一酸化炭素中毒家兎의 大腦, 間腦, 小腦 및 延髓의 酸素所費量에 關하여

宋豊鎬,정상섭,李圭源,權宏保,鄭福得 慶北大學校 醫科大學 1972 慶北醫大誌 Vol.13 No.1

In order to observe a possible effect of CO intoxication on the oxygen consumption rates (QO_2) of cerebrum, diencephalon, cerebellum and medulla oblongata, the rabbit was exposed to either 0.1% CO gas for six hours or 0.2% CO gas for two hours daily for five days. The QO_2 of the brain tissues was measured by the Warburg's standard manometric method, and a comparison was made with the control. The results obtained are summarized as follows: 1. The QO_2 of the cerebrum, diencephalon, cerebellum and medulla oblongata of the normal rabbit was 3.68±0.45,3.13±0.79,1.32±0.24 and 1.80±0.24㎕O_2/hr./㎎ D.W. respectively, and QO_2 of the cerebrum was the highest and the cerebellum the lowest. 2. QO_2 of the brain tissues studied herein in the 0.1% and 0.2% CO exposed groups showed no significant change from the control in general, though there was a slight increase of QO_2 in the cerebrum and cerebellum of 0.2% CO exposed group.

두부외상後 발생한 Normal Pressure Hydrocephalus의 Ventriculoatrial Shunt

宋豊鎬 慶北大學校 醫科大學 1976 慶北醫大雜誌 Vol.17 No.2

頭蓋腔內壓 上昇과 Dibenzyline 前處置가 家兎의 肺容壓率 및 肺洗滌液의 蛋白含量에 미치는 影響

宋豊鎬 慶北大學校 醫科大學 1979 慶北醫大誌 Vol.20 No.1

雜種白色家兎를 實驗動物로 使用하여 硬腦膜外腔에 生理的 食鹽水를 注入함으로서 頭蓋腔內壓을 70∼80mmHg로 20分間 上昇시킨 後 肺容壓率 및 肺洗滌液의 蛋白含量에 미치는 影響을 觀察하였으며 아울러 交感神經 遮斷劑인 dibenzyline을 前處置한 後 같은 方法으로 頭蓋腔內壓을 上昇시켜 그 結果를 比較觀察하였던 바 다음과 같은 結果를 얻었다. 對照群에서의 inflation 및 deflation時의 肺容壓率의 平均値 및 標準誤差는 0.82±0.06ml/cmH_2O 및 0.70±0.40ml/cmH_2O였으며 頭蓋腔內壓만 上昇시킨 群에서의 肺容壓率은 inflation時 0.60±0.03ml/cmH_2O 및 deflation 時 0.55±0.03ml/cmH_2O로서 對照群에 比해 有意하게 減少하였다. 交感神經 遮斷劑인 dibenzyline을 前處置한 群에서의 肺容壓率은 inflation時 0.99±0.09ml/cmH_2O 및 deflation 時 0.90±0.06ml/cmH_2O로서 inflation時는 對照群의 그것에 比해 有意한 差異는 없었으나 deflation時는 有意하게 增加하였으며 頭蓋腔內壓만을 上昇시킨 群에 比해서는 顯著하게 增加하였다. 이것은 divenyline을 前處置함으로서 肺容壓率의 減少를 防止시켰다고 생각된다. 肺洗滌液의 蛋白含量은 對照群에서 1.38±0.09mg/100ml, 頭蓋腔內壓만을 上昇시킨 群에서는 1.79±0.10mg/100ml, dibenzyline 前處置群에서는 1.20±0.08mg/100ml로서 頭蓋腔內壓만을 上昇시킨 群에서는 對照群에 比해 有意하게 增加되었으며 dibenzyline 前處置群은 對照群에 比해 오히려 若干 減少하였으나 有意하지는 않았다. 體重에 對한 肺歲의 무게比는 對照群에서 1.73±0.03×10 exp(-3), 頭蓋腔內壓만을 上昇시킨 群에서는 1.77±0.06×10 exp(-3), dibenzyline 前處置群에서는 1.85±0.04×10 exp(-3)으로서 dibenzyline 前處置群에서는 對照群에 比해 有意하게 增加하였다. 血壓의 變化는 頭蓋腔內壓만을 上昇시킨 群에서는 頭蓋腔內壓을 上昇시키기 前에 比해 若干 增加하는 傾向을 보였으나 dibenzyline 前處置群에서는 別變化를 보이지 않았다. 全實驗群에서 肺臟의 肉眼的 및 顯微鏡學的 檢査上에서 對照群의 所見과 別差異를 觀察할 수 없었다. 以上의 結果로 미루어 보아 頭蓋腔內壓이 上昇하여 血流力學的 變化로 因한 肺臟의 肉眼的 및 組織學的 病變이 招來되기 以前에도 肺機能에 直接的인 影響을 미치는 肺胞表面活性物質의 機能 및 構成成分에 變化를 招來하여 肺容壓率의 減少가 올 수 있으며 이와 같은 것은 交感神經 遮斷劑로서 防止시킬 수 있을 것으로 思料된다. The pulmonary functions in terms of compliance and surfactant activities have been reported to be changed by the nonthoracic injuries and shock, which are generally termed as adult respiratory distress syndrome, shock lung or traumatic wet lung. The pulmonary compliance or surfactant activity is also reported to decrease in head injury, the cause of which is believed to be the sympathetic stimulation. In the present study, an effort was directed to elucidate the possible changes of the pulmonary compliance by the application of the increased intracranial pressure, as well as the effect of, dibenzyline, a sympatholytic agent, on the pulmonary activities. The albino rabbits were used throughout the entire experiment, and a hole of approximately 3mm in diameter was drilled on the right frontal bone of the animal under 1% procaine local anesthesia. In the experimental group, approximately 25­30㎖ of normal saline was injected into the epidural space through the hole by the aid of polyethylene tube which raised the intracranial pressure to approximately 70-80mmHg for 20 minutes, which is equivalent to the diastolic blood pressure of the animal. In the group where dibenzyline was pretreated, dibenzyline (12mg/kg BW) was injected intramuscularly at least 16 hours prior to the experiment. The lung compliance was measured by the changes of pressure-volume(P-V) curves obtained from the excised left lung of the rabbit by inflating or deflating the lung with air. The lung compliance was calculated from the fifth and sixth P-V curves with 2 to 10 cmH_2O pressure segment. Immediately after the P-V curves recorded, the same lung was used for lung washing with 60ml of normal saline. The protein content of the lung washing was measured by the biuret reaction. The lung weight/body weight (L/B) ratio was measured using the right lung. Also, the right lung was used for the microscopic examinations. During the entire process of the increased intracranial pressure, the arterial blood pressure was also measured. The results obtained are summerized as follows. The inflation and deflation lung compliance were 0.82±0.06ml/cmH_2O and 0.70±0.40ml/cmH_2O respectively in the control group, whereas in the increased intracranial pressure (ⅡCP) group, both inflation lung oompliance(060±0.30ml/cmH_2O) and deflation lung compliance (0.55±0.03ml/cmH_2O) were significantly decreased from the control (p<0.01). When dibenzyline was pretreated, inflation (0.99±0.09ml/cmH_2O) and deflation lung compliance (0.90±0.06ml/cmH_2O) did not change from the control significantly. Howerer, comparing with the ⅡCP group, a significant increase in both inflation and deflation lung compliance was observed (p<0.01). The protein content of the control group was 1.38±0.09mg/100ml, whereas in the ⅡCP group, it was slgnificantly increased (1.79±0.10mg/100ml, p<0.01). When dibenzyline was pretreated, the protein content become less than the control value. The L/B ratio in the control was 1.73±0.03×10 exp (-3), while that of ⅡCP group was 1.77±0.06×exp (-3). In dibenzyline pretreated group, L/B ratio was increased significantly (1.85±0.04×exp (-3) p<0.05). The microscopic examinations revealed no significant change in any experimental groups comparing with control. The arterial blood pressure showed a tendency of slight increase in the ⅡCP group, and when dibenzyline was pretreated, no change in arterial blood pressure was observed. From the above results, it has been concluded that the ⅡCP produces a definite decrease in he lung compliance which can be protected or ameliorated by the applicaion of the sympaothytic agent. Also, the decreased lung compliance by the IICP is accompanied by the concommitant increase of the protein content in the alveolar space, the cause of which may be due to the alterations of the surfactant characteristics and imbalance of composition.

先天性水頭症의 脈絡膜叢除去術

宋豊鎬,洪元培,曺守鎬,朴淵默,金乘來 慶北大學校 醫科大學 1972 慶北醫大誌 Vol.13 No.2

We have experienced 2 cases of the congenital hydrocephalus, preserved almost normal absorption mechanism of the cerebrospinal fluid to be confirmed with indigocarmine test. These cases have been maintained in arrest state of the hydrocephalus since direct choroidal plexectomy in the lateral ventricle was carried out to keep balance between production and absorption of the cerebrospinal fluid. In dye test using indigocarmine injected into the enlarged lateral veatricle, it was not found out in the cerebrospinal fluid of the lumbar puncture, but was noticed to be analysed quantitatively in urine collecting for 12 hours. This has been supposed normal pathway of the cerebrospinal fluid was obstructed but there was really the communication between the lateral ventricle and supratentorial subarachnoid space. And it was the "open site" communicating directly between the lateral ventricle and subarachnoid space that it was thought of paperthin cerebral mantle on the ventriculogram. Through this open site of the cerebral mantle, the choroidal plexus in the lateral ventricle was removed and cauterized easily and simply.

先天性水頭症의 脈絡膜叢除法術

宋豊鎬,洪元培,曺守鎬,朴淵默,金乘來 慶北大學校 醫科大學 1972 慶北醫大雜誌 Vol.13 No.2

頭部外傷後 發生한 Normal Pressure Hydrocephalus의 Ventriculoatrial Shunt.

宋豊鎬 慶北大學校 醫科大學 1976 慶北醫大誌 Vol.17 No.2

著者는 심한 頭部外傷으로 因하여 本院에 神經外科에 入院한 患者中에서 normal pressure hydrocephalus(NPH)로 診斷된 5例를 對象으로 ventricular shunting을 施行한 後 그 結果를 觀察하였다. 術後 다만 spasticity는 比較的으로 好轉되었으나 다른 神經學的 臨床症狀은 術前과 差異가 없었으며 이것은 旣存 腦實質의 損傷이 심하였기 때문인 것으로 생각된다. Author report surgical experience of ventricular shunting in five cases of normal pressure hydrocephalus following severe craniocerebral injury. In all cases, the previous neurological symptoms due to brain damage were not improved significantly but spasticity in the extremities was seemed to be disappeared after ventricular shunting.

一酸化炭素中毒家兎의 大腦, 間腦, 小腦 및 延髓의 酸素消費量에 關하여

宋豊鎬,鄭相燮,李圭源,權宏保,鄭福得 慶北大學校 醫科大學 1972 慶北醫大雜誌 Vol.13 No.1

Neurofibromatosis associated with congenital unilateral pulsating exophthalmos

Nam, Wee Hyun,Song, Poong Ho,Chung, Sang Sup,Lee, Chul Woo 대한신경외과학회 1972 Journal of Korean neurosurgical society Vol.1 No.1

문헌상으로 선천적 박동성 안구돌출증을 동반하는 신경섬유종증의 보고례는 흔하지 않다. 저자는 15세 소녀에서 우측 안구돌출, 시력장애, 안검마비, 안검부종 등을 호소하는 예를 경험하였다. 초증은 2세때 소결절로 시작되어 점차 증대하여 지난 2년동안 악화하였다. 다발성으로 "Cafeau-lait"의 착색이 어릴 적부터 볼 수 있었다. 안구의 박동은 맥박과 일치하였으며 안구돌출은 18.5㎜이나 잡음은 청진할 수 없었다. 우측안구는 하방으로 전위되었으며 움직이지 않고 고정되어 있었다. X선상으로 우측 전두와는 파괴되었으며 비중격(Nasal septum)은 좌측으로 전위되어 있었으며 Sella turcica는 확대되어 있었다. 우측 개두술에서 측두부 안부조직이 심히 종창되어 있고 측두골은 심히 엷어져 있었으며 뇌경막은 비후되어 두개골에 유착되어 있었다. Sphenoidal bone은 파괴되어 없어졌으며 이 골결손부를 통하여 측우엽의 첨단이 안구 속으로 밀려 안구를 전하방으로 압박하고 있었다. 두개강내에 특유한 종양은 발견할 수 없었고 종창된 염부조직의 조직검사에서 신경섬유종을 발견할 수 있었다. 본례는 수술후 경과가 양호하여 퇴원하였다. 본증의 보고를 문헌 고찰과 아울러 기술하였다. A typical case of neurofibromatosis associated with congenital pulsating unilateral exophthalmos, which was verified roentgenologically, surgically and microscopically, has been reported and the literatures reviewed. The clinical and roentgenological findings were emphasized.

胸髓에 發生한 類皮腫一例

李正吉,宋豊鎬,金仁洪,정상섭,李哲雨 慶北大學校 醫科大學 1972 慶北醫大誌 Vol.13 No.1

A rare case of dermoid tumor of the thoracic spinal cord is reported and related literatures reviewed. Total surgical excision was performed and a good long-term relief of all neurological deficits obtained.

Neurofibromatosis Associated with Congenital Unilateral Pulsating Exophthalmos

Nam, Wee Hyun,Song, Poong Ho,Chung, Sang Sup,Lee, Chul Woo 慶北大學校 醫科大學 1971 慶北醫大誌 Vol.12 No.1

大部分의 搏動成 眼球突出은 眼窩內나 바로 眼窩後面 卽 海綿靜脈洞에 動靜脈吻合이 있을때 나타난다. 어떤 神經織維腫에서는 先天性 骨缺損이 頭??骨의 여러 部位에서 同伴될 수 있으며 特히 眼窩尖部骨組織의 缺損으로 側頭葉이 眼窩內로 脫出하여 腦壓으로 因한 搏動性 眼球窩出을 일으키는 機轉을 設明한 症例를 文獻上 볼 수 있다. 筆者는 蝶形骨 小翼 및 大翼의 缺損이 있고 搏動性眼球突出을 보이며 皮膚에 cafe-au-lait spots와 右側 上眼瞼, 側頭皮下 및 胴體에 神經織維腫을 가진 一例를 經驗하였기에 文獻考察과 함께 報告한다. A typical case of neurofibromatosis associated with congenital unilateral pulsating exophthalmos, which was verified roentgenologically, surgically and microscopically, has been reported and the literatures reviewed. The clinical and roentgenological findings were emphasized.