저온 열처리한 가토 좌골 신경의 재생

김재도,김상진,정철윤,홍영기,김기찬,Kim, Jae-Do,Kim, Sang-Jin,Jung, Cheoul-Yun,Hong, Young-Gi,Kim, Ghi-Chan 대한근골격종양학회 1997 대한골관절종양학회지 Vol.3 No.2

저온 열처리 후 신경의 기능적 회복과정을 연구하기 위해 가토의좌골 신경을 $60^{\circ}C$로 30분간 처리한 후 2주, 4주, 8주, 12주, 16주 후에 근전도 검사 및 조직학적 검사를 실시하여 다음과 같은 결과를 얻었다. 1. 신경전도 검사에서 평균 진폭은 실험 2주째에는 5마리 중 1마리를 제외하고는 측정되지 않았으며, 4주째에는 대조군의 7.2%, 8주째에는 26.8%, 12주째에는 52.9%, 그리고 16주째에는 89.5%의 수준으로 회복되었다. 평균 잠복기는 정상 대조군에서 0.62msec였으며, 실험군에서는 4주째에 3.58msec, 8주째에 2.68msec, 12주째에 1.2msec로 시간이 경과함에 따라 회복되어, 16주째에는 0.622msec로 대조군과 차이가 없었다. 2. 침근전도 검사에서 실험 2, 4, 8주째까지는 많은 수의 세동전위 및 양성 예파가 관찰되었으나, 12주째부터는 그 수가 감소하여 16주째에는 세동전위는 관찰되지 않았고 양성 예파만 관찰되어 손상된 신경이 회복됨을 나타내었다. 3. 조직학적 검사에서 실험 2주 및 4주째에는 유수신경섬유에 상당한 공포성 변성이 있고 신경섬유의 수가 감소된 것을 관찰할 수 있었으나, 시간이 경과할수록 신경섬유의 수가 점차 회복 되었으며 16주째에는 대조군과 차이가 없었다. 이상의 성적으로 미루어 보아 저온열처리에 의해 손상된 신경은 처리후 시간이 경과하며 기능적으로나 형태적으로 회복되므로, 임상적으로 신경이 종양조직으로 둘러싸이거나 접촉된 사지에서도 사지보존술이 가능할 것으로 사료된다. Malignant tumors of extremeties involving major neurovascular structures have been treated by amputation. However recent development of diagnostic tools(CT, MRI etc.), surgical techniques, anticancer chemotherapeutic agents, and radiation techniques allow surgeons to treat malignant tumors in the limb without amputation. It has been reported that a local application of low-heat to the tissue with tumor can kill tumor cells. It is, however, not known if the attendant neural and vascular injuries may be recovered. The present study was, therefore, undertakn to address this question in rabbit sciatic nerves. A low-heat injury to the sciatic nerve was induced by perfusing the nerve with $60^{\circ}C$ saline for 30 minutes and the courses of functional and morphological recovery of the nerve were evaluated for 16 weeks. The results are summerized as follows : 1. In the electromyographic nerve conduction test the average amplitude was markedly attenuated at 4 and 8 weeks after the low-heat treatment, but it progressively increased to the level 89.5% of the control at 16 week post-treatment. The average latency in the control group was 0.62 msec. The latency in the experimental group was much longer than this at 4 and 8 week post-treatment, but it progressively reverted to the control level, showing 0.622 msec at 16 weeks. 2. In the needle EMG, many fibrillation potentials and positive sharp waves were appeared until 8 weeks post-treatment. After 16 weeks, however, no fibrillation potential was observed. 3. In the early phase of post-treatment period, the myelinated nerve fibers contained many vacuoles and the number of myelinated nerve fibers appeared to be considerably reduced. However, as time goes myelinated nerve fibers were regenerated, such that after 16 weeks the histologic appearance of the nerve was similar to that of the control group.

저산소환경이 일차 배양된 대뇌겉질 신경세포의 ubiquitin-proteasome system에 미치는 영향

양성준(Seong-Jun Yang),김민정(Min-Jung Kim),정호중(Ho-Joong Jeong),김기찬(Ghi-Chan Kim),길영기(Young-Gi Gil),김강련(Kang-Ryune Kim),김현(Hyun Kim) 대한체질인류학회 2008 대한체질인류학회지 Vol.21 No.1

저산소환경에 만성으로 노출된 경우 신경세포는 적응하기 위하여 세포 내의 다양한 신호 경로의 활성화를 통해 반응한다. 그 중 ubiquitin-proteasome system은 세포의 생존을 위한 핵심적인 기전으로 proteasome이 억제될 때 비정상적인 단백질이 세포 내에 축적되어 세포자멸사와 신경세포의 퇴행이 일어난다. 이번 실험에서 저자들은 ubiquitin-proteasome system을 억제하는 proteasome 억제제와 저산소환경이 일차 배양한 대뇌 겉질 세포에 미치는 영향을 관찰하였으며, 도파민생성 세포에서의 결과와 비교하였다. 저산소환경이나 합성된 억제제인 PSI (Z-lle-Glu(OtBu)-Ala-Leu-al)를 투여한 신경세포의 자멸사는 증가하였으며, PARP와 caspase 3의 활성도 증가하였다. 특히 NF-κB의 발현이 PSI를 처리한 경우와 저산소환경에서 증가하였다. 저산소환경에서 배양한 신경세포에 PSI를 처리한 경우에는 이들 단백질의 발현이 현저하게 증가하였다. α-synuclein의 발현 역시 증가하였는데 특히 저산소환경에서 현저하게 증가하였다. 이 실험을 통해 저산소환경과 proteasome 억제제를 처리했을 경우 신경세포의 자멸사가 증가하였을 뿐 아니라, α-synuclein의 생성 및 NF-κB의 발현이 증가하였음을 확인하였다. 이를 통해 저산소환경이 ubiquitin-proteasome system을 교란할 수 있음을 제시하였다. 이러한 결과는 저산소환경이 신경퇴행성질환의 원인이 될 수 있음을 제시하는 것이다. The ubiquitin-proteasome system is crucial in maintaining cellular growth and metabolism. Dysfunction of this system may contribute to neurodegenerative diseases, such as Parkinson’s disease. But its effects on primary neurons are largely unknown. In the present study, we investigated the effects of proteasome inhibitor and hypoxia on primary neuronal cultures to determine whether proteasomal malfunction induces neuronal death. Neuronal apoptosis increased in primary cultured cortical neurons with treatment of proteasomal inhibitor in normoxic condition and in the presence or absence of proteasomal inhibitor in hypoxic condition. Also expression of PARP and activated caspase 3 increased. NF-κB, a key transcription factor in this system expression increased in hypoxic condition and proteasomal inhibition. Interestingly, hypoxic condition induced an expression and accumulation of α-synuclein in neuron, one of components of Lewy body in Parkinson’s disease. Our findings determine that hypoxic condition may affect the ubiquitin-proteasome system. Furthermore, it suggests that hypoxic condition and proteasomal inhibitors are involved, at least in parts, in neurodegeneration of mouse model for Parkinson’s disease.

단지양 근위축증(Monomelic Amyorophy) 3례 : 증례 보고 Case Report

김기찬,정호중,정상욱,정흥채,조근열 고신대학교 의학부 1999 高神大學校 醫學部 論文集 Vol.14 No.1-2

Monomelic amyotrophy is a rare form of motor neuron disease which is insidious onset in the second and fourth decades, male preponderance, sporadic occurrence, wasting and weakness confined to one limb, and absence of involvement of the cranial nerves, cerebrum, brain, stem, and sensory system. Symptoms and signs often progress for several years before spontaneously arresting. Neurologic findings and electrophysiologic studies are only useful for the diagnosis of monomelic amyotrophy and other laboratory testing are frequently normal or nonspecific. We reported three cases of typical monomelic amyotrophy with review of the articles.

급성 복부 대동맥 폐색 후 발생한급성 허혈성 말초신경병증 -증례 보고-

김기찬,정호중,정흥채,정상욱 大韓再活醫學會 2000 Annals of Rehabilitation Medicine Vol.24 No.3

외상으로 인한 후복막 유건종 제거술 후 신경인성 통증의 재활치료

김기찬,정호중 고신대학교의과대학 2007 고신대학교 의과대학 학술지 Vol.22 No.2

Desmoid tumors are infrequent and histologically benign fibrous neoplasms originating from the musculoaponeurotic structures throughout the body. These tumors are found in areas of previous traumatic or surgical scarring. The compartment syndrome is considered a true emergency condition. The internal pressure rises so high that local circulation is cut off and the affected muscle dies. The local increased pressure can also damage associated nerves resulting in a loss of both power and sensation. Lumbosacral plexopathy is characterized by intense pain in one or both legs, associated with motor and sensory deficits. Proper medications including topiramate with physical therapy and psychological modalities are critical to successful outcome of the management for neuropathic pain. We experienced a case of rehabilitation for lumbosacral plexopathy and compartment syndrome following excision of retroperitoneal desmoid tumor due to trauma in 9 year-old child.

부신기능 부전증과 동반된 혼합 유기용제에 의한 말초신경병증 : 증례보고 A Case Report

김기찬,정호중,노경환,김진하,안재두 고신대학교 의학부 2002 高神大學校 醫學部 論文集 Vol.17 No.1

N-Hexane which is contained within organic solvents is produced by cracking of crude oil and subsequent fractional distillation, but also from natural gas and coal. Its main use was for oil seed extraction, producing in the rubber industry, in glues (e.g, in the shoe industry), and as solvent in paints, lacquers, and printing ink. Most often n-hexane is mixed with other solvents. We experienced a patient with peripheral polyneuropathy due to chronic exposure of mixed solvents combined with mental deterioration owing to adrenal insufficiency. He had occupational history of dealing with adhesives containing n-hexane over 30 years and suffered from muscle wasting and weakness of all extremities and difficulty of independent ambulation for 2 years. He also had taken herb medications for 3 years intermittently. He had mental deterioration. hyponatremia and low cortisol level in plasma. After rehabilitation program, motor weakness of his lower limbs improved to good degree and mental deterioration was recovered according to coorection of hyponatremia following steroid therapy.

폐경기간에 따른 혈중 Estradiol과 Lipid Profile,골대사 표지자 및 골밀도와의 연관 관계

김기찬,정호중,정상욱,정흥채 大韓再活醫學會 2000 Annals of Rehabilitation Medicine Vol.24 No.2

경부 경막외 스테로이드 주입 후 발생한 불완전 사지마비

김기찬 고신대학교의과대학 2007 고신대학교 의과대학 학술지 Vol.22 No.1

Cervical epidural steroid injections are widely used to treat acute and chronic pain conditions involving the head, neck, and upper extremities. We have experienced a case in whom motor weakness, sensory change on whole body and swallowing difficulty following cervical epidural steroid injection in pain clinic between C6 & C7 spinous process with 18 gauge epidural needle. Spinal cord injury by epidural steroid injection is usually because of trauma from the needle, an epidural hematoma, fluid collection, ischemia from an artery injury or spasm, or an epidural abscess. Spinal cord damage can also occur as the result of arachnoiditis from the injection of a neurotoxic substance, a mistakenly injected drug, or one that contains a preservative. Epidural injections should be performed by experienced physicians who have shown competence in the technical aspects of these procedure. Fluoroscopically monitored injections are more likely to place medication at the exact target, yield more diagnostic feedback, and maximize therapeutic results.

폐경 후 골감소증 환자에서 Fluoride와 저용량 Estrogen의 병합요법

김기찬,정호중,신정범,정석모 고신대학교 의학부 2004 高神大學校 醫學部 論文集 Vol.19 No.1

Background : To investigate the changes of BMD, biochemical bone markers and lipid profiles after combination therapy of Fluoride and low dose estrogen(0.3㎎) in postmenopausal osteopenia. Materials and Method : We studied 70 women with postmenopausal osteopenia who visited at Department of rehabilitation medicine, Kosin Medical Center from march 2002 to may 2003. Subjects were divided in two groups : Gorup Ⅰ(n=30), treated with Fluocalcic® (monofluorophosphate 100㎎+Calcium 500㎎), calcium(500㎎) and low dose estrogen, and Group Ⅱ(n=40), treated with estrogen(0.625㎎) and calcium (1.0g). BMD at the L-spine and femur, osteocalcin, deoxypyridinoline, and lipid profiles were measured at baseline and 1 year after treatment. Result : 1) Average postmenopausal periods are 2.90yrs and 3.53yrs each other. 2) BMD increased significantly in two groups, and BMD in group I increased significantly more than that in groupⅡ. 3) Deoxypyridinoline decreased significantly in group Ⅰ, but decreased significantly in group Ⅱ. 4) Total cholesterol and LDL cholestero; decreased significantly in two groups, and no significant difference between two groups. Conclusion : We concluded that combination therapy with fluocalcic®, calcium and low dose estrogen in postmenopausal osteopenia was more effective than combination therapy with estrogen and calcium to prevent postmenopausal osteoporosis.

부산지역 외상성 척수손상환자 발생의 변화추이

강경문,김기찬,정호중 고신대학교의과대학 2007 고신대학교 의과대학 학술지 Vol.22 No.2

Objective: To identify trends in the epidemiologic and injury data of person with traumatic spinal cord injury (SCI). Method: Review of medical records of 312 patients with traumatic spinal cord injury from 1996 to 2005 at the four university hospitals and one training hospital in Busan was performed. The epidemiologic informations of this study were compared to those of the past study conducted between 1986-1993 and 1996-2005. Results: Average age(42.8) at injury was rised. Male-to-female ratio was 3.5:1, the population of males has decreased significantly in recent years(1996-2005). The leading cause of traumatic SCI was traffic accident. Tetraplegia accounted for 52.2% of all traumatic SCI, 47.8% were paraplegia. Complete injury decreased compared to the past occupying 41% of all the injury while tetraplegia increased. Traumatic spinal cord injury occured most commonly in August, summer, the time of 6 A.M to midday and on Saturday. Conclusion: This study showing the recent characteristics of traumatic SCI in Busan revealed increase in the average age at injury, the rate of females and incomplete injury. The most frequent time of onset was from 6 AM to midday.