• 대한미세수술학회:학술대회논문집
• /
• 2001.11a
• /
• pp.179-179
• /
• 2001

• 대한핵의학회:학술대회논문집
• /
• 1989.06a
• /
• pp.137.1-137.1
• /
• 1989

• Journal of Chest Surgery
• /
• v.30 no.11
• /
• pp.1136-1138
• /
• 1997

A 45-year-old man underwent heart transplantation due to dilated cardiomyopathy. Cyclosporine, 2 mg/kg per day, was intravenously givell postoperatively. As central neurotoxicity signs that were included pin-point pupil, no light reflex, coma, were presented at 8 postoperative hours, cyclosporine was decreased to 1 mg/kg er day. At that time the cyclosporine level was 345 $\mu\textrm{g}$/L, the serum creatinine level was 1.8mg/dl and the serum magnesium level was within normal limit. He awaked at 31 postoperative hours and all sign of cyclosporine-induced central neurotoxicity was resolved after postoperative days. He was discharged without sequale at postoperative day 28.

• Progress in Medical Physics
• /
• v.19 no.1
• /
• pp.73-79
• /
• 2008

Retinal prosthesis is regarded as the most feasible method for the blind caused by retinal diseases such as retinitis pigmentosa (RP) or age related macular degeneration (AMD). Recently Korean consortium launched for developing retinal prosthesis. One of the prerequisites for the success of retinal prosthesis is the optimization of the electrical stimuli applied through the prosthesis. Since electrical characteristics of degenerate retina are expected to differ from those of normal retina, we performed voltage stimulation experiment both in normal and degenerate retina to provide a guideline for the optimization of electrical stimulation for the upcoming prosthesis. After isolation of retina, retinal patch was attached with the ganglion cell side facing the surface of microelectrode arrays (MEA). $8{\times}8$ grid layout MEA (electrode diameter: $30{\mu}m$, electrode spacing: $200{\mu}m$, and impedance: $50k{\Omega}$ at 1 kHz) was used to record in-vitro retinal ganglion cell activity. Mono-polar electrical stimulation was applied through one of the 60 MEA channel, and the remaining channels were used for recording. The electrical stimulus was a constant voltage, charge-balanced biphasic, anodic-first square wave pulse without interphase delay, and 50 trains of pulse was applied with a period of 2 sec. Different electrical stimuli were applied. First, pulse amplitude was varied (voltage: $0.5{\sim}3.0V$). Second, pulse duration was varied $(100{\sim}1,200{\mu}s)$. Evoked responses were analyzed by PSTH from averaged data with 50 trials. Charge density was calculated with Ohm's and Coulomb's law. In normal retina, by varying the pulse amplitude from 0.5 to 3V with fixed duration of $500{\mu}s$, the threshold level for reliable ganglion cell response was found at 1.5V. The calculated threshold of charge density was $2.123mC/cm^2$. By varying the pulse duration from 100 to $1,200{\mu}s$ with fixed amplitude of 2V, the threshold level was found at $300{\mu}s$. The calculated threhold of charge density was $1.698mC/cm^2$. Even after the block of ON-pathway with L-(1)-2-amino-4-phosphonobutyric acid (APB), electrical stimulus evoked ganglion cell activities. In this APB-induced degenerate retina, by varying the pulse duration from 100 to $1200{\mu}s$ with fixed voltage of 2 V, the threshold level was found at $300{\mu}s$, which is the same with normal retina. More experiment with APB-induced degenerate retina is needed to make a clear comparison of threshold of charge density between normal and degenerate retina.

• Korean Journal of Clinical Pharmacy
• /
• v.9 no.2
• /
• pp.81-87
• /
• 1999

췌장이식의 성공률은 지난 10년 동안 상당히 상승되었다. International Pancreas Transplant Registry에 따르면 1995년 이래 미국에서만 매년 1,000건 이상의 췌장이식이 실시되고 있다. 장기이식후 나타나는 급성 거부반응은 이식 후 6개월 이내에 가장 높은 빈도수로 나타난다. 췌장이식환자에서는 신장을 이식한 것보다 두배나 높은 거부반응을 나타나며 이로 인한 입원율의 증가 항림프제(antilyinphocyte) 사용과 감염의 증가로 이환율이 높다. 더구나 Cyclosporine (CsA)을 기초로 한 면역억제제요법의 사용은 높은 급성 거부반응률(acute graft rejection)을 초래하여 이식한 장기의 조직손실이 문제가 되고 있다. 새로운 면역억제제인 Tacrolimus (FK506)의 사용은 이식환자에서의 거부반응을 감소시켜 생존율을 증가시키는 것으로 알려져 있다. Tacrolimus는 neutral macrolide로 cyclic peptide인 CsA과는 화학 구조는 매우 다르나 비슷한 면역억제 효과를 보인다. 하지만 Tacrolimus의 사용시 신경독성, 신독성, 특히 고혈당증의 발생률이 높아 일부 이식센터에서는 장기 이식 후에 사용하기를 꺼리기도 한다. 하지만 여러 연구논문에서 간과 신장 이식 후 급성 거부반응 예방에 Tacrolimus는 CsA에 비해 이점이 있는 결과를 발표하였다. 결과적으로, 현재 췌장이식 후 Tacrolimus를 기초로 한 면역억제의 효과에 대한 연구가 활발히 진행중이다. 따라서 본 연구에서는 1994-1996년 사이에 Tacrolimus 또는 CsA를 기초로 한 면역억제요법을 투여 받은 췌장이식환자 101명을 후향적으로 조사하여 Tacrolimus (n=54)와 CsA(n=57)의 급성 거부반응 예방 효과와 신부전 발생률을 비교하였다. 모든 환자는 항림프구 약물, Azathioprine, Prednisone을 이식 후 면역억제제로 투여 받았다 기준선으로부터 $20\%$ 이상의 혈청 creatinine의 상승이 있는 환자에서는 급성 신부전으로 정의하였고 신장생검법으로 거부반응을 진단하였다 Matched-pair analysis에 따르면 췌장이식환자의 6개월 생존율은 CsA군에서 $97\%$, Tacrolimus군에서 $96\%$로 별다른 차이가 없었으며 (p=0.57), 6개월간의 이식한 췌장의 보존율은 CsA군에서는 $88\%, Tacrolimus에서 $91\%$. 유의한 차이는 없었다(p=0.29). 췌장이식 후 6개월 동안 Tacrolimus의 사용은 생검으로 증명되는(biopsy-proven) 급성 거부반응의 발생빈도는 CsA보다 유의하게 낮았을 뿐만 아니라 (p<0.05) 거부반응 증상의 심각도 또한 감소시켰다 (p=0.03). 급성거부반응 발생빈도의 감소로 Tacrolimus군에서 antilymphocyte 치료가 유의하게 줄어들었다(p=0.01). CsA군에서 Tacrolimus보다 신부전의 발생률이 높았으나 통계학적 차이는 없었다. 췌장이식후의 최적의 면역억제요법의 결정하기 위해서는 향후 Tacrolimus와 CsA을 비교하는 전향적 무작위 연구가 필요하다.

• Archives of Reconstructive Microsurgery
• /
• v.10 no.1
• /
• pp.12-17
• /
• 2001

Recovery of nerve injury is conditioned by various factors including physical state, injured site, cause of injury, and neurorrhaphy Many researchers have reported on regeneration of nerve using end to side neurorrhaphy. The purpose of this study was to examine regeneration of nerve in various conditioned side to side neurorrhaphy. Total of 25 male Sprague-Dawley rats weighing 220 to 250 gm were divided into five groups of five rats each. The group 1, sham group, composed of dissection only without nerve transaction. The group 2, control group, composed of nerve division only without neurorrhaphy or sural nerve graft. The group 3 composed of one segmental sural nerve graft between the tibial and peroneal nerve after division. Group 4 had two segment graft, and the group 5 with three segment graft, each segment being 6mm long and 5 mm apart. The side to side neurorrhaphy was performed between peroneal nerve and tibial nerve using segmental sural nerve graft in rats. We exposed the sciatic nerve, tibial nerve, peroneal nerve, and sural nerve on left side with prone position. The peroneal nerve was cut on the bifurcation site from tibial nerve and the side to side epineurial neurorrhaphy was performed between peroneal nerve and tibial nerve through 6 mm sural nerve segment graft with 11-0 nylon under operating microscope. The electromyography and the weight from ipsilateral tibialis anterior muscle was performed at one month after neurorrhaphy Peroneal and tibial nerve was examined at distal and proximal to the neurorrhaphy site by methylene blue stain under light microscope for histologic appearance. The number of nerve fibers were counted using the image analyzer. Statistically, both in electromyography and number of nerve fibers, the differences in values between the groups were significant.

• Journal of the Korean Arthroscopy Society
• /
• v.12 no.3
• /
• pp.159-166
• /
• 2008

Articular cartilage is a unique tissue with no vascular, nerve, or lymphatic supply. This uniqueness may be one of the reasons why chondral injuries will hardly heal and may progress to osteoarthritis over time. Currently, there are several surgical options for the treatment of articular cartilage lesions. Although there is some discrepancy as to which procedures work best in certain patients. The spectrum of treatment alternatives for articular cartilage defects can range from simple lavage and debridement, drilling, micro-fracturing, and abrasion to osteochondral grafting and autologous chondrocyte implantation. In 1984, for the first time, results of autologous chondrocyte implantation in a rabbit model were presented, showing hyaline cartilage repair. Clinical study using autologous cultured chondrocyte implantation in chondral defects of the human knee has been reported in 23 patients in 1994. In 14 out of 16 patients treated for chondral injuries on the femoral condyles, the results were good to excellent. It is important for the surgeon to understand the autologous chondrocyte implantation technique and to be aware on the postoperative management. Attention to surgical technique and selection of appropriate patient for the autologous chondrocyte implantation will provide with the best results.

• Korean Journal of Head & Neck Oncology
• /
• v.29 no.2
• /
• pp.87-92
• /
• 2013

Complete facial nerve palsy is emotionally and physiologically devastating condition. Management of patients with the facial nerve palsy poses significant challenges to achieve the goal of returning patients to their premorbid state. We experienced a case of iatrogenic facial nerve palsy in a 66 year-old patient, who was diagnosed as facial nerve schwannoma with previous incisional biopsy. The author describes the management of this patient and reviews the literature.

• Proceedings of the KIEE Conference
• /
• 2003.07d
• /
• pp.2807-2808
• /
• 2003

말초 신경계에서 손상된 신경은 그 손상된 정도에 따라 재생의 정도가 달라진다. 이러한 신경 재생의 정도를 확인할 수 있는 방법으로 초미세 전극 어레이 기술이 연구되고 있는데 이것은 전기신호경로(via hole)를 초미세 전극어레이를 제작하여, 손상된 신경의 근위부(proximal stump)와 원위부(distal stump) 사이에 직접 삽입하여 선경으로부터 재생되어온 신경 섬유의 전기적 전도 선호를 측정 및 기록하는 것이다. 이는 신경 재생을 관찰하는 방법으로서 신경보철(neural prostheses) 기술에 이용된다. 따라서, 본 논문에서는 손상된 신경의 재생을 관찰하기 위한 implantable microelectrode array system을 설계하고, 원 신호인 선경 전도 신호의 특성과 제작된 이식형 초미세전극(implantable microelectrode)의 특성을 고찰하며, 동물 실험을 통하여 그 성능을 검증하였다.

• Journal of Korean Orthopaedic Sports Medicine
• /
• v.7 no.1
• /
• pp.15-18
• /
• 2008

Chrisman-Snook 술식은 광범위한 절개 및 비복 신경 손상 우려 등과 함께 기술적으로 복잡하다고 여겨지고 있으나, 단비골건을 전부 희생하지 않고 전거비 인대와 종비 인대를 함께 재건하면서 동시에 이식건의 등장성을 확보할 수 있어 술 후 환자의 만족도가 비교적 높고 재발 가능성이 적은 훌륭한 술식으로 사료된다.