• The Korean Journal of Pain
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• 제1권2호
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• pp.188-191
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• 1988

Recent studies have shown that narcotic drugs produce an intense prolonged analgesic action when injected into the subarachnoidal or extradural space of animals and man. In order to study the effects of intrathecal injection of morphine on postoperative pain relief and segmental block effect, we administered 0.25 mg of morphine sulfate (0.25 mg of morphine/1 ml normal saline) into lumbar subarachnoid space prior to brahial plexus block for upper extremity surgery group The results were as follows: 1) more than 20 hours analgesic effect at least 2) no segemental block effect in analgesia 3) some adverse effect (Nausea, Vomiting, Pruritus, Urinary retention).

• Journal of Gastric Cancer
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• 제9권4호
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• pp.207-214
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• 2009

목적: 위체부에 발생하는 조기위암에 대해 원위부 위아전 절제술(SDG)이 표준 술식으로 시행되나 술 후 기능장애와 합병증이 있으며, 이런 단점을 최소화하기 위해 내시경적점막절제술을 하지만 림프절의 전이여부를 알 수 없는 단점이 있다. 위의 절제 범위를 줄이고 유문을 보존하고, 림프절의 절제가 가능한 위구획절제술(SG)에 대해 그 유용성을 평가하고자 한다. 대상 및 방법: 2004년 1월부터 2007년 7월까지 본원에서 위체부의 조기위암 환자 중 41명에서 SG를 하였고, 40명에서는 SDG를 하였다. 의무기록 및 전화를 이용한 설문을 이용하여 수술 후 6개월과 12개월의 영양상태와 술 후 합병증에 대해 두 군을 비교하였다. 결과: 영양상태의 변화(혈색소, 혈장단백, 혈장알부민, 혈장콜레스테롤, P>0.05)와 체중의 변화에서 유의한 차이는 보이지 않았다. SG군에서 SDG군에 비하여 내시경 시 잔여음식물(P<0.05)이 많았으나, 상복부 불편감이나 식사 시조기 팽만감에는 큰 차이가 없었다(P>0.05). 식도염은 두군에서 비슷한 발생률을 보였고(P>0.05), 담즙 역류는 SG군과 SDG군에서 각 한 명만 관찰이 되었다. 결론: SG군에서는 유문이 보존되므로 담즙 역류로 인한식도염, 위염의 발생 감소와, 위절제범위의 감소와 유문보존으로 인한 영양학적인 장점을 기대하였으나, 현재까지의 결과는 두 군에서 큰 차이를 발견할 수 없었다. SG의 장점과 단점을 알기 위해서는 더 오랜 기간의 경과관찰과 연구가 필요할 것으로 생각한다.

• Applied Microscopy
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• 제21권2호
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• pp.1-13
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• 1991

In order to investigate the factors of the control mechanism of somitogenesis, early chick embryos (H-H stage $8{\sim}13$) were treated with heat shock, ${\alpha}$-amanitin and cycloheximide and morphological changes of somite were examined by light microscopy, transmission and scanning electron microscopy. In normal chick embryo, somites were formed from the somitomere which preexisted in segmental plate. Somites were wrapped with extracellular collagen fibrils and connected with neural tube, notochord and ectoderm. And then, somites were differentiated to sclerotome, dermatome and myotome by the interaction of nervous tissue. Abnormal somites were observed after formation of six or seven so mites in heat shock treated group. Amounts of collagen fibrils were obviously decreased in this group. In cycloheximide treated group, most so mites were smaller and neural tube formation was incomplete. Chromatins were condenced and formed several heterochromatins in the nucleus of somite cells. Lipid like cytoplasmic dense mass and lipid droplets were also observed. Segmentation of somites seemed to be normal progress in ${\alpha}$-amanitin treated group. Center of somite, however, hollowed in longitudinal sectioned samples. These results suggested that so mites were already existed in the segmental plate as the form of somitomere. Segmented somites were contacted with neural tube or notochord and the somites were tightly connected with each other by the extracellular collagen fibrils which were secreted from neuroepithelium and somite cells. Somites are thought to differentiate into sclerotome, dermatome and myotome by these interactions.

• Journal of Nutrition and Health
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• 제29권10호
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• pp.1059-1071
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• 1996

This study was performed to investigate the effect of dietary protein level on renal senescence. Male rats of 337.8$\pm$5.7g body weight were underlateral nephrectomy or shamoperation. The rats were divided into high protein(40% casein), normal protein(15% casein) and low protein(8% casein)diets and fed experimental diets ad libitum for 24 weeks. The results are summarized as follows. There was a hypertophy of the remnant kidney of uninephrectomized rats of 40% or 15% protein group, coming up to the comparable weights of both kidneys of sham-operated rats. However, the hypertrophic effect was not seen in uninephrectomized rats of 8% protein group. Serum albumin was lower in uninephrectomized rats. With increasing dietary protein level blood urea nitrogen was increased, whereas, urinary urea nitrogen excretion was decreased. Urinary solute excretion was higher in uninephrectomized group than in sham-operated group. However, effect of dietary protein level on urinary solute excretion varied dpending on th solutes tested. GFR and urinary protein excretion, throughout experiment, increased with feeding period and with dietary protein level. Proteinuria was most severe in uninephrectomized rats fed 40% casein diet. Maximum urine concentration ability measured after dehydration was not different among the experimental groups. Light microscopic examination showed focal segmental glomerulosclerosis and mild increas of glomerular mesangial matrix in uninephrectomized rats fed 40% and 15% protein diet, however, which was not observed in uninephrectomized rats fed 8% protein diet and in sham-operated rats fed 40% diet. Immunofluorescence studies revealed segmental deposits of albumin in the mesangium and capillary loops in high protein and uninephrectomized groups. Minimal granular deposition of IgG was noted in the mesangium of all experimental groups. In conclusion, high protein intake accelerated deterioration of renal function and it was correlated with morphological change. Low protein intake was effective in preventing these changes.

• Journal of Korean Neurosurgical Society
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• 제58권4호
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• pp.350-356
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• 2015

Objective : Cases of contralateral radiculopathy after a transforaminal lumbar interbody fusion with a single cage (unilateral TLIF) had been reported, but the phenomenon has not been explained satisfactorily. The purpose of this study was to determine its incidence, causes, and risk factors. Methods : We did retrospective study with 546 patients who underwent a unilateral TLIF, and used CT and MRI to study the causes of contralateral radicular symptoms that appeared within a week postoperatively. Clinical and radiological results were compared by dividing the patients into the symptomatic group and asymptomatic group. Results : Contralateral symptoms occurred in 32 (5.9%) of the patients underwent unilateral TLIF. The most common cause of contralateral symptoms was a contralateral foraminal stenosis in 22 (68.8%), screw malposition in 4 (12.5%), newly developed herniated nucleus pulposus in 3 (9.3%), hematoma in 1 (3.1%), and unknown origin in 2 patients (6.3%). 16 (50.0%) of the 32 patients received revision surgery. There was no difference in visual analogue scale and Oswestry disability index between the two groups at discharge. Both preoperative and postoperative contralateral foraminal areas were significantly smaller, and postoperative segmental angle was significantly greater in the symptomatic group comparing to those of the asymptomatic group (p<0.05). Conclusion : The incidence rate is not likely to be small (5.9%). If unilateral TLIF is performed for cases when preoperative contralateral foraminal stenosis already exists or when a large restoration of segmental lordosis is required, the probability of developing contralateral radiculopathy is increased and caution from the surgeon is needed.

• Journal of Korean Neurosurgical Society
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• 제55권6호
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• pp.331-336
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• 2014

Objective : The purpose of this study was to evaluate the differences in sagittal spinopelvic alignment between lumbar degenerative spondylolisthesis (DSPL) and degenerative spinal stenosis (DSS). Methods : Seventy patients with DSPL and 72 patients with DSS who were treated with lumbar interbody fusion surgery were included in this study. The following spinopelvic parameters were measured on whole spine lateral radiographs in a standing position : pelvic incidence (PI), pelvic tilt (PT), sacral slope (SS), lumbar lordosis angle (LL), L4-S1 segmental lumbar angle (SLL), thoracic kyphosis (TK), and sagittal vertical axis from the C7 plumb line (SVA). Two groups were subdivided by SVA value, respectively. Normal SVA subgroup and positive SVA subgroup were divided as SVA value (<50 mm and ${\geq}50mm$). Spinopelvic parameters/PI ratios were assessed and compared between the groups. Results : The PI of DSPL was significantly greater than that of DSS (p=0.000). The SVA of DSPL was significantly greater than that of DSS (p=0.001). In sub-group analysis between the positive (34.3%) and normal SVA (65.7%), there were significant differences in LL/PI and SLL/PI (p<0.05) in the DSPL group. In sub-group analysis between the positive (12.5%) and normal SVA (87.5%), there were significant differences in PT/PI, SS/PI, LL/PI and SLL/PI ratios (p<0.05) in the DSS group. Conclusion : Patients with lumbar degenerative spondylolisthesis have the propensity for sagittal imbalance and higher pelvic incidence compared with those with degenerative spinal stenosis. Sagittal imbalance in patients with DSPL is significantly correlated with the loss of lumbar lordosis, especially loss of segmental lumbar lordosis.

• Journal of Korean Neurosurgical Society
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• 제62권5호
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• pp.603-609
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• 2019

Objective : The purpose of this retrospective study was to determine which of the proximal adjacent segment disease (ASD) and distal ASD was more prevalent and what parameters is more related to ASD in proximal levels and distal levels after more than 2 levels fusions. Methods : The medical records were reviewed retrospectively for 856 cases. A total of 66 cases of ASD were enrolled. On preop magnetic resonance imaging, disc degeneration was measured at the upper and lower parts of surgically treated levels and confirmed by the commonly used Pfirrmann grade. Segmental flexibility in sagittal plane was embodied in segment range of motion (ROM) obtained through flexion and extension X-ray before surgery. Coronal angle was recorded as methods Cobb's angle including fusion levels preoperatively. For the comparison of categorical variables between two independent groups, the chi-square test and Fisher exact test were performed. Results : Proximal ASD and distal ASD were 37/856 (4.32%) and 29/856 (3.39%), respectively. The incidence of proximal ASD was relatively high but insignificant differences. In comparison between ASD group and non ASD group, proximal Pfirmman was higher in proximal ASD and distal Pfirmman was higher in distal ASD group (p=0.005, p<0.008, respectively). However, in the ROM, proximal ROM was higher in proximal ASD, but distal ROM was not different between the two groups (p<0.0001, p=0.995, respectively). Coronal angle was not quite different in both groups (p=0.846). Conclusion : In spite of higher frequency in ASD in proximal level in spinal fusion, it is not clear that incidence of ASD in proximal level is not higher than that of distal ASD group in more than 2 level thoracolumbar fusions. Not only Pfirrmann grade but also proximal segmental ROM is risk factor for predicting the occurrence of ASD in patients more than 2 level of thoracolumbar spine fusion operation excluding L5S1.

• 대한치과교정학회지
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• 제37권5호
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• pp.331-340
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• 2007

이 연구는 한국인 여자 유명 모델과 일반인의 정면입술의 차이점을 비교하여 아름다운 입술의 특징을 규명하며 양악 전방 분절골절단술을 시행한 환자에서 정면입술의 변화를 측정하고 그 수술 결과를 한국인 모델과 비교하여 차이점을 알아보고자 하였다. 한국인 유명 모델 30명, 일반인 26명과 양악 전방 분절골절단술을 받은 환자의 10명을 대상으로 정면입술 부위의 12개의 선 길이, 홍순의 5개의 각도와 둘레 및 면적을 측정하였고, 통계분석은 unpaired & paired t-test를 이용하였다. 한국인 유명 모델 군과 일반인 군의 비교에서 하안면 얼굴 폭경, 하안면 수직 길이, 상홍순의 높이, 하순의 길이, 상홍순의 구각부 각도와 central bow의 각도는 의미 있는 차이로 일반인 군보다 유명 모델 군에서 작았다. 그러나, 입술의 폭, 하홍순의 높이, Cupid's bow tip간 거리와 하홍순의 구각부 각도는 유명 모델 군에서 컸고 입술의 둘레와 전체 면적에서도 일반인 군보다 쳐다 양악 전방 분절골절단술을 받은 환자의 정면입술에서는 하안면 얼굴 폭경, 상홍순의 높이, Cupid's bow tip에서 구각부까지의 길이와 상홍순의 면적이 통계적으로 의미 있는 변화를 보였고 한국인 유명 모델과의 비교에서 비슷한 수치를 나타내었지만 상순의 길이는 반대로 증가하였다. 연구의 결과는 교정치료 혹은 양악 전방 분절골절단술을 계획할 때 정면 입술 심미성을 평가하는데 도움이 될 것으로 생각된다.

• Journal of Chest Surgery
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• 제2권2호
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• pp.167-167
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• 1969

Two groups of esophagus graft were done in canine esophagus in 34 adult mongrel dogs. For the first group segmental replacement graft was done with fresh autologous pericardium tube, and for the second, patch graft was done utilizing fresh autologous pericardium, fresh homologous pericardium,and dacron piece. All eight dogs in the first segmental replacement graft group died 2 to 5 days after operation with severe empyema caused by anastomosis disruption. Among 26 patch graft dogs 2 died during operation and 7 died 13 to 18 days after operation. For the 17 long-term patch grafted survivors esophagography and postoperative weight check were done. Postoperative stool was collected and examined for dacron patch excretion. One, two, three, and four months postoperative long-term survivors were sacrificed to obtain specimens in each group respectively and the following observations were made.I. Survival; Autologous pericardium patch group showed no mortality but in homologous pericardium and dacron patch group only two thirds were long-term survivors. II. Postoperative swallowing; There was no case which demonstrated postoperative dysphagia. About half of the cases showed postoperative weight increase and in only 3 cases weight decrease followed operation. III. Dacron patch was excreted in the stool 8 to 23 days after operation. Animals which excreted dacron patch up to 9 days after operation all died of empyema due to anastomosis disruption.IV. Postoperative esophagogram; All esophagograms in each group showed no leakage of barium, no passage disturbances and no remarkable stenotic signs.V. Morphological findings; [A] Macroscopical findings; In one month group specimens of each group dense adhesion with surrounding structures was noted and luminal surface was smooth with contraction of the patched area. In two month groups anastomosis sutures were still exposed but patched area showed lesser abnormality. In three to four months groups sutures were covered completely and patched area showed only very slight signs of contraction. [B] Microscopic findings; In one month group luminal surface of the replaced tissue [transplanted tissue] showed almost complete epithelial covering that is composed of several layers of squamous cells with no evidence of keratinization. Basement membrane was also well distinct throughout. Slight to minimal inflammatory cells comprising of large mononuclears, lymphocytes and plasma cells were observed in the subepithelial fibrous stroma consisted entirely of loose fibrous tissue containing many newly formed capillaries and fibroblastic proliferation. Scattered suture granulomas were found, few of which became acutely inflamed. In two months group repairing process progressed with lesser degree of inflammatory cell infiltration and young capillary proliferation. Fibrous tissue was more matured showing even focal collagenization.Suture granuloma persisted but with lesser reactive changes. Epithelial covering was that of a mature non-keratinizing stratified squamous epithelium. In three and four months groups the replaced area showed essentially similar histological findings. However, subepithelial stroma still consisted entirely of connective tissue without evidence of smooth muscle regeneration. In this group, inflammatory cell infiltration was minimal or negligible. Among these patch materials autologous pericardium group showed the most satisfactory repairing process.The above mentioned results may signify the feasibility of autogenous pericardium patch graft in clinical esophageal surgery.

• Journal of Chest Surgery
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• 제2권2호
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• pp.168-186
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• 1969

Two groups of esophagus graft were done in canine esophagus in 34 adult mongrel dogs. For the first group segmental replacement graft was done with fresh autologous pericardium tube, and for the second, patch graft was done utilizing fresh autologous pericardium, fresh homologous pericardium,and dacron piece. All eight dogs in the first segmental replacement graft group died 2 to 5 days after operation with severe empyema caused by anastomosis disruption. Among 26 patch graft dogs 2 died during operation and 7 died 13 to 18 days after operation. For the 17 long-term patch grafted survivors esophagography and postoperative weight check were done. Postoperative stool was collected and examined for dacron patch excretion. One, two, three, and four months postoperative long-term survivors were sacrificed to obtain specimens in each group respectively and the following observations were made. I. Survival; Autologous pericardium patch group showed no mortality but in homologous pericardium and dacron patch group only two thirds were long-term survivors. II. Postoperative swallowing; There was no case which demonstrated postoperative dysphagia. About half of the cases showed postoperative weight increase and in only 3 cases weight decrease followed operation. III. Dacron patch was excreted in the stool 8 to 23 days after operation. Animals which excreted dacron patch up to 9 days after operation all died of empyema due to anastomosis disruption. IV. Postoperative esophagogram; All esophagograms in each group showed no leakage of barium, no passage disturbances and no remarkable stenotic signs. V. Morphological findings; [A] Macroscopical findings; In one month group specimens of each group dense adhesion with surrounding structures was noted and luminal surface was smooth with contraction of the patched area. In two month groups anastomosis sutures were still exposed but patched area showed lesser abnormality. In three to four months groups sutures were covered completely and patched area showed only very slight signs of contraction. [B] Microscopic findings; In one month group luminal surface of the replaced tissue [transplanted tissue] showed almost complete epithelial covering that is composed of several layers of squamous cells with no evidence of keratinization. Basement membrane was also well distinct throughout. Slight to minimal inflammatory cells comprising of large mononuclears, lymphocytes and plasma cells were observed in the subepithelial fibrous stroma consisted entirely of loose fibrous tissue containing many newly formed capillaries and fibroblastic proliferation. Scattered suture granulomas were found, few of which became acutely inflamed. In two months group repairing process progressed with lesser degree of inflammatory cell infiltration and young capillary proliferation. Fibrous tissue was more matured showing even focal collagenization. Suture granuloma persisted but with lesser reactive changes. Epithelial covering was that of a mature non-keratinizing stratified squamous epithelium. In three and four months groups the replaced area showed essentially similar histological findings. However, subepithelial stroma still consisted entirely of connective tissue without evidence of smooth muscle regeneration. In this group, inflammatory cell infiltration was minimal or negligible. Among these patch materials autologous pericardium group showed the most satisfactory repairing process. The above mentioned results may signify the feasibility of autogenous pericardium patch graft in clinical esophageal surgery.