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마우스 삼차신경 척수로핵 미측소핵 아교질 신경세포에서 Bicuculline Methiodide (BMI)의 비 $GABA_A$ 수용체 매개성 반응
최순정,한성규,이경은,서봉직,Choi, Soon-Jeong,Han, Seong-Kyu,Lee, Kyung-Eun,Suh, Bong-Jik 대한안면통증구강내과학회 2010 Journal of Oral Medicine and Pain Vol.35 No.4
Bicuculline은 전기생리학 연구 분야에서 가장 일반적으로 사용되는 $GABA_A$ 수용체 길항제중 하나다. 물에 잘 녹지 않는 특성 때문에 실험적으로는 bicuculline methiodide (BMI)와 같은 4차암염(quaternary ammonium salts)의 형태로 주로 제작되어 이용되고 있다. 그러나 다수의 연구에서 BMI가 비 $GABA_A$ 수용체 매개 반응이 알려졌다. 삼차신경 척수로핵 미측소핵 아교질은 유해자극 과정과 연관이 있는 것으로 알려져 있으나, 아교질 신경세포에서 BMI의 비 GABAergic 활성에 대해서는 거의 알려지지 않았다. 본 연구는 whole cell patch clamp 방법을 이용하여 마우스 삼차신경 척수로핵 미측소핵의 아교질 신경세포에서 전류고정법(current clamp)과 전압고정법(voltage clamp)을 통해 BMI가 막전압 변화 및 세포막 전류의 변화에 미치는 영향을 조사하여 다음과 같은 결과를 얻었다. 첫째, 삼차신경 미측소핵 아교질 신경세포에서 BMI는 세포막 탈분극을 유발하였다. 둘째, BMI에 의한 효과가 $GABA_A$ 수용체에 매개하지 않는다는 결과들이 도출 되었다. 셋째, BMI에 의해 유발된 세포막 탈분극은 PIC와 CNQX, AP-5, strychinine과 TTX을 포함하고 있는 길항제 혼합물의 존재하는 조건에서도 지속적으로 유지되었다. 그리고, BMI에 의해 유도되는 탈분극의 반응이 fBIC의 다른 유도체이며 GABA 수용체 억제제로서 알려져 있는 BMB 또는 BMC에서도 나타나는지 확인해 보는 실험 결과 BMI는 막전류의 내향성 전류를 유도하지만, fBIC의 다른 유도체인, BMB와 BMC는 외향성 전류를 유도하였다. 이상의 결과들을 종합해 보면 마우스 삼차신경 척수로핵 미측소핵 아교질 신경세포에서 Bicuculline Methiodide (BMI)는 free base bicuculline (fBIC)과는 달리 $GABA_A$ 수용체를 매개하지 않고 막 탈분극을 유발한다는 확실한 결론에 도달했다. 또한, 이 결과는 BMI의 작용기전이 fBIC의 활동기전과 다를 수 있음을 의미하며 이와 같이 fBIC와 BMI의 다른 반응을 보이는 것은 다름 아닌 fBIC에 결합된 $I^-$ 에 의한 특이적 반응과 관련된 기전이 있을것이라는 제안을 해 볼 수 있다. 이러한 제안은 GABA 수용체의 길항제로 알려진 BMB나 BMC의 경우는 BMI와는 다르게 외향성 전류가 기록된 결과를 통해 BMB, BMC와 다르게 BMI에는 fBIC에 $I^-$를 붙여서 사용을 한 결과에 의해 뒷받침이 된다. 앞으로의 연구에서는 삼차신경 척수로핵 미측소핵 아교질 신경세포에서 BMI에 의해 유도된 세포막 탈분극의 세부 기전에 대한 증명이 필요할 것으로 보인다. 이 세부 기전이 밝혀지게 되면 작용기전과 관련해서 $I^-$의 역할이 밝혀지게 될 것이며, 이는 향후 $I^-$를 활용한 다양한 전기생리학적 연구와 임상적인 활용을 보다 확대시키는 결과로 이어 지리라 기대해 본다.
폐쇄성 수면무호흡환자에서 확대 구개수구개피판을 이용한 치험례
김지연(Ji-Youn Kim),김성민(Soung-Min Kim),명 훈(Hoon Myoung),황순정(Soon-Jung Hwang),서병무(Byoung-Moo Seo)이종호(Jong-Ho Lee),정필훈(Pill-Hoon Choung),김명진(Myung-Jin Kim),최진영(Jin-Young Choi) 대한구강악안면외과학회 2011 대한구강악안면외과학회지 Vol.37 No.1
The uvulopalatal flap (UPF) technique is a modification of uvulopalatopharyngoplasty (UPPP) for the surgical treatment of obstructive sleep apnea. In the UPF technique, an uvulopalatal flap is fabricated and sutured to the residual mucosa of the soft palate to expand the antero-posterior dimensions of the oropharyngeal inlet. In the extended uvulopalatal flap (EUPF) technique, an incision at the tonsillar fossa is added to the classical UPF technique followed by the removal of mucosa and submucosal adipose tissue for additional expansion of the lateral dimension. The EUPF technique is more conservative and reversible than UPPP. Therefore, complications, such as velopharyngeal insufficiency, dysphagia, dryness, nasopharyngeal stenosis and postoperative pain, are reduced. In the following case report, the patient was diagnosed with obstructive sleep apnea and treated with the EUPF technique. The patient’s total respiratory disturbance events per hour (RDI) was decreased to 15.4, the O 2 saturation during the sleep was increased, and the excessive daytime sleepiness had disappeared after the surgery without complications. The authors report this case with a review of the relevant literature.
Osteomyelitis of Mandibular Condyle : A Case Report in 9-year-old Child
이경은,최순정,서봉직,Lee, Kyung-Eun,Choi, Soon-Jeong,Suh, Bong-Jik Korean Academy of Orofacial Pain and Oral Medicine 2009 Journal of Oral Medicine and Pain Vol.34 No.3
Osteomyelitis means inflammation of the bone marrow. It usually begins in the medullary cavity, involving the cancellous bone; then it extends and spreads to the cortical bone and eventually to the periosteum. The cause is usually thought to be microbiological. But there still are factors that predispose to produce a possible bone infection such as injuries, syphilis, actionomycosis, chronic kidney failure, alcoholism, malnutrition, radiotherapy, and chemotherapy. Treatment of modalities have been directed toward eradicating microbes and improving circulation in the early stage. In the case presented, surgical debridement and IV antibiotics were the treatment of choice. Osteomyelitis in children is mainly affected in the mandible. And in childhood, the mandibular condyle is regarded as an important center of mandibular growth. Therefore, in young patients, osteomyelitis involving this region may cause a restraint of mandibular development, resulting in facial asymmetry. So diagnosis in the early stage is important in child with osteomyelitis. Recently, we have encountered an interesting case of osteomyelitis of the mandibular condyle in 9-year-old boy. So we present the case and review the literature about osteomyelitis.
팽준영,명훈,황순정,서병무,최진영,이종호,정필훈,김명진,Paeng, Jun-Young,Myoung, Hoon,Hwang, Soon-Jung,Seo, Byoung-Moo,Choi, Jin-Young,Lee, Jong-Ho,Choung, Pill-Hoon,Kim, Myung-Jin 대한악안면성형재건외과학회 2006 Maxillofacial Plastic Reconstructive Surgery Vol.28 No.4
Objectives: Distraction osteogenesis has recently evolved a challenging technique to overcome the limitations of conventional augmentation procedures. The aim of this report was to evaluate the clinical result of alveolar distraction osteogenesis for implant installation. Methods: Twenty five patients with alveolar ridge deficiencies were treated with vertical alveolar distraction osteogenesis by intraoral device (total 27 devices: 25 extraosseous and 2 intraosseous devices). After the latency periods of 5-7 days, activation of the device was started. The distraction rhythm and rate was 0.75-1.0 mm a day with 2 or 3 times a day. After 3-4 months, dental implants were placed with removing the distractor simultaneously. Results: On average, a vertical gain of $9.8{\pm}3.4\;mm$ was obtained by distraction osteogenesis. Total 84 implants were installed. Average follow up period was $13.5{\pm}7.5$ months. No implant was removed during the follow up period. Three patients showed infection during the distraction osteogenesis. Three devices were broken and 2 devices among them were replaced with new one. Conclusion: Relatively larger amount of alveolar bone augmentation could be obtained with distraction osteogenesis. For the ideal anatomically and functionally ideal regeneration of alveolar bone to install dental implant, the complication of distraction should be controlled.
이수연,명훈,서병무,황순정,이종호,김명진,최진영 대한구순구개열학회 2006 대한구순구개열학회지 Vol.9 No.2
The case records of 24 patients in Seoul National University Hospital who had bone grafting of 29 alveolar clefts between 2001 and 2004 were examined. Details were recorded of age, sex, preoperative orthodontictreatment, the time of bone grafting, the type of donor site, cleft width, functional load applicationand the success of grafting as established by lowest marginal bone levels. Using this results and review of literature, we concluded that secondary bone graft with iliac bone before canine eruption with root development of 1/2 to 1/3 provide more favorable results and the functional load introduced to the grafted bone lower the resorption rates.
구순구개열 환자에서의 상악골 열성장의 골신장술을 위한Internal distraction device와 Rigid external distraction의 비교
팽준영,명훈,황순정,서병무,최진영,이종호,정필훈,백승학,김명진 대한악안면성형재건외과학회 2005 Maxillofacial Plastic Reconstructive Surgery Vol.27 No.4
Distraction osteogenesis for the advancement of hypoplastic maxilla of cleft patients has shown successful results. In this report, rigid external distraction(RED) system and internal distraction device were used for maxillary advancement. Each system has its advantages and disadvantages. Larger amount of advancement can be achieved with RED system. But complex external device may give patients psychological stress. Internal device is invisible. However its distraction amount have limitation for the advancement (< 20mm) and the vector cannot be changed freely during distraction. The authors treated five cleft patients with maxillary hypoplasia(three with RED system and two with internal distractor). Their results were satisfactory. We present the pros and cons of RED and internal system for maxillary distraction osteogenesis.
한국인에 있어서 하행구개동맥의 위치 연구 (Le Fort I형 골 절단술과 관련하여)
이일구,명훈,황순정,서병무,이종호,정필훈,김명진,최진영,Lee, Il-Gu,Myoung, Hoon,Hwang, Soon-Jung,Seo, Byoung-Moo,Lee, Jong-Ho,Choung, Pil-Hoon,Kim, Myung-Jin,Choi, Jin-Young 대한악안면성형재건외과학회 2007 Maxillofacial Plastic Reconstructive Surgery Vol.29 No.6
Purpose: The Le Fort I osteotomy is a commonly performed maxillary procedure for dentofacial deformity. One of the risks of this procedure is major hemorrhage resulting from injury to the descending palatine artery. So it is very important to know the exact position of the descending platine artery. An increased understanding of the position of this artery can minimize the intra-operative bleeding while allowing extension of the bone cuts to achieve exact positioning maxilla. The aim of this investigation was to study the position of the descending palatine artery as it relates to the Le Fort I osteotomy. Methods and patients: Total 40 patients who underwent Le Fort I osteotomy in SNUDH OMFS were studied in this study. We measured the distance from the pyriform aperture to the descending palatine artery (DPA distance) using a ruler. We investigated the relationship between DPA distance, the distance from A point to the McNamara line on lateral cephalography and the patient's body height. Results: The average distances from the pyriform rim to the descending palatine artery were 35.3 mm on the right (range: $30{\sim}40mm$) and 33.7mm (range: $30{\sim}41mm$) on the left in males. Those in females were 33.4 mm on the right (range: $28{\sim}40mm)$ and 32.8mm (range: $27{\sim}38mm$) on the left. The significances between the distance the DPA distance, the body height and the distance from A point to McNamara line were not found. <Simple Regression Analysis> Conclusion: Injury to the descending palatine artery during Le Fort I osteotomy can be minimized by not extending the osteotomy more than 30 mm posterior to the pyriform aperture in mal, and 27 mm in female.