluated the characteristics of CES according to the causes of the injuries resulting in CES. Subjects and Methods: Thirty-nine cases of CES diagnosed by clinical features and electrophysiological studies were recruited. We investigated segments or roots involved, muscle strength grades of key muscles, external anal sphincter tones, and changing patterns of theses findings. Their characteristics were compared according to the traumatic and non-traumatic lesions. Results: In traumatic lesions, lower segments, such as sacral roots, were involved more frequently and severely (p<O.OOl). In non-traumatic lesions, L5 and Sl roots were more injured and S2,3,4 roots were less injured (p<O.05). However, there was no significant difference of severity among the injured segments in non-traumatic disorders. There was no typical recovery pattern in both traumatic and non-traumatic cases. Conclusions: In traumatic CES, lower segments or roots were injured more prevalently and severely. Relatively, upper segments were more affected in non-traumatic CES.

유기용제 노출에 따른 신발제조업체 근무 여성근로자들에서의 후천적 색각이상

변주현,이광영,김영기,고광욱,이용환 대한산업의학회 2001 대한직업환경의학회지 Vol.13 No.3

목적 : 복합유기용제에 노출되는 신발제조업체 근무 여성근로자들에서 유기용제 누적노출량과 후천성 색각이상 발현빈도간의 상관성을 조사하기 위해 본 연구를 실시하였다. 방법 : 신발제조업체 근무 여성근로자들 가운데 유기용제에 노출되는 85명과 유기용제에 노출되지 않는 근로자 88명을 대상으로 조사하였다. 조도가 표준화된 방에서 시력검사와 색각이상 검사를 실시하였다. 작업 부서를 접착, 사상 및 선처리 부서로 나누었고 작업 부서별로 현재노출량과 누적노출량을 구하였다. 결과 : 색각이상의 유병률은 노출군이 대조군보다 통계학적으로 유의하게 높았으며 (P=0.017). 유기용제 노출군 85명 가운데 후천적 색각이상인 청황색 색각이상자가 5명(5.9 %)이었다. 안증상도 노출군이 대조군보다 발생빈도가 높았으며 통계학적으로 유의한 차이를 보였다(P=0.001). 색 혼란지수에 영향을 줄 수 있는 변수들인 연령, 교육기간, 누적노출량 등은 유의한 변수로 나타나지 않았다. 결론 : 유기용제 노출군에서 색각이상의 유병률이 대조군보다 유의하게 높았으며, 특히 유기용제 노출군에서 후천적 색각이상인 청황색 색각이상도 발견되었다. 그러나 유기용제 누적노출량과 색 혼란지수와 유의한 연관성은 발견할 수 없었는데 이는 유기용제의 노출량이 너무 낮았으며, 근로자의 이직률 또한 놓아 누적노출량 계산을 위한 추적기간이 제한되었기 때문인 것으로 생각되며 앞으로 고농도 노출 근로자를 대상으로 연구를 하면 분명한 결과를 얻을 수 있을 것으로 기대된다. Objectives : This study was undertaken to investigate the relationship between color vision defects and occupational exposure to mixed organic solvents in women workers who were engaged in the shoe manufacturing industry. Methods : A total of 173 women workers were involved in this study, 85 of whom were exposed to mixed organic solvents and were defined as the exposed group, and 88 workers comprised the non-exposed control group. The patients were questioned as to their drinking history, the year in which they were exposed and whether they had eye symptoms of blureed vision, eye fatigue, and eye irritation. The exposed workers in the shoe manufacturing factory were engaged in 3 work areas which were pasting, trimming, and cleaning. Their Color vision was assessed using the Hahn's double 15 hue test under standard illumination and their current and cumulative exposure levels were measured. Results : The prevalence of color vision defect was 21.2% in the exposed group and 8.0% in the control group, and the blue-yellow defect was found to be 5.9% in the exposed group. The logistic regression for the acquired dyschromatopsia and color confusion index showed that there were no variables that had significant relationships. Eye symptoms were more frequently developed in the exposed group. Conclusions : There is a possibility of developing color vision defects when workers are exposed to mixed organic solvents. However, the results of the color confusion index showed that there was no significant relationship to the coumulative exposure level, because of the low exposure level and high occupational turn over rate of the workers. Because the workers in the present study were exposed to low level solvents it will be necessary to study workers exposed to higher levels of organic solvents.

저칼슘식이로 사육한 생쥐의 골수세포 배양에 의한 파골세포양세포의 형성

박주철,강선주,임도선,김현만,고재승 대한구강해부학회 1995 대한구강해부학회지 Vol.19 No.1

Although it is now well established that osteoclasts are derived from mononuclear hematopoietic stem cells, most likely within the granulocyte-macrophage lineage, the exact differentiation process of osteoclast precusors has only been partially discovered. This study was carried out to investigate the following topics by examining the osteoclast-like cell formation from the calcium-deficient mouse bone marrow cells; 1) the effect of calcium deficiency on the formation of the mononuclear phagocytes and the mononuclear precusors of the osteoclast in the mouse bone marrow; 2) the effect of TNF (tumor necrosis factor)-α on the differentiation of osteoclast-like cells from the calcium-deficient mouse bone marrow culture; 3) the formation of the osteoclast-like cell from the calcium-deficient mouse bone marrow mononuclear cells and the relationship between the osteoblast cell line(MC3T3E1) and osteoclast-like cell formation; 4) formation of the osteoclast-like cells from the mononuclear cells which were col1ected from PTH-pretreated mouse bone marrow cells to investigate the relationship between PTH and calcium deficiency in osteoclast-like cell formation. Bone marrow cells were isolated from marrow of mouse feeding normal diet or calcium deficient diet for 7 and 14 days. Bone marrow mononuclear cells were fractionated by cetrifugation on Hypaque-Ficoli density gradients. PTH-pretreated mouse bone marrow mononuclear cells were obtained by collecting the nonadherent cells after the culture of normal mouse marrow cells with PTH for 6 days. The prepared cells were cultured on dentin disc at the concentration of 1.5-2 X 10^(6) cells per 0.5ml of a-MEM containing 10% FCS for 3, 5 and 7 days. Thereafter, TRAP staining, NSE staining, effect of calcitonin on the osteoclast-like cell and scanning electron microscope analysis of resorption lacunae on the dentin disc were performed. The results were as follows; 1. Number of the osteoclast precusors and mononuclear phagocytes in bone marrow was increased by calcium-deficient diet. 2. More osteoclast-like cells were formed from the calcium-deficient mouse bone marrow cells than from normal cells. 3. Formation of osteoclast-like cells was significantly stimulated by TNF-α in normal mouse bone marrow cells and calcium-deficient mouse bone marrow cells at concentration of l0ng/ml and 100ng/ml. 4. Osteoblast cell line(MC3T3E1) did not play an important role in osteoclast-like cell formation. 5. Formation of the osteoclast-like cells from the mononuclear cells which were collected from PTH-pretreated mouse bone marrow cells was similar to that of calcium-deficient mouse bone marrow mononuclear cells, which suggests that the effect of calcium deficiency in osteoclast formation may be mediated by PTH.

인공 석회화 기질의 개발 및 파골세포에 의한 기질흡수에 관한 연구

김현만,박주철,임도선,박수진,김윤지,고재승 대한구강해부학회 1997 대한구강해부학회지 Vol.21 No.1

To develop artificial matrix resorbable by osteoclasts can be used as a model system that biological function of osteoclasts would be assayed in vitro in a standardized condition instead of using heterogenous bone or dentin slices. The present study developed artificial substrates consisted of apatite crystals. collagen gen. agar, apatite crystals under collagen film, mixture of apatite crystals and collagen, and mixture of agar and apatite crystals. And osteoclastic attachement and resorption activity on the each substrate was assayed in vitro. Osteoclasts attached to apatite crystals, collagen, mixture of apatite crystals and collagen, and mixture of apatite crystals and agar, however, not to agar. This suggested that apatite crystals and collagen should be exposed on the surface of artificial substrate where osteoclasts can attach. Osteoclasts attached to the substrate resorbed the substrate consisted of apatite crystals, mixture of apatite crysals and collagen, and apatite crystals under thin film of collagen, however, not of collagen, mixture of apatite crystals and agar. This suggested that the first phase of osteoclasts in resorbing matrix is to secrete acid and the end result of this phase, whatever it may be, may activate secretion of hydrolytic enzymes specific to organic components.

척추손상 쥐의 지방유래 줄기세포와 미노사이클린의 운동기능 회복효과

장재혁,고현윤,차영선,박형욱,신용범,손현주 부산대학교 병원 암연구소 2009 부산대병원학술지 Vol.- No.25

경막 외 스테로이드 주사에 반응 없는 추간판성 요통에 대한 추간판 내 시술 효과

신용범,고현윤,손현주,장재혁,박형욱,신명준,김수연 부산대학교 병원 암연구소 2008 부산대병원학술지 Vol.- No.23

Objective: To determine the effect of intradiscal therapy with discography in patients with back pain of no effect using epidural steroid. Subject and methods: Thirty patients with herniated nucleus pulposus (HNP) who had not have any improvement using repeated epidural steroid were studied. Degree of disc degeneration, provocation pain and intradiscal pressure were evaluated in 41 discs. Intradiscal triamcinolone was injected to degenerated discs and intradiscal electrothermal therapy (IDET) was performed to the patients who had no improvement using intradiscal steroid. Patients were asked to report pain according to a visual analogue scale (VAS). Results: Thirty of 41 discs showed significant degeneration. In 19 of 30 (63.3%) patients, VAS was reduced over 50% after intradiscal steroids. Low intradiscal pressure without provocation pain and ruptured discs were significantly higher in these patients (p<0.05). After IDET, 8 of 9 patients noted over 50% reduction of VAS. Conclusions: In patients with discogenic back pain combined with radicular pain, intradiscal therapy according to discography may be helpful in patients with no improvement using epidural steroid.

H9c2 심근 세포주에서 외인성 nitric oxide가 허혈에 의한 세포 독성에 미치는 영향

정성구,장현용,김명천,고영관,정주호,배영미,박원서,김대중,유영민,김성수,임성빈 대한응급의학회 2001 대한응급의학회지 Vol.12 No.4

Background: Nitric oxide(NO) is known to have protective effects on an ischemic heart and to exert triggering effects on ischemic preconditioning. However, the effects of NO during the ischemic period have not been investigated. To investigate the role of exogenous nitric oxide in a model of ischemic heart cell death, we studied the effects of ischemic preconditioning and ischemia in a normal and an ischemic buffer. Methods: Rat cardiac myoblast cells(H9c2) were cultured in a normal and an ischemic buffered medium. For the ischemic culture of heart cells, the cells were cultured in a dessicator with GasPak for 5 hrs. In ischemic preconditioning, the cells were pretreated with ischemic buffer for 5 min and then perfused with normal medium for 30 min. For the measurement of the cytotoxicity, a MTT(3-4-Sdimethylthiazol-2-yl-2,5-diphenyl tetrazolium bromide) assay was performed. A DAPI(4',6-diamidino-2-phenylindole dihydrochloride) staining procedure and a flow cytometry analysis were performed to confirm apoptotic cell death by ischemia. Results: Cell viability, as determined by using a MTT assay, showed that the preconditioned group treated with NO showed more cell death than with the not-preconditioned groups in both normal and ischemic buffers. But, In normal medium and not-preconditioned groups, NO showed protective effect according to the concentrations(100,1000μM) . No treatment with NO produced the different results. In normal medium, the protective effect of ischemic preconditioning was demonstrated, but no protective effect of ischemic preconditioning could be seen in the case of the ischemic buffer. The DAPI staining and flow cytometry analysis of heart cells showed characteristic apoptotic features. Conclusion: NO added in the ischemic phase had deterious effects on heart cells. Ischemic preconditioning was more harmful than ischemia alone. The toxicity of the cells was characteristic apoptosis.

신경인성방광으로 인한 방광요관역류에서 임계 배뇨근압 및 용량

장재혁,고현윤,신용범,손현주 부산대학교 병원 암연구소 2008 부산대병원학술지 Vol.- No.23

Purpose: We investigated relationships of detrusor pressure and bladder volume at the onset of vesicoureteral reflux (VUR) with other urodynamic and clinical parameters in neurogenic bladders after spinal cord injury. Materials and Methods: Videourodynamics were performed in 15 patients with spinal cord injury. Neurological levels of spinal cord injuries were categorized as cervical in 6 cases, thoracic in 6 cases, and lumbosacral in 3 cases. The interrelationships of detrusor pressure and bladder volume at the onset of VUR, bladder comp Hanco maximum detrusor pressure, and maximum bladder capacity were assessed. Results: A weak correlation existed between detrusor pressure and bladder volume at VUR (r=0.493, p=0.062). Detrusor pressure at VUR and bladder compliance presented an inverse correlation (r=-0.525, p=0.044). Pressure-volume index at VUR had a strong correlation with bladder volume at VUR divided bladder capacity (r=0.861, p<0.00l). Conclusions: Detrusor pressure and bladder volume at the onset of VUR appeared to have relationships with other factors associated with VUR in neurogenic bladders after spinal cord injury. Further studies acquiring additional patient data and follow-up data about reflux resolution permit to develop the management guide and prognostic factor of the secondary VUR in neurogenic bladders after spinal cord injury.