뇌척수액 비루의 외과적 치험 5례 : Report of Five Operative Cases

한병갑,강성돈,김종문 대한신경외과학회 1990 Journal of Korean neurosurgical society Vol.19 No.1

This report describes five cases of cerebrospinal fluid(CSF) rhinorrhea which were caused by head injury in four cases and developed after surgical removal of brain tumor in one case. Intrathecally-enhanced brain computerized tomography (CT) with metrizamide, in addition to isotope cisternography, was helpful in localization of the CSF leakage site. All five cases which could not be managed conservatively were successfully repaired by surgical means using biological fibrin glue.

Flowcytometric Analysis of DNA Content and Cell Kinetics in Nervous System Neoplasms

Han, Byung Kab,Kim, Tae Young,Kim, Jong Moon 대한신경외과학회 1990 Journal of Korean neurosurgical society Vol.19 No.2

유식세포분석분리기(flowcytometer)는 종양학에서 종양세포군의 DNA양 및 세포주기 분석, 단크론항체(monoclonal antibody)를 이용한 종양인자(tumor marker)의 색출, 진단의 보조역할, 종양의 분화도와 비교한 예후판정, 치료결과의 판정, 화학요법제 선택 등에 널리 이용되고 있다. 본 실험에서는 34례의 신경계 종양에서 유식세포분석분리기를 이용하여 DNA의 정량적 분석 및 세포주기분석을 시행하였다. 총 34례의 검체중 9례는 신선한 조직(fresh tissue)이었으며, 25례는 파라핀성형(paraffin-embedded)된 조직을 이용하였다. 34례중 19례 (55.9%)는 DNA양 분석에서 배수성(euploid)이었으며, 15례(44.1%)는 비배수성(aneuploid)이었다. 11례의 뇌수막종중 8례(72.7%)는 배수성이었으며, 3례(27.3%)는 비배수성이었다. 9례의 신경초종(2례의 청신경초종, 7례의 척수신경초종)중 5례(55.6%)는 배수성이었으며, 4례 (44.4%)는 비배수성이었다. 위결과에서 조직학적으로 양성인 신경계종양도 상당수에서 비정상적인 DNA양을 가지고 있음을 알 수 있었다. 세포주기분석은 31례에서 가능하였으며, 다형성교아세포종, 고도 역형성 성상세포종(highly anaplastic astrocytoma), 중등도 역형성 성상세포종, 뇌수막종, 신경초종의 핵산합성주기 세포비율(DNA synthetic phase fraction)은 각각 21%, 15%, 7%, 6%, 18%였다.

중증 두부 손상 환자의 예후인자와 그 유용성

이병곤,한병갑,김태영,김종문 대한신경외과학회 1996 Journal of Korean neurosurgical society Vol.25 No.3

The prognosis of severe head injured patients(Glasgow Coma Scale 3 to 8) was assessed through clinical prognostic factors in 209 cases, retrospectively. Severe head injured patients were 9.1% of all head trauma and 55% of cases were diffuse brain injury. Mechanism of injury were motorvehicle accident, falls, bicycle, and others. The patients with normal pupillary reaction had a significantly higher percentage of good outcome(77%) than the patient with bilateral 3rd nerve palsy(14.2%)(p<0.0001). 79% of good motor responsive patients had a good outcome compared to none of patients with poor motor response(p<0.0001). The patients with short duration of unawareness(within 30days) significantly higher percentage of good outcome(98%) than the patients with long duration of unawareness(24%)(p<0.0001). The patients with initial high GCS score(6-8 score) had a significantly higher good outcome(58%) than the patients with low GCS score(3-5 score)(p<0.0001). 87% of pediatric patients had a good outcome compared to 38% of adults(p<0.0001). The diffuse head injured patients without basal cistern compression had a significantly higher percentage of good outcome(83%) than the patients with basal cistern compression(41%)(p<0.0001). 62% of patients with skull fracture had a good outcome compared to 39% of patients without skull fracture(39%)(p<0.0017). Individual prognostic factors affect to patient's outcome and utilize to be powerful tool for assessing the relative efficacy of alternative treatments as well as patient's prognosis.

Heligmosomoides polygyrus 감염 마우스의 비장세포로 부터 만든 Conditioned Supernatant의 면역억제작용

하대유,한병갑,김명선,고유승 大韓免疫學會 1996 大韓免疫學會誌 Vol.18 No.3

Heligmosomoides polygyrus is gastrointestinal parasitic nematoda which is common parasire of wild rodents. The experimental infection with this parasite has been studied extensively in models of host-parasite interaction. The present study was undertaken to investigate both the effects of administration of conditioned supernatant or conditioned medium(CM) prepared from H. polygyrus-infected mice on the humoral and cellular immune responses in mice. Normal conditioned supernatant(NCM) was prepared from uninfected mouse splenocytes stimulated with Con A. Supematants conditioned by Con A-stimulated splenocytes of H. polygyrus -infected mice were prepared on different days post-infection, namely on day 6(HCM-D6), day 14 (HCMD14) and day 18 (HCM-D18) post-infection with H. polygyrus L3 larvae. Effects of NCM, HCM-D6, HCM-D14 and HCM-D18 on delayed-type hypersensitivity(DTH) to sheep red blood cells (SRBC), contact hypersensitivity to dinitrofluorobenzene (DNFB), hemagglutinin response to SRBC, ovalbumin (OVA)-induced active systemic anaphylaxis(ASA), and anti-OVA specific IgE were investigated. Effect of anti-IL-4 antibody (11B11) on immunoinhibitory action of HCMD18 in OVA-induced ASA was also investigated. It was found that the administration into mice of HCM-D6, HCM-D14 or HCM-D18 significantly suppressed DTH to SRBC, contact hypersensitivity to DNFB, hemagglutinin response compared with NCM. The degree of immunosuppressive activity of HCM was less marked in HCM-D6 than HCM-D14 and HCM-D18. Interestingly, HCM-D18 prepared from ICR mouse strain also showed the profound suppression of OVA-induced ASA in BALB/c and C57BL/6 mouse strains as well as in ICR mice. ASA-inhibitory activity of HCM-D18 was Somewhat abrogated in terms of mouse mortality when mice were treated in the combination of HCM-D18 and anti-IL-4 antibody, indicating that IL-4 may play a role, at least in part, in the inhibitory activity of HCM. Taken together, the present study may be the first to demonstrate that conditioned supernatants prepared from the spleen cells of H. polygyrus-infected mice may suppress the in vivo humoral and cellular immyne responses to heterologous antigens, particularly fatal anaphylaxis induced by OVA, strongly suggesting that

飮食制限이 마우스의 體液性 및 細胞性 免疫反應에 미치는 影響

하대유,한병갑,남기종 의과학연구소 1990 全北醫大論文集 Vol.14 No.1

흉부 척추강내에 발생한 Enterogenous Cyst

임규남,김태영,한병갑,김종문 대한신경외과학회 1995 Journal of Korean neurosurgical society Vol.24 No.8

The case of an 33-year-old man with an intradural and extramedullary enterogenous cyst in the thoracic spinal canal is presented. Enterogenous cysts are rare cystic tumors located in the spinal canal and causing spinal compression, and about half of the cases of enterogenous cysts are associated with congenital anomalies. This patient, however, had no vertebral anomaly or other evidence of congenital malformation. We reviewed literatures and recorded the distinguished features of intraspinal enterogenous cysts and discuss the clinical, radiological and histological findings.

Heligmosomoides polygyrus 감염 마우스의 면역반응 잠재력

하대유,고유승,한병갑 大韓免疫學會 1996 大韓免疫學會誌 Vol.18 No.2

Heligmosomoides polygyrus(=Nematospiroides dubis) is gastrointestinal parasitic nematoda which is common parasite of wild rodents in North America, Western Europe and the CIS. The experimental infection with this parasite has been studied extensively in models of host-parasite interaction. The present study was undertaken to investigate the effect of H. polygyrus infection on the humoral and cellular immune responses in mice. It was found that H. polygyrus infection suppressed delayed-type hypersensitivity(DTH) to SRBC, contact hypersensitivity to dinitroflurobenzene (DNFB) and hemagglutinin response to SRBC. Surprisingly, H. polygyrus infection suppressed active systemic anaphylaxis(ASA) induced by ovalbumin(OVA), but elicited marked increase of the total IgE antibody and total IgG production compared with uninfected mice. In a histological examination of the mucosal mast cell(MMC) response in vivo in ICR mice, H. polygyrus infection elicited a enhance MMC response 14 days post-infection, but did not show any difference 21 days post-infection, but did not show any difference 21 days post-infection compared with uninfected controls, suggesting mucosal mastocytosis response may depend on certain stage of life cycle of H. polygyrus. Taken together, the present study strongly suggested that H. polygyrus infection in mice in-creased the total IgE and IgG antibody production, but suppressed cellular immune response to SRBC and DNFB, hemagglutinin respose and OVA-induced anaphylaxis, and that mucosal mastocytosis may be decreased or increased depending on certain stage of life cycle H. polygyrus.

교통성 뇌수종 환자에서 요추강 복막강간 도관술의 효능 및 예후 인자에 대한 분석

채병문,김태영,한병갑,김종문 대한신경외과학회 1995 Journal of Korean neurosurgical society Vol.24 No.9

The effect of lumboperitoneal(LP) shunt and the prognostic factors of 40 cases of communicating hydrocephalus confirmed by brain computerized tomography(CT) and/or magnetic resonance imaging(MRI) and radioisotope cisternography(RI) were analyzed. Possible prognostic factors such as disease entity, CT or MRI findings, and the type of radioisotope cisternography were compared to improvement of clinical status after LP shunt. The etiology of communicating hydrocephalus in the analyzed 40 cases included trauma in 13 cases(32.5%), subarachnoid hemorrhage(SAH) in 12 cases(30%), intracerebral hemorrhage(ICH) in 10 cases(25%), and idiopathic in 5 cases(12.5%). An overall clinical improvement after LP shunt was seen in 22 cases(55%). Howcver, in 17 cases of SAH and idiopathic group, improvement after LP shunt was seen in 13 cases(75%), indicating that LP shunt is more effective in SAH/idiopathic group than trauma/ICH group(p < 0.05). Many findings of brain CT/MRI such as Evan's index, periventricular low density, 3rd ventricular width, obliteration of cerebral sulci, rounding of frontal horn, and cortical atrophy were analyzed as prognostic factors. Except for the absence of cortical atrophy(P < 0.05), none of the factors were related to the patient's outcome. The type of abnormal RI cisternography findings(Type Ⅰ,Ⅱ,Ⅲ) also did not show any relationship with the effectiveness of LP shunt. These findings suggest that SAH/idiopathic group were more favorable candidates for LP shunt than trauma/ICH group, and that there are no reliable brain CT/MRl findings indicating a good prognosis after LP shunt except for the absence of cortical atrophy. RI cisternography findings are also not a reliable diagnostic tool in evaluating the indication of LP shunt in communicating hydrocephalus.