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Serotonin이 통각유발물질에 의해 유발된 척수반사에 미치는 영향
오석전,한희철,남숙현 고려대학교 의과대학 1987 고려대 의대 잡지 Vol.24 No.1
This present study was performed to investigate the effect of 5-hydroxytryptamine (5-HT, serotonin) on spinal flexion reflex evoked by algestic substance (KCI) in cat. This experiment was done on 26 α-motoneurons and 31 γ -motoneurons which showed responses to intra-arterial injection of KCI in gastrocnemius-soleus muscle. The results are as follows: 1. Potassium ion 3.8 ㎎ injected as a form of KCI increased the impulse discharges of α-and γ- motoneurons, which meant the flexion reflex. 2. The intra-arterial injection of 135 ㎍ 5-hydroxytryptamine (5-HT) increased the impulse discharges of α and γ flexor motoneurons of which responses had latency of 21 ± 3.3 sec. and duration of 81 ± 21.8 sec. 3. The intra-venous injection of 5-HT showed similar effects on the impulse discharges of spinal motoneurons. 4. The responses of α flexor motoneurons to KCI began to decrease at 5-6 min. after intra-arterial injection of 135 ㎍ 5-HT. The latency was increased to 5.2 ± 1.2 sec. and the duration was decreased to 57±10.3 sec. The changed responses were recovered at 52 min. after 5-HT injection. 5. 135 ㎍ 5-HT also reduced the responses of γ flexor motoneurons to KCI at 5-6 min. after injection. The latency was increased to 6.1±1.5 sec., the duration was decreased to 57±10.7 sec. and the changed responses were recovered at 58 min. after 5-HT injetion. To summarize the above results, 5-HT indirectly excites the spinal motoneurons but decreases the response of spinal motoneurons to KCI. It suggests that the 5-HT could reveal the analgesic effects by inhibition of the pain transmission in the spinal cord.
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김남규,김광명,이지웅,정환영,오석전 한양대학교 의과대학 1992 한양의대 학술지 Vol.12 No.1
The author analysed 68 cases of posterior fossa tumor which were treated at Hanyang University Hospital from Jaunary 1986 to September 1991. The results were analysed and summarized as follows. 1.The cases of childhood were 38.2%, and the cases of adults were 61.8%. The cases below 10 year-old appeared peak age group which were 23.5%. 2.Among 68 cases of posterior fossa tumor, 17 cases of medulloblastoma, 13 cases of astrocytoma, 9 cases of hemangioblsstoma, 8 cases of meningioma were encountered. 3.The posterior fossa tumors were occupied on the cerebellar hemisphere in 26 cases, the cerebellar vermis in 18 cases, the cerebellopontinve angle in 19 cases. 4.The mainsymptoms were those of increased intracranial pressure. Headache was encountered in 82.3%, nausea & vomiting in 64.7%, gait disturbance in 29.4%. In acoustic neuroma, hearing disturbance were encountered in 76.9% of cases which were higher rate than the rate of symptom of increased intracerebral pressure. 5.64.7% of posterior fossa tumor were accompatined with hydrocephalus. The more closely situated to the outflow tract of cerebrospinal fluid and the larger the tumor was, the more frequently encountered the hydrocephalus was. 6.Total removal of tumor was done in 39 cases, subtotal removal was done in 17 cases, partial removal was done in 9 cases, biopsy was done in 3 case. Combined radiotherapy and chemotheraphy was done in 19 cases and 10 cases respectively. 7.The result of treatment was good in 63.3% and morbidity 16.2% mortality 7.4%. The aggressive therapeutic approach with combined mdality, utilizing radical resection of the tumor, scheduled postoperative ratiotheraphy and chemotherapy, seemed to exert benificial influence on the outcome.
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전교통동맥류 출혈의 뇌전산화단층촬영술과 뇌동맥조영술 소견의 분석
김남규,이훈경,정환영,김광명,오석전 한양대학교 의과대학 1991 한양의대 학술지 Vol.11 No.1
In anterior communicating artery aneurysm that accounts for about 30% of intracranial aneurysms, it has been pointed out that the hemodynamic factor plays a very important role in all stages such as initiation, growth and rupture of aneurysm. There are several principles which are generally agreed in surgical field: careful protection of perforators, preparation for temporary clipping of afferent artery of aneurysm and dissection of the neck of aneurysm prior to exposure of the dome. However, there is controversy about the direction of approach to the aneurysm. While Yasargil has approached almost all the anterior communicating artery aneurysm through the right side, Flamm said that he operated the anterior communicating artery aneurysm via the same side of the predominant A₁ Based upon the angiographic findings, the author reviewed 96 cases of ruptured anterior communicating artery aneurysm to propose a standard related to the direction of surgical approach by analyzing the relationships between unilateral predominance of A₁, afferent artery and direction of cerebral angiogram, the author tried to suggest a point referred to which carotid artery should be selected first when direct jcarotid angiography is inevitable. The results were summarized as followings: 1. Of 53 cases which had intracranial hematoma, 28 cases showed unilateral predominance. Among them the predominance of hematoma was opposite to the afferent artery in 82.1%(23/28) and was ipsilateral to the direction of aneurysm in 64.3% (18/28) 2. Of 91 cases which had subarachnoid hemorrhage, 29 cases showed unilateral predominance. Among them the predominace of hematoma was opposite to the afferent artery in 72.4% (21/29) and was ipsilateral to the direction of aneurysm in 58.6% (17/29). 3. Asymmetricity of caliber of A₁was observed in 71.9%(69/96) and which was 3 times more frequent than that of reported incidence of control group (2.2-23%). 4. The incidence of predominance of left A₁was 54.2% (52/96) and that of right A₁was 17.7% (17/96). Among them, predominant A₁was operated as afferent artery in 94.2% (65/69). 5. Of 69 cases in which a unilateral A₁showed predominance, the direction of aneurysm was opposite to the side of predominant A₁in 66.7%(46/69) and ipsilateral to the predominant A₁in only 2.9% (2/69). 6. Above findings suggest that in cases with suspected anterior communicating artery aneurysm rupture that direct carotid angiography is inevitable, contralateral carotid aneurysm rupture that direct carotid angiography is inevitable, contralateral carotid angiography should be undertaken when intracranial hematoma or subarachnoid hemorrhage showed unilateral predominance on brain CT, and left carotid angiography is preferable than right if there is no predominance of intracranial hematoma or subarachnoid hemorrhage on brain CT. And it is desirable to approach the anterior communicating artery aneurysm via the side of the predominant A₁when the direction of aneurysm is uncertain on cerebral angiogram.
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정환영,김광명,한윤경,김남규,오석전 한양대학교 의과대학 1991 한양의대 학술지 Vol.11 No.1
Surgical refinement on the lumber interbody fusion has been undertaken both in procedure and instrumentation. From 1970 to 1990, a total of 165 cases of lumbar interbody fusion was performed with anterior retroperitoneal or posterior interlaminar approach Method: Autogenous bone grafts were taken from the iliac bone. The shape of the bone graft was either square peg or round dowel. In retroperitoneal method, lumbar sympathectomy approach was used and in the posterior method, interlaminar fenestration method was preferred. The preocedure consisted of thorough rmoval of soft tissue from the intrespace and snug insertion of autogenous bone graft. Round bone dowel 12 mm in diameter, 15-20 mm in thickness or similar size of square peg were used. The upper surface of graft should be packed 3-5mm deeper than the posterior rims of the vertebral bodies. Immediately after the surgery, the result was checked by plain X-rays and/or CT scan. In follow-up, solid fusion was confirmed in 70% of retroperitoneal method and 87% of posterior round dowel insertion and 85% of posterior square peg graft. The others showed fibrous fusion. Pedicle screw fixation was added in 5 cases. Strong full-thichness of bone and close contact between bone graft and vertebral bodies assures solid fusion. Square peg graf was more difficult to make standard size in comparison with round dowel which was taken by using dowel bone cutter. Retropulsion of the bone graft occured in square peg with higher frequency than round dowel. Newly deviced instruments were interchangeable drills, rounded tip drill, slender bone graft impactor, slender ring curette, osteophyte impactor. they are easy to use, safe and efficient for the precise and addurate microsurgery. Posterior lumbar interbody fusion using round dowel graft and reined instrumentation assured close contact between graft and vertebral bodies, and safe and easy procedures and uktimately showed better results.
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석전수실 한국도교학회 1990 道敎學硏究 Vol.6 No.1
Among many exercises of Taoism we have been regarded Fangzhong(Sexual technique) as immoral and out of value. We even believe that Fangzhong lost its influence after Kou qian-zhi, Lu xiu -jing and hong-jing prooposed the new Taoism since they strongly criticized it. On the other hand the moral of Sheng sheng(to make things living lively) had been the essential one through out the history of traditional Chinal and Fangzhong was important exercise in connection with this moral. Socially it brought them fertility of every life, individually it brought them purification and eternization of body and mind. Even pleasure was regarded natural phenomenon derived from feeling unless it remained within the limit of moderation. When mass sexual exercise went beyond the limit of moderation and conflicted against other morality they shifted the scene of sexual exercise within the individual's body by operating many images and moving thier floating body(qi). They call it Cunsi(visualization of internal Gods), In this meditation they regarded their body as the androgyne and one's self devided into many selves of Gods. Cunsi itself had old tradition since Warring States era. Even dual sexual exercise adopted certain kind of this meditaion as part of it's process and it Inner Alchemy of Taoism had great importance since by comparing common alchemy one could regard his body as the fireplace of alchemy and could describe the process of meditation as the process of alchemy using the term of sexual exercise. Dr. Sakade pointed out the term Neidan(inner alchemy) had been used since Sui era. It would be firmly established after they found common featwe between the sexual term of Waidan(alchemy using many metals) and the sexual term of meditation achieved within the androgenious body of individual. We should also notice that there are common viewpoint of body between the Cunsi and the Neidan. They both grasped man's body as mt. Kun lun which is regarded as microcosmos. They both intended to escape from man's body tied to mundane life. It also meant to escape from microcosmic body and fused into macrocosmos. If we can grasp interrelation among Fangzhong, Cunsi and Neidan like this, it is not exact to illustrate that the harmfullness of Waidan insisted Taoist to the pass of Neidan. Actually Waidan had been practiced even after Sung dynasty, but they are much more facinated in the idea of inner alchemy because of spiritual pureness and depth of it.
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