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- 저자 : 최선길 (검색결과 85 건)
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최선길,최상일,김주명,최덕영,임광세 대한신경외과학회 1976 Journal of Korean neurosurgical society Vol.5 No.2
The salient pathological findings following acute blunt cord trauma, now documented by a number of investigators, are hemorrhagic necrosis of central gray matter and increased. catecholamine, especially dopamine concentration of the traumatized cord level, which have progressive and, according to some authors, reversible nature. But paraplegia and disappearence of sensory evoked potential (SEP) are the obvious clinical conditions appeared immediately after blunt cord trauma which are sudden events not progressive ones. These phenomena are clearly results of neuronal conduction block of white matter at the traumatized cord level. Dohrmann et al. demonstrated in their electron microscopic studies that the myelinated nerve fibers of the traumatized cord level with 300 gm-㎝ force are resemble those of a control animal until 15 to 20 minutes after impact. At this point, we can imagine 2 phases of pathophysiological process of acute blunt cord trauma, ie; 1. Initial alterations of normal cord physiology. 2. Secondary or aggrevating processes to the initial alterations of normal physiology. There are a number of reports and arguements about so called secondary aggrevating processes but neither explanations nor experimental studies about those immediate pathologic clinical phenomena. As the initiation of the investigations about the immediate physiological alterations, we planned this experiment to observe radioactive potassium uptake of the white matter of the bluntly traumatized spinal cord. At first, we carried dorsal laminectomy out on the T2 and T6 level of adult Mongoreal dogs and injected K^(42) Cl, 500 micro Ci into the right atrium via catheterized antecubital vein. At 6 seconds after injection of K^(42), 5cc bolus of saturated KCl was shot intravenously via same route to produce instant cardiac arrest. As rapidly as possible, the cord of T2 and T6 were excised and dissection of white matter was done which was facilitated by use of loupe. After tissue weighing, tissue indicator was counted with Well-type Scintillating Counter. As a result, the radioactivity of T6 white matter (cpm/mg) was 77% (SD=2.04) of that of T2, which was essentially same as the regional blood flow rates measured by Bingham et al. with fractional indicator technique. Secondly, we elicited seizures on the animals by electrical stimuli delivered to the electrode attached on the bifrontal scalp. Seizure duration was 3 minutes and at the time of termination of tonic phase 500 micro Ci of K^(42) Cl was injected. 6 seconds later cardiac arrest was produced and radioactivity of the white matter of T2 and T6 were measured with same way described above. .Radioactive potassium uptake of the white. matter of T2 and T6 were 57.82% (SD=2.62) and 61.38% (SD=3.69) to those of control animal. This result can be explained as a greatly increased K^(+)ion concentration in the interstitial space of white matter during the convulsive seizure. Next time, the animals were laminectomized on the level of T2 and T6, and 500 gm-㎝ force was impacted on the T6 exposed cord while T2 segment served as non-traumatized control. 15 minutes after impact, 500 micro Ci of K^(42) was injected and at 6 seconds after injection cardiac arrest was produced. And radioactivity of white matter was measured. The K^(42) uptake of the T6 white matter was 171%(SD=24) to that of T2, which was thought as a reflection of increases regional blood flow. Alteration of blood-brain barrier resistance must be influenced upon the K' ion uptake but they may be masked by increased blood flow, which was supported by a biphasic curve obtained from time-lag experiments, ie; decreased uptake in 1 1/2 hour group, increased uptake in 2 1/2 hour group and approach to the base line in the 4 hour group. Another experimental study to discover so called immediate physiological changes will be presented in the next report.
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소아 두뇌외상에 대한 임상적 고찰 : Analysis of 481 Cases
최선길,이상철,황도윤,최덕영,강성구,임광세 대한신경외과학회 1975 Journal of Korean neurosurgical society Vol.4 No.2
Clinical observation and analysis were performed on 481 cases of craniocerebral injuries under 15 years of age those were treated at Chung-ang university hospital during the period from January, 1972 to August, 1975. Following results were obtained: 1. There were 302 males and 179 females and sex ratio was 1.7 : 1. 2. Age incidence of the accidents was greatest at 5 years of age and mostly distributed to the age group between 5 to 7. 3. Seasonal peak of the accidents was at June. 4. The most frequent cause of the craniocerebra1 injuries was traffic accident (277 cases. 57.59%), and the next was fa11 from height (159 cases, 33.06%). 5. No deterioration of consciousness before and after the admission was observed in 176 cases (36.6%). 6. Pupillary change was observed in 28 cases in which unilateral were 21 and bilateral were 7. Babinski sign was elicitable in 91 cases. 7. Early convulsion and vomiting were frequent symptoms in childhood. 8. Skull fracture was observed in 204 cases (40.33%) in which linear fracture was most frequent. The location of the linear fracture was parietal and the predilection sites of the depressed fractures were frontal and parietal. 9. The accompanying rate of skull fracture in intracranial hemorrhage was; epidural 75%, subdural 50% and subarachnoid 17.3%. 10. The overall mortality was 8.32%. In non-surgical group (442 cases), the mortality rate was 7.47% but in surgical group (39 cases), operation mortality was 17.95%.
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肺吸蟲症 診斷에 있어서 ELISA법의 應用에 관한 硏究
崔銑吉,李駿商,林漢鍾 고려대학교 의과대학 1984 고려대 의대 잡지 Vol.21 No.1
Human paragonimiasis is one of the common trematode diseases and of very important public health problem in Korea. Although many techniques have been deviced for immunological diagnosis of paragonimiasis, they exhibit low sensitivity and specificity. In this study the enzyme-iinked immununosorvent assay (ELISA) was employed in the diagnosis of human paragonimiasis using Paragonimus VBS(veronal buffered saline) antigen, peroxidase conjugated anti-human Ig G and ortho-phenylenediamine as a substrate by micromethod according to technique of Voller et al. (1979) and McLaren et aI. (1978) with minor modifications. Sera tested were categorized into 106 paragonimiasis, 20 clonorchiasis, 12 taeniasis, 10 toxoplasmosis, 10 hymenolepiasis and 10 non-infected human cases. The results obtained are as follows: 1. In the preliminary study optimal dilutions of conjugate, stock antigen and serum were 1/5,000, 1/400 and 1/400 respectively. 2. The O.D. (optical density) values of the ELISA in the sera of paragonimiasis cases using stock antigen and VBS antigen were 1.291±0.731 and 1.466±0.813, respectively, and the mean O.D. values in the sera of paragonimiasis cases using VBS antigen were not significantly different from that of stock antigen in sensitivity. (p<0.001) Results showed a standard sensitivity in the application of the ELISA in the diagnosis of human paragonimiasis using VBS antigen. 3. The mean O.D. values of the ELISA in 106 sera of paragonimiasis cases were 1.243±0.863 and those of other parasite infection groups and non-infected human group were 0.487±0.549 in clonorchiasis, 0.513±0.521 in taeniasis, 0.158±0.235 in hymenolepiasis, 0.222±0.235 in non-infected human group and that in paragonimiasis was significantly higher than those of other groups. 4. Distribution of the O.D. values of the ELISA, 86 (81.1%) out of 106 paragonimiasis sera, 3 out of 52 other parasite infection group sera and none out of 10 non-infected human group showed highter than that of the positive serum of 1.000 at 488nm) O.D. value. In conclusion, results of this study suggest that the ELISA is more applicable and reproducible in the diagnosis of human paragonimiasis than other immunological tests used especially in seroepidemiological study.
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