흰쥐에서 말초신경 손상후 뒤뿌리신경절세포의 신경영양인자와 그 수용체의 발현 양상

백선용,양만석,문총석,김봉선,김재봉,김진정 대한해부학회 1999 Anatomy & Cell Biology Vol.32 No.2

생체분해성 망막압정을 이용한 망막고정에 대한 실험적 연구

김용백,민병무,김창식,박근성,김승영,길숙종,조항진,이성복,노승무,송규상,강대영,조준식,양준묵,정경수,최선웅,이진호,김학용,인현빈 충남대학교 의과대학 지역사회의학연구소 1998 충남의대잡지 Vol.25 No.1

Biodegradable retinal fixation devices obtain mechnical fixation of the retina with desirable chorioretinal scarring and with the potential for local, sustained release of antimetabolites and steroids to inhibit proliferative vitreoretinopathy. We manufactured a biodegradable retinal tack with barb that was designed in order to prevent intrusion from implantation of retinal tacks. This study was carried to evaluate the efficacy for retinal fixation and the capability for sustained release of drugs with a newly designed biodegradable retinal tack Biodegradable retinal tacks were made of polymers of glycolic acids and were designed with barbs in a shape to prevent the disinsertion. Biodegradale retinal tacks are divided into 3 parts, a conical portion that is inserted into the sclera, a cylinder portion that remains in the vitreous, and a neck portion between the pin and the cylinder. The tapered conical end was manufactured to allow easy insertion through the retina and choroid into the sclera. A cylinder portion was manufactured with a tapered angle that fixes firmly into the orifice of 19 gauge spinal needle. A neck portion, 0.4 mm in diameter, was designed to prevent disinsertion from following implantation of retinal tack. The applicator was a 19 gauge spinal needle and its orifice was prepared to 15°angle to accept the tapered cylinder portion of the retinal tack. The retinal tacks, secured in the needles, were passed through the formed vitreous and inserted into the retina, choroid, and sclera and were released by pushing the internal needle, usually within 2-3mm of the medullary ray of the posterior rabbit retina A retinal tack was placed in each of 8 pigmented rabbit eyes. Slit-lamp biomicroscopy, indirect ophthalmoscopy and fundus photography were performed periodically from 1 day to 8 weeks after surgery. Eight eyes were enucleated and studied by light microscopy at 8 weeks. Biomicroscopic evaluation of the animals revealed edemas adjacent to the retinal surfaces immediately after insertion of the biodegradable retinal tacks in all the animals. These edemas disappeared after 1 week. The first noticeable change in the size of retinal tacks was shown after 2weeks. The size of the retinal tacks gradually got smaller, decreasing to about one-half at 4 weeks and about one-third at 8 weeks. All retinal tacks remained in inserted places without any movement for an 8 week period. On light microscopy, epiretinal proliferations were seen to extend into the vitreous cavity. Cellular capsules that lined the inner aspect of the scleral defect caused by tack insertion were found. However the adjacent retina had a normal cytologic appearance and architecture in all specimens. We manufactured a biodegradable retinal tack that is designed to prevent intrusion from implantation of retinal tacks. All biodegradable retinal tacks reduce in size with time, but no retinal tacks extruded from the inserted place. The newly designed biodegradable retinal tack can be used for retinal fixation and may be used as a vehicle for the introduction of pharmacologic agents to prevent the cellular events that promote proliferative vitreoretinopathy.

뼈에 발생한 악성 림프종 환자의 치료 효과 판정에서 ^(18)F-FDG Positron Emission Tomography의 유용성

김남돈,박연희,기승석,박용진,김형준,류백렬,김흥태,김성은,천기정,최창운,임상무 대한핵의학회 2003 핵의학 분자영상 Vol.37 No.5

원발성골림프종은 매우 드문 질환이기는 하나, 복합항암요법이나 방사선 치료등에 높은 반응율을 보이며, 좋은 예후를 가지는 림프절의 비호지킨 림프종의 일종이다. 그러나, 치료 효과 판정에 있어 골병변의 특이성에 의한 모호한 방사선학적 특징으로 어려움이 있어 왔다. 본 증례는 위와 같은 원발성골림프종 환자에서 PET 스캔을 사용하여 민감하게 완전 반응을 평가할 수 있었던 예로, 앞으로 다른 고식적인 방법과 함께 이 질환의 진단과 치료 평가 있어 유용하게 사용 될 수 있을 것으로 전망할 수 있었다. Purpose: Accurate assessment of the lesion after treatment of patients with bone lymphoma is difficult. In this patient who demonstrated complete remission after chemotherapy, the regions of fluorine-18 fluorodeoxyglucose (^(18)FFDG)PET uptake diminished more rapidly following therapy, indicating a complete response at much earlier stage than did Magnetic Resonance Imaging (MRI) or CT based findings. With the conventional methods, such as MRI and CT. It was difficult to assess whether the residual tumor tissue was viable or not. Decision to complete response is very important in patients with ymphoma to plan the further treatment. We experienced a patient with primary lymphoma of bone who revealed complete response to chemotherapy on ^(18)FFDGPET while CT showed persistent destructive bone lesion. Thus, ^(18)FFDGPET study after therapy may be superior to CT in the evaluation of response to treatment in primary lymphoma of bone.

생체분해성 고분자를 이용한 사시수술용 제형개발 및 효용성에 대한 연구

민병무,김용백,김승영,김창식,박근성,길숙종,조항진,이성복,노승무,송규상,강대영,조준식,양준묵,정경수,최선웅,이진호,김학용,인현빈 충남대학교 의과대학 지역사회의학연구소 1998 충남의대잡지 Vol.25 No.1

A new device, muscle clamping system was developed to facilitate exact quatifying technique A strabismus surgery, and reduce the risk of complications. The device is composed of a lower fixing body with three jaws and an upper supporting body. They are used to clip an extraocular muscle and fix it to the sclera with a single bite. Superior rectus recession on 16 rabbit eyes were performed with this new device. Conjunctival injection, muscle adhesion strength, and light microscopic findings were examined at 1, 2, 4 and 8 weeks postoperatively. The Conjunctival injection were minimal, adhesion power ranged from 420 to 600 gram gravity, which is sufficient in withstand the normal pull of human extraocular muscle. In microscopic exam, some Inflammatory cells and fibrosis were found. The new device was technically easy, fast, and accurate, so it may be useful in stabismus surgery.

Rat의 복강에 삽입한 Filorouracil-Polyglycolic acid제형의 Fluorouracil용출에 관한 연구

노승무,정경수,오정연,김진향,양준묵,강대영,송규상,최정목,최선웅,이진호,조준식,민병무,김용백,김창식,박근성,김승영,김학용,인현빈 충남대학교 의과대학 지역사회의학연구소 1998 충남의대잡지 Vol.25 No.1

A common form of relapse in adenocarcinoma of the stomach is intraperitioneal dissemination, in fact, among gastric adenocarcinoma patients who have undergone surgery intended to cure, approximately 50% of the patients develope initial recurrence in the peritoneal cavity regardless of the anatomic site of the primary tumor within the stomach. The efficacy of systemic postoperative chemotherapy to prevent peritoneal recurrence of gastrric adenocarcinoma is not satisfactory. There is still a great need for improved therapeutic strategies on the disseminated microscopic disease and small miliary nodules remaining on the peritoneal surface or lymphatics after operation. The authers have made fluorouracil-polyglycolic acid composite disks(Fu-PGA disks) with fluorouracil and biodegradable polymer: polyglycolic acid for more effective intraperitoneal chemotherapy. We inserted the Fu-PGA disk(s) in the peritoneal cavity of rat and pharmacokinetic study was performed to measure fluorouracil concentration in the peritoneal fluid, plasma, liver, kidney and heart tissue at 24 hour, 72 hour and 168 hour after insertion of Fu-PGA disk(s). Myelosuppressive action of this composite also was determined following its administration. The data of this study suggested that Fu-PGA composite will be a new device releasing drugs in a controlled manner and having targetability to peritoneum, and this device will be improving the efficacy of intraperitoneal chemotherapy for gastric adenocarcinoma.

Rat의 복강에 삽입한 Fluorouracil-Polyglycolic acid 제형의 Fluorouracil 용출에 관한 연구

노승무,정경수,오정연,김진향,양준묵,강대영,송규상,최정목,최선웅,이진호,조준식,민병무,김용백,김창식,박근성,김승영,김학용,인현빈 忠南大學校 癌共同硏究所 1998 癌共同硏究所 硏究誌 Vol.2 No.1

A common form of relapse in adenocarcinoma of the stomach is intraperitoneal dissemination, in fact, among gastric adenocarcinoma patients who have undergone surgery intended to cure, approximately 50% of the patients develope initial recurrence in the peritoneal cavity regardless of the anatomic site of the primary tumor within the stomach. The efficacy of systemic postoperative chemotherapy to prevent peritoneal recurrence of gastrric adcnocarcinoma is not satisfactory. There is still a great need for improved therapeutic strategies on the disseminated microscopic disease and small miliary nodules remaining on the peritoneal surface or lymphatics after operation. The authers have made fluorouracil-polyglycolic acid composite disks(Fu-PGA disks) with fluorouracil and biodegradable polymer: polyglycolic acid for more effective intraperitoneal chemotherapy. We inserted the Fu-PGA disk(s) in the peritoneal cavity of rat and pharmacokinetic study was performed to measure fluorouracil concentration in the peritoneal fluid, plasma, liver, kidney and heart tissue at 24 hour, 72 hour and 168 hour after insertion of Fu-PGA disk(s). Myelosuppressive action of this composite also was determined following its administration. The data of this study suggested that Fu-PGA composite will be a new device releasing drugs in a controlled manner and having targetability to peritoneum, and this device will be improving the efficacy of intraperitoneal chemotherapy for gastric adenocarcinoma.

위암환자의 복강내에 투여한 Mitomycin C-Carbon Particle의 Mitomycin 용출에 관한 연구

노승무,조영훈,정경수,오정연,김진향,양준묵,강대영,송규상,조준식,최선웅,이진호,민병무,김용백,김창식,박근성,인현빈,정현용,김학용 충남대학교 의과대학 지역사회의학연구소 1998 충남의대잡지 Vol.25 No.1

Locoregional recurrence is the most common type of recurrence in surgical operation of gastric adenocarcinoma, and peritoneal dissemination is one of the most difficult problems in advanced gastric adenocarcinoma treatment. Because the peritoneal cavity is the most common site of the first recurrence after gastric cancer resection, intraperitoneal chemotherpy seems a logical choice for cancer chemotherapy. The Mitomycin C(MMC) adsorbed by the activated charcoal particles(CH) is relatively released when the drug concentration surrounding the carbon particles becomes low in the peritoneum of the peritoneal cavity. For the intraperitoneal chemotherapy on the advanced gastric adenocarcnoma, mitomycin C adsorbed on activated carbon particles was administered in the peritoneal cavity just before abdominal wall closure. The closed drainage tubes were inserted in the peritoneal cavity and clamped for tuo hours after completion of operation. MMC concentrations were serially measured in peritoneal fluid, plasma and urine at 2hour, 48 hour, 72 hour and 168 hour following its administration in order to study the efficacy of the MMC-CH as a drug delivery system. There were minimal toxicities in born marrow, liver, and gastrointestinal system after intraperitoneal MMC-CH administration. The data of this study suggested that MMC-CH may have a somewhat more beneficial effect than surgery alone when administered in optimal dose and schedules, but the MMC concentration of the peritoneal fluid was not sufficient to eradicate remnant cancer cells, and effective duration of maintenance was only below 24 hours in the peritoneal fluid and plasma.

벽체의 저부활동에 의한 토압

김기범,전용백 대구대학교 과학기술연구소 1995 科學技術硏究 Vol.2 No.1

This research observed the movement of backfill according to wall displacement and earth pressure which occured by wall base failure in case of surcharge loading on rigid wall backfill. Analysed results upon those basis are as follows 1. By means of adding surcharge load, the pressure wall endures from the surface of the backfill to 42cm depth, decreased steeply, however, below that point, we could understand the pressure is residual. And the point of pressure application, through surcharge load displaced H/2 point, a little higher point than H/3 which is Coulomb's asumption during the course of base failure. 2. Allowing wall displacement, in the stage of short distance, the decrease of earth pressure shows steep curve as Keizo Ugai's theory shown the and after the minimum earth pressure, the pressure goes up slowly. And come to an state of revolve activity and the influence which affect earth pressure shows greater when the location of loading plate is closer to wall plate. 3. The limitation of the state of active at 0.01H∼0.05H of wall displacement quantity showed similar with -those of 0.01H∼0.04.

유리체절제술중 발생한 의인성망막열공

김용백,박근성,홍성태 충남대학교 의과대학 지역사회의학연구소 1995 충남의대잡지 Vol.22 No.2

To determine the current incidence, location and treatment of intraoperative iatrogenic retinal breaks occuring during pars plana vitrectomy, we reviewed the records of 208 consecutive eyes after pars plana vitrectomy. Thirty seven of 208 eyes (18%) developed 68 intraoperative tears. Of the 68 tears, 14 (21%) were located in the anterior to equator and 54 (79%) were located in the posterior to equator. Thirty six retinal tears (43%) were located in the upper quadrants and in the lower quadrants, we detected 47 retinal tears (57%). Patients with proliferative diabetic retinopathy and proliferative vitreoretinopathy had a higher incidence of iatrogenic retinal breaks than those with other diagnoses. Methods used to treat the retinal tears included cryotherapy, laser photocoagulation, scleral buckling, internal tamponade of gas, air and silicone oil. Thirty three of 37 eyes (89%) were reattached. According to the use of endolaser photocoagulation, we divided the period of study that the first half : 1989. 5. - 1991. 6. and the second half : 1993. 1 - 1993. 12. The results of chorioretinal adhesion in the 1st half were higher than those of the second half. These results show that vitreoretinal surgery for proliferative diabetic retinopathy and proliferative vitreoretinopathy requires careful managements for prevention of iatrogenic retinal tears. Despite improvements in instrumentation and surgical techniques, iatrogenic retinal tears continue to be an important complication of pars plana vitrectomy. However, with careful intraoperative examination, most iatrogenic retinal tears can be identified and treated successfully.

후방인공수정체 공막봉합고정후 발생한 망막박리

김용백,정상엽 충남대학교 의과대학 지역사회의학연구소 1997 충남의대잡지 Vol.24 No.2

To determine clinical features and outcomes of retinal detachment(RD) after trans-scleral fixation of posterior chamber intraocular lens(PC-IOL), we reviewed 259 eyes (203 patients) that received trans-scleral fixation of PC-IOL between 1988 and 1993 with a minimum follow-up of 6 months retrospectively. The mean age of the patients was 53.4±17 years and the mean follow-up period was 16.2±17 months. The causes of trans-scleral fixation of PC-IOL were as follows: aphakia in 106 eyes, posterior capsule rupture during extracapsular cataract extraction(ECCE) in 78 eyes, intracapsular extraction(ICCE) in 26 eyes, PC-IOL exchange for PC-IOL exchange with PC-IOL in 3 eyes. Retinal detachment occurred in 8 out of 259 eyes(3.2%). The incidences of RDs were as follows: PC-IOL exchange for IC-IOL tilt in 2/9 eyes(10.5%), posterior capsule rupture during ECCE in 1/16 eyes(6.3%), ICCE in 1/26 eyes(3.9%), posterior capsule rupture during phacoemusification in 2/78 eyes(2.6%), aphakia in 2/106 eyes(1.9%), anterior IOL exchange with PC-IOL in 0/3 eyes(0%). The sites of retinal breaks corresponded with the directions of needles during fixation in 5/8 eyes(62.5%) and all retinal breaks were found anterior to the equator. The occurrence of RD was between 2 weeks and 4.8 years after fixation but it occured within 2 months in most cases. Pars plana vitrectomy and scleral buckling was performed in 7 eyes and in one eye scleral buckling was done. Retinal reattachment was achieved in all eight eyes though three eyes required two or more surgical interventions and silicone oil remained in situ in two. The vitretomy should be performed with meticulous care to reduce vitreous traction as much as possible during trans-sclera fixation of PC-IOL and a close follow-up examination for RD is required within at least two months.