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이지현,조양제,김원주,이민구,이지현 한국유전체학회 2013 Genomics & informatics Vol.11 No.4
The multidrug resistance protein 2 (MRP2, ABCC2) gene may determine individual susceptibility to adverse drug reactions(ADRs) in the central nervous system (CNS) by limiting brain access of antiepileptic drugs, especially valproic acid (VPA). Ourobjective was to investigate the effect of ABCC2 polymorphisms on ADRs caused by VPA in Korean epileptic patients. Weexamined the association of ABCC2 single-nucleotide polymorphisms and haplotype frequencies with VPA related to adversereactions. In addition, the association of the polymorphisms with the risk of VPA related to adverse reactions was estimatedby logistic regression analysis. A total of 41 (24.4%) patients had shown VPA-related adverse reactions in CNS, and the mostfrequent symptom was tremor (78.0%). The patients with CNS ADRs were more likely to have the G allele (79.3% vs. 62.7%,p = 0.0057) and the GG genotype (61.0% vs. 39.7%, p = 0.019) at the g.‒1774delG locus. The frequency of the haplotypecontaining g.‒1774Gdel was significantly lower in the patients with CNS ADRs than without CNS ADRs (15.8% vs. 32.3%, p= 0.0039). Lastly, in the multivariate logistic regression analysis, the presence of the GG genotype at the g.‒1774delG locuswas identified as a stronger risk factor for VPA related to ADRs (odds ratio, 8.53; 95% confidence interval, 1.04 to 70.17). Wedemonstrated that ABCC2 polymorphisms may influence VPA-related ADRs. The results above suggest the possible usefulnessof ABCC2 gene polymorphisms as a marker for predicting response to VPA-related ADRs.
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신경인지재활치료가 편마비 환자의 손 기능에 미치는 영향 이지현, 강보라
이지현,강보라 한국인지운동치료협회 2019 한국신경인지재활치료학회지 Vol.11 No.2
목적: 본 연구는 손 기능이 손상된 급성기 편마비환자에게신경인지재활치료를 적용하여 손 기능과 과제를 수행하는능력에 미치는 영향을 알아보고자 한다. 방법: 대상자는 고양시 Y재활병원에 입원하여 치료받고있는 환자로 뇌졸중 진단을 받았으며, 실험의 내용을 이해하고 참여 의사를 밝힌 자로 선정하였다. 대상자는 49세 여성으로 2019년 2월 24일 발병되어 우측 뇌기저핵 부위의 뇌내출혈로 인한 좌측 편마비를 진단받았다. 연구 기간은 2019년3월 18일부터 5월 10일까지 진행되었으며, 8주 동안 주 5회30분씩 총 40회기의 신경인지재활치료를 실시하였다. 결과: 연구 결과 뇌졸중 상지 기능 검사에서 치료 전 오른쪽32점, 왼쪽 23점, 치료 후 오른쪽 32점, 왼쪽 29점으로 왼쪽상지의 기능변화가 나타났다. 그루브드 막대 검사 결과 치료전 오른손 57초(수행 개수 25개, 떨어진 개수 0개)에서 치료후 62초(수행 개수 25개, 떨어진 개수 0개)였으며, 왼손은323초(수행 개수 25개, 떨어진 개수 2개)에서 126초(수행 개수 25개, 떨어진 개수 0개)로 왼손의 시간 단축과 수행도의증가가 나타났다. 상자와 나무토막 검사에서는 오른손 80개에서 81개, 왼손 25개에서 48개로 오른손 1개, 왼손 23개로향상되었다. 결론: 신경인지재활치료가 급성기 뇌졸중 환자의 손 기능및 과제수행의 질에 효과가 있는 것으로 나타났다. The purpose of this study is to reveal the effect of neurocognitive rehabilitation therapy on hand function for hemiplegic patients. The subject of the study was a female patient aged 49 with left hemiplegia caused by intracranial hemorrhage, and the cognitive-therapeutic exercise was applied to her for 30minutes once a day from March 18, 2018 to May 10, 2019. In this study, after neurocognitive treatment, the results of the MFT found no change found in the right hand. The left hand improved from 23 to 29 scores. The results of the grooved pegboard test, which evaluated the hand function, were as follows. The right hand performed from 57 seconds (25 performed, 0 dropped) to 62 seconds (25 performed, 0 dropped) after treatment, and the left hand improved from 323 seconds (25 performed, dropped 2) to 126 seconds (25 performed, dropped 0) after the treatment. The results BBT, the right hand performed from 81 to 80, The left hand improved from 25 to 48. Neurocognitive rehabilitation therapy was found to be effective on hand function and task performance in acute stroke patients.
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이지현,정찬종,이승철,신호진 대한마취통증의학회 2014 Korean Journal of Anesthesiology Vol.67 No.2
Natural orifice transluminal endoscopic surgery (NOTES) is an evolving field of minimally invasive surgery. NOTES reaches the target organ by inserting the endoscope through a natural orifice (e.g. mouth, anus, urethra, vagina) and offers advantages of less postoperative pain and lower complication rate. Since its first description in 2004, NOTES has progressed from use on animal models to humans. We experienced anesthetic care of two patients who underwent transoral NOTES under general anesthesia.
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이지현,이수일,이승철,최소론,이원지 대한마취통증의학회 2012 Korean Journal of Anesthesiology Vol.62 No.5
Background: Partially paralyzed patients may be placed in the risk of pharyngeal dysfunction. Bupivacaine acts as acetylcholine receptor ion channel blocker and may synergistically interact with rocuronium to augment NM blockade. Thus, this study aims to elucidate whether or not, at a therapeutic concentration, bupivacaine by itself may cause NM blockade and reduce an effective concentration of rocuronium. Methods: Twenty-two left phrenic nerve-hemidiaphragms (Male SD rats, 150-250 g) were hung in Krebs solution. Three consecutive ST, 0.1 Hz and one TT, 50 Hz for 1.9 s were obtained before drug application and at each new drug concentration. A concentration of bupivacaine in Krebs solution (n = 5) was cumulatively increased by way of 0.01, 0.1, 1, (1, 2, 3, 4, 5, 6, 7) × 10 μM. In a Krebs solution, pre-treated with bupivacaine 0 (n = 5), 0.1 (n = 5), 1.0 (n = 5), 10 (n = 2) μM, and then concentrations of rocuronium were cumulatively increased by way of 1, 3, 5, 7, 9, 12, 14, 16, 18, 20 μM. EC for each experiment were determined by a probit. The EC50’s of rocuronium were compared using a Student’s t-test with Bonferroni’s correction. Differences were considered significant when P < 0.05. Results: The potency of bupivacaine for normalized TF was 11.4 (± 1.1) μM. Below 30 μM of bupivacaine, the single twitch potentiation sustained despite the development of tetanic fade and partial inhibition of PTT. Bupivacaine significantly facilitated the NM blockade induced by rocuronium. Conclusions: Clinicians should be aware that bupivacaine by itself at its therapeutic concentration inhibit NM conduction and enhances rocuronium-induced muscle relaxation. Background: Partially paralyzed patients may be placed in the risk of pharyngeal dysfunction. Bupivacaine acts as acetylcholine receptor ion channel blocker and may synergistically interact with rocuronium to augment NM blockade. Thus, this study aims to elucidate whether or not, at a therapeutic concentration, bupivacaine by itself may cause NM blockade and reduce an effective concentration of rocuronium. Methods: Twenty-two left phrenic nerve-hemidiaphragms (Male SD rats, 150-250 g) were hung in Krebs solution. Three consecutive ST, 0.1 Hz and one TT, 50 Hz for 1.9 s were obtained before drug application and at each new drug concentration. A concentration of bupivacaine in Krebs solution (n = 5) was cumulatively increased by way of 0.01, 0.1, 1, (1, 2, 3, 4, 5, 6, 7) × 10 μM. In a Krebs solution, pre-treated with bupivacaine 0 (n = 5), 0.1 (n = 5), 1.0 (n = 5), 10 (n = 2) μM, and then concentrations of rocuronium were cumulatively increased by way of 1, 3, 5, 7, 9, 12, 14, 16, 18, 20 μM. EC for each experiment were determined by a probit. The EC50’s of rocuronium were compared using a Student’s t-test with Bonferroni’s correction. Differences were considered significant when P < 0.05. Results: The potency of bupivacaine for normalized TF was 11.4 (± 1.1) μM. Below 30 μM of bupivacaine, the single twitch potentiation sustained despite the development of tetanic fade and partial inhibition of PTT. Bupivacaine significantly facilitated the NM blockade induced by rocuronium. Conclusions: Clinicians should be aware that bupivacaine by itself at its therapeutic concentration inhibit NM conduction and enhances rocuronium-induced muscle relaxation.
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이지현,김지연,박기태 大韓小兒齒科學會 2010 大韓小兒齒科學會誌 Vol.37 No.1
이소맹출은 치아가 비정상적인 위치나 방향으로 맹출하는 것으로 정의되며 구치부에서는 근심측으로 맹출하여 인접치아의 치근 흡수나 조기 탈락을 야기하여 공간 상실을 일으킬 수 있고, 부분 맹출된 경우 치은 하방의 치아우식 위험성이 증가하고 농양을 형성할 수도 있다. 구치부의 이소맹출 가운데 66% 정도는 가역적인 경우로 특별한 치료 없이 자연적으로 정상적인 맹출이 일어나며, 비가역적인 이소맹출의 경우에는 치아의 맹출 상태, 인접치에 의해 매복된 양, 인접치의 동요도, 통증이나 감염 여부 등의 여러 요인을 고려하여 본격적인 치료가 필요하다. 본 논문에서는 비가역적으로 이소맹출된 상악 제1대구치와 하악 제2대구치를 치간이개 고무줄, modified Halterman appliance 그리고 외과적 노출 후 modified Halterman appliance를 이용한 방법 등으로 정상적인 맹출을 유도한 증례를 보고하는 바이다. Ectopic eruption is defined as the eruption of the tooth in an abnormal position or orientation. In the molar region, ectopic eruption may cause distal root resorption and premature exfoliation of the neighbor teeth and uncontrolled space loss is followed. Prolonged partial impaction of the permanent molar may also cause undetected caries or abscess formation of the neighbor teeth. While 66% of ectopically erupting permanent molars are corrected spontaneously without treatment, the treatment is necessary for the irreversible ectopic eruption cases. The optimal treatment approach depends on a number of factors including the clinical eruption status of the molar, amount of enamel ledge and the mobility of the neighbor tooth, and the presence of pain or infection. This case report presents the results of treatment of the ectopically erupting maxillary first permanent molars and mandibular second molars using elastic separators or modified Halterman appliance with or without surgical approach.
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