안와골절 수술 환자에서 전산화단층촬영과 수술 중 촬영한 영상의 차이에 대한 고찰

함동식,이충현,양재욱 대한안과학회 2011 대한안과학회지 Vol.52 No.8

Purpose: To analyze the morphologic differences in blowout fracture seen on preoperative CT images compared to intraoperative images. Methods: The present study included 63 patients (63 eyes) with orbital fractures that were repaired by orbital reconstruction between January 2009 and April 2010. We assessed the medial, inferior, and inferomedial orbital fractures and excluded superior and lateral wall fractures. We captured intraoperative blowout fracture images using a camera or endoscope and compared the fracture type (fracture size, fracture surface) seen on intraoperative images with that observed on the preoperative CT images. Results: The study consisted of patients between 20 and 50 years of age with a mean age of 27.76 years (men: 49 eyes, women: 14 eyes). The proportions of small fractures and medium fractures were similar on the preoperative CT images; however, large fractures were observed more frequently on the intraoperative images. The proportions of mono-fragment fractures and multi-fragment fractures were similar on the preoperative CT images, but multi-fragment fractures, especially inferior orbital fractures, were more frequent on the intraoperative images. Features of the trapdoor fracture differed most between images in terms of fracture size and surface. Conclusions: The morphology of blowout fractures, especially trapdoor fractures, differed between preoperative CT images and intraoperative images. J Korean Ophthalmol Soc 2011;52(8):902-909

OSL 연대측정과 탄성파 탐사를 이용한 정선 조양강 일대 구하도 형성과정 추정

함동식,홍성찬 한국지형학회 2023 한국지형학회지 Vol.30 No.3

There are many studies about fluvial terrace in Korea, but only a few researches carried on abandoned channel. Jeongseon-Gun, the study area, has plenty of abandoned channel due to development of meandering streams. We aim to understand the formation age and process of abandoned channel, comparing with nearby fluvial terrace. OSL dating and seismic survey were carried out. As a result, fluvial terrace consisted of a total of 10 terraces and incision rate was calculated to be 0.235m/ka. Meander cutoff occurred 166.62~97.80ka at two abandoned channel in study area. This period was the transition from the glacial period to interglacial period, and erosion due to increased discharge affected to cutoff.

Devic's Disease로 시작된 다발성 경화증 1예

함동식 중앙대부설한국의과학연구소 1993 한국의과학 Vol.25 No.4

Reversal of Hypoglycemia Unawareness with a Single-donor, Marginal Dose Allogeneic Islet Transplantation in Korea: A Case Report

양혜경,함동식,박헌석,Marie Rhee,유영혜,김민정,김지원,이승환,홍태호,최병길,조재형,윤건호 대한의학회 2015 Journal of Korean medical science Vol.30 No.7

Pancreatic islet transplantation is a physiologically advantageous and minimally invasive procedure for the treatment of type 1 diabetes mellitus. Here, we describe the first reported case of successful allogeneic islet transplantation alone, using single-donor, marginal-dose islets in a Korean patient. A 59-yr-old patient with type 1 diabetes mellitus, who suffered from recurrent severe hypoglycemia, received 4,163 islet equivalents/kg from a single brain-death donor. Isolated islets were infused intraportally without any complications. The immunosuppressive regimen was based on the Edmonton protocol, but the maintenance dosage was reduced because of mucositis and leukopenia. Although insulin independence was not achieved, the patient showed stabilized blood glucose concentration, reduced insulin dosage and reversal of hypoglycemic unawareness, even with marginal dose of islets and reduced immunosuppressant. Islet transplantation may successfully improve endogenous insulin production and glycemic stability in subjects with type 1 diabetes mellitus.

Adenoviruses Expressing PDX-1, BETA2/NeuroD and MafA Induces the Transdifferentiation of Porcine Neonatal Pancreas Cell Clusters and Adult Pig Pancreatic Cells into Beta-Cells

유영혜,함동식,박헌석,이마리,김지원,윤건호 대한당뇨병학회 2011 Diabetes and Metabolism Journal Vol.35 No.2

Background: A limitation in the number of insulin-producing pancreatic beta-cells is a special feature of diabetes. The identification of alternative sources for the induction of insulin-producing surrogate beta-cells is a matter of profound importance. PDX-1/VP16, BETA2/NeuroD, and MafA overexpression have been shown to influence the differentiation and proliferation of pancreatic stem cells. However, few studies have been conducted using adult animal pancreatic stem cells. Methods: Adult pig pancreatic cells were prepared from the non-endocrine fraction of adult pig pancreata. Porcine neonatal pancreas cell clusters (NPCCs) were prepared from neonatal pigs aged 1-2 days. The dispersed pancreatic cells were infected with PDX-1/VP16, BETA2/NeuroD, and MafA adenoviruses. After infection, these cells were transplanted under the kidney capsules of normoglycemic nude mice. Results: The adenovirus-mediated overexpression of PDX-1, BETA2/NeuroD and MafA induced insulin gene expression in NPCCs,but not in adult pig pancreatic cells. Immunocytochemistry revealed that the number of insulin-positive cells in NPCCs and adult pig pancreatic cells was approximately 2.6- and 1.1-fold greater than those in the green fluorescent protein control group,respectively. At four weeks after transplantation, the relative volume of insulin-positive cells in the grafts increased in the NPCCs,but not in the adult porcine pancreatic cells. Conclusion: These data indicate that PDX-1, BETA2/NeuroD, and MafA facilitate the beta-cell differentiation of NPCCs, but not adult pig pancreatic cells. Therefore PDX-1, BETA2/NeuroD, and MafA-induced NPCCs can be considered good sources for the induction of pancreatic beta-cells, and may also have some utility in the treatment of diabetes.

원저 : 제2형 당뇨병 동물모델에서 항 혈관내피세포 성장인자(Anti-Vascular Endothelial Growth Factor (VEGF)) 투여 시 췌장에 대한 효과

김지원 ( Ji Won Kim ),함동식 ( Dong Sik Ham ),박헌석 ( Heon Seok Park ),안유배 ( Yu Bai Ahn ),송기호 ( Ki Ho Song ),윤건호 ( Kun Ho Yoon ),유기동 ( Ki Dong Yoo ),김명준 ( Myung Jun Kim ),정인경 ( In Kyung Jeong ),고승현 ( Seung Hy 대한당뇨병학회 2009 Diabetes and Metabolism Journal Vol.33 No.3

연구배경: 대표적인 당뇨병성 합병증인 당뇨병성 신증과 망막병증은 공통적으로 혈관내피세포성장인자(Vascular endothelial growth factor, VEGF)가 합병증의 발생에 중요한 역할을 하는 것이 알려져 있으나 항 VEGF 치료가 췌도나 베타세포에 직접적으로 어떠한 영향을 주는지는 거의 알려진 바가 없다. 이에 당뇨병성 합병증 치료를 목적으로 하는 항 VEGF 치료가 췌장과 당뇨병의 경과에 미치는 영향을 관찰하고, 당뇨병이 진행되면서 나타나는 췌도 및 베타세포의 변화에 있어서 VEGF의 역할을 규명하고 치료에 응용하고자 하였다. 방법: 이에 당뇨병 동물모델인 db/db mouse에 12주간 VEGF 수용체 type 2 antagonist (ATWLPPR, 5 mg/kg)를 복강 내 투여하여 혈당의 변화와 함께 췌장의 면역염색을 통하여 베타세포 질량 및 췌도의 형태적인 변화를 관찰하고 VEGF의 췌도 내 발현 및 혈관신생 정도를 평가하였다. 결과: 12주간 항 VEGF peptide를 투여한 결과, 복강 내당부하검사 시 db/db mouse에 비해 항 VEGF 투여군에서 현저한 고혈당을 보였으며 고혈당이 심해지면서 항 VEGF 투여군에서 체중의 증가가 적었다. 췌장의 무게(db/dm vs. db/db vs. anti-VEGF group, 0.321±0.05 vs. 0.206±0.13 vs. 0.158±0.12 g) 및 베타세포 질량(db/dm vs. db/db vs. anti-VEGF group, 4.08±0.1 vs. 3.77±0.2 vs. 2.89±0.2 mg, P<0.05) 역시 db/db군에 비해 항 VEGF군에서 더 감소되었다. 또한 정상 췌도에 비해 당뇨병이 발생한 군에서 췌도 내 VEGF 발현이 증가되었으나, 항 VEGF 투여시 췌도 내 VEGF 단백의 발현이 감소하였고(db/dm vs. db/db vs. anti-VEGF group, 3.63±2.86 vs. 6.60±3.56 vs. 2.74±1.55%, * P<0.05) 췌도의 크기가 감소하였으며, 췌도 내 섬유화 진행이 더 심하게 관찰되었고(db/dm vs. db/db vs. anti-VEGF group, 3.37±1.51 vs. 13.96±3.20 vs. 16.99±4.96%, * P<0.05) 췌도 내 내피세포의 증식이 더 감소되어 있었다. 결론: 제2형 당뇨병 동물모델에서 혈관내피세포 성장인자(VEGF)는 정상 췌도보다 당뇨병이 발생한 췌도에서 발현이 증가되므로 당뇨병의 발병 기전과 관련이 있을 것이며, 베타세포의 증식 및 췌도 변형에 중요한 역할을 하므로 당뇨병의 치료에도 응용할 수 있을 것으로 생각되고, 당뇨병성 미세혈관 합병증의 치료나 예방을 목적으로 제2형 당뇨병모델에 항 VEGF를 투여할 경우 고혈당 상태를 더 악화시키고 베타세포 증식을 억제하며 췌도 파괴를 가속화 시키므로, 항 VEGF 치료 시 이에 대한 충분한 고려가 필요할 것이다. Background: Vascular endothelial growth factor (VEGF) is associated with the development of diabetic complications. However, it is unknown whether systemic VEGF treatment has any effects on the pancreatic islets in an animal model of type 2 diabetes mellitus. Methods: Anti-VEGF peptide (synthetic ATWLPPR, VEGF receptor type 2antagonist) was injected into db/db mice for 12 weeks. We analyzed pancreatic islet morphology and quantified beta-cell mass. Endothelial cell proliferation and the severity of islet fibrosis were also measured. VEGF expression in isolated islets was determined using Western blot analysis. Results: When anti-VEGF was administered, db/db mice exhibited more severe hyperglycemia and associated delayed weight gain than non-treated db/db mice. Pancreas weight and pancreatic beta-cell mass were also significantly decreased in the anti-VEGF-treated group. VEGF and VEGF receptor proteins (types 1 and 2) were expressed in the pancreatic islets, and their expression was significantly increased in the db/db group compared with the db/dm group. However, the elevated VEGF expression was significantly reduced by anti-VEGF treatment compared with the db/db group. The anti-VEGF-treated group had more prominent islet fibrosis and islet destruction than db/db mice. Intra-islet endothelial cell proliferation was also remarkably reduced by the anti-VEGF peptide. Conclusion: Inhibition of VEGF action by the VEGF receptor 2antagonist not only suppressed the proliferation of intra-islet endothelial cells but also accelerated pancreatic islet destruction and aggravated hyperglycemia in a type 2 diabetes mouse model. Therefore, the potential effects of anti-VEGF treatment on pancreatic beta cell damage should be considered. (Korean Diabetes J 33:185-197, 2009)

이종 췌도 이식을 위한 Ba²+-알진산 미세피막화 췌도 형성

박헌석 ( Heon Seok Park ),함동식 ( Dong Sik Ham ),유영혜 ( Young Hye You ),신주영 ( Ju Young Shin ),김지원 ( Ji Won Kim ),조재형 ( Jae Hyoung Jo ),김온유 ( On You Kim ),강길선 ( Gil Son Khang ),윤건호 ( Kun Ho Yoon ) 한국조직공학과 재생의학회 2010 조직공학과 재생의학 Vol.7 No.5

Islet transplantation is one of the promising treatment strategies for the cure of diabetes. However, the hurdles such as shortage of human tissue, immune rejection and recurrence of autoimmunity should be overcome for successful islet transplantation. Xeno-transplantation can be a solution to shortage of human sources. Immune isolation by microencapsulation of islet with alginate polymer could escape the immune injuries. Microencapsulated xenoislet transplantation is a one of the ideal strategies to cure the diabetes. Here, we introduce microencapsulation of islets for successful xenogenic islet transplantation. We achieved optimization of encapsulating condition. First, we demonstrated viability and insulin secreting capacity of encapsulated islets in vitro. We confirmed their ability of maintaining normoglycemia and escaping immune rejection after rat or porcine islet transplantation to diabetic mouse models.

W-C-N 확산방지막의 전자거동(ElectroMigration) 특성과 표면 강도(Surface Hardness) 특성 연구

김수인,김창성,이재윤,박준,노재규,안찬근,오찬우,함동식,황영주,유경환,이창우,Kim, Soo-In,Hwang, Young-Joo,Ham, Dong-Shik,Nho, Jae-Kue,Lee, Jae-Yun,Park, Jun,Ahn, Chan-Goen,Kim, Chang-Seong,Oh, Chan-Woo,Yoo, Kyeng-Hwan,Lee, Chang-Woo 한국진공학회 2009 Applied Science and Convergence Technology Vol.18 No.3

Copper is known as a replacement for aluminum wire which is used for semiconductor. Because specific resistance of Cu ($1.67{\mu}{\Omega}$-cm) is lower than that of Al ($2.66{\mu}{\Omega}$-cm), Cu reduce RC delay time. Although melting point of Cu($1085^{\circ}C$) is higher than melting point of Al, Cu have characteristic to easily react with Silicon(Si) in low temperature, and it isn't good at adhesive strength with Si. For above these reason, research of diffusion barrier to prevent reaction between Cu and Si and to raise adhesive strength is steadily advanced. Our study group have researched on W-C-N (tungsten-carbon-nitrogen) Diffusion barrier for preventing diffusion of Cu through semiconductor. By recent studies, It's reported that W-C-N diffusion barrier can even precent Cu and Si diffusing effectively at high temperature. In this treatise, we vaporized different proportion of N into diffusion barrier to research Cu's Electromigration based on the results and studied surface hardness in the heat process using nano scale indentation system. We gain that diffusion barrier containing nitrogen is more stable for Cu's electromigration and has stronger surface hardness in heat treatment process. 반도체 공정에서 기존 금속배선으로 사용되던 Al을 대체하여 사용되는 금속배선으로는 Cu가 그 대안으로 인식되고 있다. 이는 비저항값이 Al ($2.66{\mu}{\Omega}$-cm)보다 Cu ($1.67{\mu}{\Omega}$-cm)가 더 작아 RC 지연 시간 (RC delay time)을 극복하기 때문이다. 그러나 Cu의 녹는점은 $1085^{\circ}C$로 높지만 저온에서 쉽게 Si기판과 반응하는 특성을 가지고 있고, 또한 Si과의 접착력이 좋이 않는 것으로 알려져 있다. 이러한 이유로 Cu와 Si과의 반응을 방지하고 접착력을 높이기 위하여 확산방지막의 연구가 꾸준히 진행되고 있다. 본 연구그룹에서는 Cu의 확산을 방지하기 위하여 W-C-N의 확산방지막에 대하여 연구하여 왔다. 지금까지 보고된 연구 결과에 의하면 W-C-N (tungsten-carbon-nitrogen) 확산방지막은 고온에서도 Cu와 Si과의 확산을 효과적으로 방지하는 것으로 보고되었다. 이 논문에서는 W-C-N 확산방지막에 질소(N) 비율을 다르게 증착하여 지금까지 진행한 연구 결과를 기반으로 새로이 Cu의 전자거동현상(Electromigration)에 대하여 연구하였고, 고온 열처리 과정에서 박막의 표면강도 (Surface hardness)를 Nano-Indenter system을 이용하여 연구하였다. 이러한 연구를 통하여 박막내 질소가 포함된 W-C-N 확산방지막이 Cu의 전자거동에 더 안정적이며, 고온 열처리 과정에서도 표면 강도가 더 안정한 연구 결과를 획득하였다.

W-C-N 확산방지막의 전자거동(electromigration) 특성과 표면 강도(surface hardness) 특성 연구

김수인,김창성,이재윤,박준,노재규,안창근,오찬우,함동식,황영주,유경환,이창우 한국진공학회 2009 한국진공학회 학술발표회초록집 Vol.36 No.-

눈꺼풀 악성종양 수술에서 눈꺼풀 전층절제 후 시행한 직접봉합법의 미용적 효과

이동은(Dong Eun Lee),조승환(Seung Hwan Jo),함동식(Dong Sik Ham),이정재(Jung Jae Lee),양재욱(Jae Wook Yang) 대한안과학회 2018 대한안과학회지 Vol.59 No.2

Purpose: To evaluate the degree of eyelid deformation and satisfaction after direct closure in patients with 40-70% eyelid defects after resection of an eyelid malignant tumor. Methods: We retrospectively reviewed the clinical records of patients diagnosed with eyelid malignant tumors between January 2009 and June 2016, who were treated with resection of 40-70% of the eyelid, followed by reconstructed direct closure only or by direct closure with lateral canthotomy and cantholysis. Age, sex, diagnosis, tumor location, satisfaction, and complications were analyzed, and the ratio of horizontal width ratio and vertical height ratio were compared before and after surgery. Results: The results of satisfaction were: 12 patients (60%), very good; five patients (25%), good; and three patients (15%), fair. The average preoperative horizontal width ratio and vertical height ratio were 1.03 ± 0.01 and 1.08 ± 0.30, respectively. The average postoperative horizontal width ratio and vertical height ratio were 1.04 ± 0.08 and 1.01 ± 0.17, respectively There was no significant difference in horizontal width ratio or vertical height ratio before and after surgery (p = 0.314 and p = 0.087, respectively). Conclusions: Eyelid reconstruction with a direct closure can be performed without a flap or graft for 40-70% of eyelid defects when resecting the eyelid of a malignant eyelid tumor.