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중증 외상성 뇌부종 환자에서 양측 전두-측두부 감압적 개두술의 의의
신형식,김진용,김태홍,황용순,김상진,박상근,Shin, Hyung Shik,Kim, Jin Yong,Kim, Tae Hong,Hwang, Yong Soon,Kim, Sang Jin,Park, Sang Keun 대한신경외과학회 2000 Journal of Korean neurosurgical society Vol.29 No.9
Objective : The treatment of malignant posttraumatic brain swelling remains a frustrating endeavor for neurosurgeon. Mortality and morbidity rates remain high depite advances in medical treatment of increased intracranial pressure. If conventional therapy fails in patients suffering from intracranial hypertension, there is only small number of second-tier option left including decompressive craniectomy. The role of decompressive craniectomy in posttraumatic brain swelling remains controversial. We assessed the efficacy and indications of decompressive craniectomy. Methods : The authors performed decompressive bifrontotemporal craniectomy in 22 patients with malignant posttraumatic brain swelling. Epidural pressure monotoring was performed in all patients. The clnical data and surgical outcomes were reviewed retrospectively. Result : The favorable outcome(GOS score 4-5) was 59%(13 of 22 patients), whereas the mortality rate was 32% (7 of 22 patients). Two patients(9%) remained in severely disabled state. Increased rate of favorable outcome was seen in the patients who had 8 or more of GCS score at admission and exhibited B wave in ICP monitoring and who showed steady state or slow deterioration in clinical course. Conclusion : If conservative therapy fails, decompressive bifrontotemporal craniectomy should be considered in the management of malignant posttraumatic brain swelling before irreversible ischemic brain damage occur.
신형식,김영순,강길선,Mushtaq Ahmad Dar,Shafeeque G. Ansari,Hyung-il Kim,Chu Van Chiem 한국화학공학회 2005 Korean Journal of Chemical Engineering Vol.22 No.5
Diamond films on the p-type Si(111) and p- type(100) substrates were prepared by microwave plasma chemical vapor deposition (MWCVD) and hot-filament chemical vapor deposition (HFCVD) by using a mixture of methane CH4 and hydrogen H2 as gas feed. The structure and composition of the films have been investigated by Xray Diffraction, Raman Spectroscopy and Scanning Electron Microscopy methods. A high quality diamond crystalline structure of the obtained films by using HFCVD method was confirmed by clear XRD-pattern. SEM images show that the prepared films are polycrystalline diamond films consisting of diamond single crystallites (111)-orientation perpendicular to the substrate. Diamond films grown on silicon substrates by using HFCVD show good quality diamond and fewer non-diamond components.
Nifedipine이 건강 치은 조직의 치은 섬유모세포에 미치는 영향
신형식,한희란,김명은,Shin, Hyung-Shik,Han, Hee-Ran,Kim, Myung-Eun 대한치주과학회 1996 Journal of Periodontal & Implant Science Vol.26 No.3
Gingival overgrowth is a well known side effect of several drugs, including nifedipine, phenytoin, cyclosporin, dilitiazem, verapamil. A number of studies have been performed to investigate the mechanism by which nifedipine(a calcium channel blocking agent) affects the gingival tissue. The aim of the present work was to investigate the effect of nifedipine on healthy gingival fibroblasts with special emphasis on determining the changes in cellular proliferation and protein and collagen synthesis. Gingival fibroblasts were obtained from the explants of healthy gingiva of extracted 3rd molars or premolar teeth extracted from the patients for orthodontic treatment. To evaluate the effect of nifedipine on cell proliferation, the cells were seeded at a cell density of $1{\times}10^4$cells/well in 24-well culture plates and treated with 100 and 200ng/ml of nifedipine for 10days. After trypsinization, the cells were counted with a haemocytometer on 1st, 3rd, 5th, 7th and 10th days. Then, MTT assay was carried out. For total protein and percent collagen synthesis, $3{\mu}Ci/ml$ $^3H-proline$ was added to each well for the final 4 hours of the incubation period. The results indicate that nifedipine does not influence cell proliferation in healthy gingival fibroblast in vitro and has a specific effect in reducing total protein and percent collagen synthesis. On the above the findings, exogenous nifedipine does not influence on healthy human gingival fibroblast proliferation and protein and collagen synthesis.
Microencapsulation 헤모글로빈 인공적혈구의 용혈
김민호 ( Min Ho Kim ),강형섭 ( Hyung Sub Kang ),김진상 ( Jin Shang Kim ),백병걸 ( Byeong Kirl Baek ),홍철운 ( Chul Un Hong ),김성종 ( Seong Jong Kim ),신형식 ( Hyung Shik Shin ),김기범 ( Gi Beum Kim ) 한국조직공학과 재생의학회 2010 조직공학과 재생의학 Vol.7 No.2
The purpose of this study was to reduce the hemolysis of artificial red blood cells by extracting phospolipids from egg yolk through microencapsulation to evaluate the oxygen transfer rate of artificial red blood cells in an intravascular artificial lung device. In this study, hemosome was produced to encapsulate hemoglobin which extracted the red blood cell of bovine blood with phospolipids reduced egg yolk. The solution blended blood with hemosome at the rate of 4 to 1 and normal blood measured the oxygen transfer rate. The hemolysis of the microencapsulated artificial red blood cell measured less than the normal red blood cell through absorptivity. Due to the phospolipids enclosing the red blood cell to protect it, the produced hemosome operated at a higher oxygen transfer rate by reducing the demolition of hemoglobin. Consequently, hemolysis was observed to advance through micoencapsulation.
Myoglobin에 의한 급성 신부전에서 Oxygen Free Radical의 역할
김주섭 ( Joo Seop Kim ),정대윤 ( Dae Yune Jung ),김장만 ( Jang Man Kim ),조홍래 ( Hong Rae Cho ),배수동 ( Soo Tong Pai ),강구 ( Gu Kang ),신형식 ( Hyung Sik Shin ) 대한외상학회 1991 大韓外傷學會誌 Vol.4 No.2
Highly reactive oxygen metabolites have been known to have a role in several models of acute renal failure. Especially hydroxyl radicals have been proved to be important mediators by some previous authors. This study was aimed to determine the role of superoxide radical as well as hydroxyl radical and to compare the protective effects of both scavengers in myoglobinuric renal failure. Acute renal failure was induced by intramuscular injection of hypertonic glycerol (6mg/kg, half-dose in each hindlimb muscles) in rats. Rats treated with glycerol and hydroxyl radical scavenger, dimethylsulfoxide (DMSO), showed lower serum blood urea nitrogen (BUN) and creatinine level than rats with glycerol alone. And also significant protection was noticed histologically. Superoxide radical scavenger, superoxide dismutase (SOD), had a similar protective effects. In contrast, allopurinol, an inhibitor of xanthine oxidase, was not protective at all. The present study may suggest that both superoxide and hydoxyl radical playa role of tissue injury in myoglobin-induced renal failure. Beside xanthine oxidase, other souces of oxygen free radical may exist.
김진용,박상근,김한성,신형식,황용순,김상진,Kim, Jin Yong,Park, Sang Keun,Kim, Han Sung,Shin, Hyung Shik,Hwang, Yong Soon,Kim, Sang Jin 대한신경외과학회 2000 Journal of Korean neurosurgical society Vol.29 No.8
Although the most commonly encountered orbital tumor is metastatic tumor, adenocarcinoma of stomach metastasized to the optic nerve is rarely reported. The authors discuss a rare case of metastatic adenocarcinoma of left optic nerve with a review of literature. A 44-year-old man presented with decreased visual acuity of left eye for 3 months. Neurologic examination revealed left optic neuropathy. On MR imaging, a homogenously wellenhanced mass surrounding left optic nerve around optic canal was noticed. The X-rays and the whole body bone scan sho-wed multiple bony metastasis. Subtotal removal was performed via combined subfrontal and pterional approach and metastatic adenocarcinoma from the stomach was confirmed histologically. Postoperative course was uneventful, but there was no improvement of visual acuity.
간세포암에서 현미부수체 불안정성과 p53 유전자 이형접합 소실
김준석(Jun Seok Kim),임만섭(Man Sup Lim),김두진(Doo Jin Kim),김주섭(Joo Seop Kim),김관석(Kwan Seok Kim),김홍기(Hong Ki Kim),조성진(Seong Jin Cho),권미정(Mi Jung Kwon),남은숙(Eun Sook Nam),최경찬(Kyung Chan Choi),신형식(Hyung Sik Shin 한국간담췌외과학회 2009 한국간담췌외과학회지 Vol.13 No.3
Purpose : Hepatocellular carcinoma (HCC) shows various molecular and genetic alterations in its development and progression. Recently, microsatelite instability (MSI) and the loss of heterozygosity (LOH), have been postulated as useful prognostic factors in many malignant tumors. LOH is related to the allelic loss of various tumor suppressor genes, however, MSI has been found to be the result of a mismatched DNA pairing. Our objectives were to evaluate MSI and p53 gene LOH and to correlate this to clinicopathological factors. Methods : MSI analysis was performed by using polymerase chain reaction with 5 microsatellite markers (BAT25, BAT26, D2S123, D5S346 and D17S250 recommended in the 1998 NCI International Workshop) on 50 surgically resected tumors. p53 LOH was detected with 4 markers(D17S796, TP53, D17S5, D17S513). Results : MSI and p53 LOH were detected in 30% and 66%, respectively. 18% of HCCs exhibited MSI in 5 NCI-recommended markers and 18% of HCCs demonstrated MSI in 4 p53 markers. MSI was mostly detected in BAT25 and BAT26 markers. MSI was more frequently detected in tumor grade Ⅰ, small HCC, and non-lymphovascular group. For the most aprt, p53 LOH was detected by D17S513 marker(38.1%). p53 LOH results were correlated with higher tumor grade and invasiveness. LOH-High group showed a significant correlation with advanced HCCs and lymphovascular invasion. There was no demonstrated correlation between MSI and p53 LOH was not demonstrated. Conclusion : These results suggest that MSI may be involved to some extent in hepatocarcinogenesis and tumor invasion. Also MSI and p53 gene LOH may be a useful clinical indicator in determining the prognosis among patients with HCC.
임상 : 신경정신과질환과 뇌하수체병변이 동반된 환자의 분석
김승국 ( Seung Kook Kim ),박상근 ( Sang Keun Park ),황용순 ( Yong Soon Hwang ),신준재 ( Jun Jae Shin ),신형식 ( Hyung Shik Shin ),김태홍 ( Tae Hong Kim ) 대한뇌종양학회 2011 대한뇌종양학회지 Vol.10 No.1
Purpose: The possible toxic effect of chronic neuroleptic drug on the neuroendocrine system has been well documented, and hyperprolatinemia is a common side-effect of antipsychotics. Recently we experienced 12 schizophrenic patients with pituitary lesions. It can be postulated that pituitary dysfunction may cause schizophrenia, or neuroleptic drugs may induce pituitary lesion in the patient with schizophrenia. We analyzed these patients and reviewed related literatures. Materiala and Methods: From October 2007 to April 2009, ten patients who had been treated at department of psychiatry under the diagnosis of schizophrenia (6 patients) and other psychiatric diseases (6 patients) were enrolled in this study. The pituitary lesions were detected by MRI and consulted to neurosurgical department. Various possible clinical information, medication history, radiological finding and result of neurosurgical management were analyzed. Result: Radiological findings of twelve patients with pituitary lesions were definite pituitary tumors in 6, cystic lesions in 3 and suspicious tumorous lesions in 3 patients. Medicated drugs at psychiatric department were risperidone, clozapine and other antidepressants. We had operated for 4 patients who had schizophrenia concomitant with definite pituitary tumors. After surgery psychological symptoms of these patients were improved in spite of minimized neuroleptic drugs. The pituitary lesions in the none operated patients were diminished or unchanged during the suitable observation period. Conclusion: Neuroleptic drug may act as toxic effect on pituitary gland by blocking predominantly dopamine receptors of the D2 class as well as other receptors to varying degrees. We experienced 10 psychiatric patients with pituitary lesions. It may be considered that neuroleptic drugs enhance pituitary lesions, or high prolactin level aggravates schizophrenic symptoms.
전기영동법을 이용한 고체산화물 연료전지용 Ce0.8Sm0.2Ox 전해질 박막 제조
김동규 ( Dong Gyu Kim ),송민우 ( Min Wu Song ),이경섭 ( Kyeong Seop Lee ),김연수 ( Yeon Su Kim ),김영순 ( Young Soon Kim ),신형식 ( Hyung Shik Shin ) 한국화학공학회 2011 Korean Chemical Engineering Research(HWAHAK KONGHA Vol.49 No.6
본 연구에서는 나노 크기의 세리아를 사마리움으로 일부 도핑(samaria-doped ceria(SDC))한 분말을 urea를 첨가제로 사용하여 수열합성법으로 합성하였으며 그 특성들을 XRD, FESEM, TEM 등을 통해 관찰하였다. 합성 시간 및 합성 온도가 증가함에 따라 분말의 결정성 및 입도가 증가함을 확인하였다. 또한 이온전도도의 측정을 통해 합성된 SDC 파우더가 중·저온(600~800℃ ) 부근에서 0.1 S/cm의 이온전도도를 보여 중·저온형 고체산화물 연료전지(IT-SOFC)의 고체 전해질에 적합함을 확인할 수 있었다. 합성된 SDC 분말은 중·저온 고체산화물 연료전지의 음극지지형 전해질로 사용하기 위해 전기영동 증착 방법을 이용하여 다공성 NiO-SDC 기판 위에 SDC 박막 증착을 시도하였다. 증착 용액은 acetone을 용매로 사용하고, 20 V의 인가전압으로 10초간 증착한 결과 얇고 치밀하며 기공이 없는 SDC 박막이 형성 되었음을 FESEM 분석을 통해 확인할 수 있었다. In this work, a nano-sized samaria-doped ceria(SDC) was prepared by a urea-based hydrothermal method and characterized by XRD, FESEM and TEM. It was observed that the increase in synthesis time and temperature gave rise to crystallity and particles size. Moreover, the synthesised powders had a excellent ion-conductivity(0.1 S/cm at 600~800℃ ) which is suitable for electrolyte of intermediate temperature-solid oxide fuel cell(IT-SOFC). Subsequently for use as electrolyte for anode-supported IT-SOFC, we tried to deposit the SDC powder on a porous NiO-SDC substrate by electrophoretic deposition(EPD) method. From the FESEM observation, a compact and gas-tight SDC thin film was obtained when using acetone solvent with constant voltage of 20 V for 10 s.