허혈성 신경손상기전 연구를 위한 기관형적 해마조직절편배양 인공 허혈모델

이무섭,민경수,김동호 충북대학교 의과대학 충북대학교 의학연구소 1999 忠北醫大學術誌 Vol.9 No.2

연구목적: 허혈성 신경손상의 연구에 있어서 유용한 방법으로서 쥐의 뇌 해마 조직을 잘라내어 얇은 조직 절편을 만들어 배양하고 인공적으로 저산소 상태를 만들어서 허혈성 신경손상의 연구에 사용 가능한 모델을 만들고자 하였다. 대상 및 방법: 생후 4-7일 된 쥐의 뇌에서 해마를 제거하고 조직절단기를 이용하여 400-500㎛정도 두께의 횡절편을 만든다. 이 절편을 투명한 계면막에 옮긴 뒤 배양액 내에서 36.5℃, 90-100% 습도, 5% CO₂의 조건하에서 약 2주간 배양한다. 배양 온도를 철저히 유지하면서 조직절편을 무산소방에 약 35분간 넣고 현미경을 이용하여 해마의 CA1 부위의 신경세포 손상의 정도를 관찰한다. propidium iodide를 함유한 배양액내에서 48시간 배양 후 조직편의 손상 정도를 도립형광현미경으로 관찰하면서 영상으로 컴퓨터에 저장한다. 조직을 무산소방내에 약 3시간정도 넣어 해마의 CA1 부위에 100%의 손상을 만들고 그 영상을 저장한다. 3시간 무산소처리후의 영상과 초기 영상을 비교하여 손상의 정도를 결정한다. 결과: 어린 쥐의 기관형적 해마조직절편배양은 저자들이 사용한 조건하에서 2주 이상 안정되게 유지되었으며, 무산소방에서 약 35분 정도 처리함으로써 해마의 CA1 부위에 40-70%의 일관성 있는 신경세포 손상을 유발할 수 있었다. 그리고 propidium iodide를 이용한 형광강도를 영상분석 소프트웨어를 이용하여 비교측정함으로써 신경세포손상의 정도를 정량적으로 측정할 수 있었다. 결론: 상기 방법을 사용하여 허혈성 신경손상의 기전연구에 유용한 모델을 만들 수 있었는데 생체모델과 달리 다양한 생리적 변수를 조절할 수 있고, 해마내의 신경세포간 연결이 유지되어 있는 아주 우수한 관내 실험방법으로 생각된다. Purpose: The authors tried to make useful in vitro artificial ischemia model using organotypic cultures of the rat hippocampus and anoxic chamber for the study of the mechanisms of ischemic neuronal injury. Materials and Methods: Hippocampal slices were prepared from 4 to 7 day old neonatal Sprague-Dawley rats by removing the brain, dissecting the hippocampal formation and making transverse slices(400-500 ㎛) using a tissue slicer. Individual slices were transferred onto the transparent Acocell interface membranes with the growth medium and grown at 36.5℃ in atmosphere with 90 to 100% humidity and 5% CO2 for 2 weeks. The cultures were transferred into an anoxic chamber at 36.5℃ for 35 minutes. The first imaging of the cultures, following the ischemic insult, was done after 48 hours of incubation with propidium iodide. Forty eight hours after the initial ischemic insult, the remaining neurons were killed by exposing the cultures to 3 hours of anoxia. The fluorescent intensity associated with 100% damage to CA1 was then determined and compared to the fluorescent intensity following the original ischemic insult. Results: We could make excellent organotypic hippocampal slice cultures which were stable over 2 weeks. Thirty five minutes artificial ischemic insult in the anoxic chamber resulted in 40 to 70% neuronal death in the CA1 of the rat hippocampal slice cultures. The amount of neuronal death was quantified by measuring the propidium iodide fluorescent intensity with the aid of image analysis software. Conclusion: Artificial ischemia model using organotypic cultures of the rat hippocampus was excellent in vitro technique which had retained much of the anatomy, synaptic circuitry as the intact hippocampus, and had eliminated some of the confounding physiologic variables. And this model must be a very important tool for the study of the mechanisms of ischemic neuronal injury.

韓國先史時代의 動物

崔茂藏 建國大學校 人文科學硏究所 1977 인문과학논총 Vol.10 No.-

Since 1940, Quaternary mammalian fossils, such as Elephas primigenius and Bos L. have been known in Hamkyung province by a japanese professor. After 20 years, a larhe amount of mammalian fossile was found with the stone artifacts in Sangwon cave, Jongsung district, Hamkyung province. According to researcher(1970) a total of 7 ordors, 17 families, 22 genera and 28 species were recognized in the fauna which was considered to be of early middle pleistocene age. The presence of Microtus sangwo-nensis, a characteristic Rodentia of the Sangwon cave, may correspond with the age of Locality 13 of Choukoutien in China. In the same region there is one another cave fauna is found in cave deposit at Chungchung am(Early late pleistocene age) and Hai sang kun(Hwanghai province, late pleistocens age). These three groups of this pleistocene fauna are indicated by a tropical or subtropical type. This faunistic association points to a milder and damper climatic than the present one. Compared with the chinese faunas, the middle and late pleistocene mammalian fauna of Korea is different, in general character, from Loc.13 of Choukoutien, Tingtsun, Upper cave of Choukoutien. During the neolitic age, Bronze age and Iron age the mammalian fauna of 7 ordors, 17 families, 29 genera and 37 species(sub-species)were recognized. In neolithic fauna there is certain southern forms(La faune chaude), such as Bubalus. Ursus srctos L. and Cervus elaphus L. survived from Early paleolithic to Iron age. Canis familiaris L. and Sus scrofa domestica were already domesticated during the neolithic age. 22 species of working bone and antler were also present from Neolithic age to Iron age. According to the whole fauna the climate of pleistocene and holocene age did not change remarkably. In conclusion I insist that we must restudy the stratigraphic sequence, plants, molluscs, stone industries and human skeletons in order to understand more certain prehistoric climate and culture.

임진강 유역 연천 원당리 A지구에서 채집된 구석기시대 석기연구 : 한국선사시대 석기제작 과정 연구

최무장 건국대학교 인문과학연구소 2000 인문과학논총 Vol.34 No.-

후기 홍적세 몽고인종의 이주

최무장 건국대학교 1996 學術誌 Vol.40 No.1

The era modern man began around 50,000 years ago. The primitive man of that time possed char-acteristics almost identical with present-day man. In anthropological terms, this primitive man and man of today are both referred to as Homo Sapi-ens Sapiens, or "advanced sapiential man. Between 50,000~10,000 years ago, man was already spread out over the continents of Asia, Europe, Africa and Oceania, and ethnic a land bridge emerged between Asia and America and a race yellow people(Mongoloid races) had gone across it in pursuit of the wooly mammoth. These were the ancestors of the American Indians. Somewhere about 30,000 year B. C. Mongolian races had acrossed Bering strait after the retreat of the ice(Late pleistocene) and thus entered the Americas, previously without hominid inhabitants. Mongoloid caracteristics are straight usually black hair, scanty beards flattish faces and slanted, almond-shaped eyes. Their main area is that of Central asia, China, Korea, Japan, but also extend south to Malaysia and Indonesia. Some scholars believed that the original American Indians, both north and south, were Mongoloid. In Cina, many paleolithic archaeological sites have been discovered, but not many have yielded human fossi remains. Of the few where touch remains have been discovered the Liuking Man(柳江人) and Upper cave Man(山頂洞人) sites have yields the best preserved specismens. The humains discovered at the Upper Cave belong to eight individuals. The skulls belong to one man and two women. The Anthropologist F. Weidenreich of the United States held that the skull of this rather old man was a member of a primitive Mongolian race, and one female skull was of Melanesoid type, the other Eskimoid, and all these of one family. A Chinese anthropologist Wu Xingzhi(吳新智), studing a fairly authentic replica of Upper Cave Man reconstructed by Hu Chengzhi in the late thirties, concluded "Upper Cave Man" represent the primitive Mongoloid type and is closely related to the ancestor of Modern Chinese, Eskimo and American Indians though there are still some typical Mongolian characters not yet well developped at that time. Upper Cave Man was dated 18,000 years B. P. by carbon 15. It represent the development haracter and begun long before then. The origin man and his culture is an extraordinarily complicated subject. A point of particular in-terest is that two incisors of the Yunanmou Man(元謀人) have deep shovel lingual of Pekin Man's teeth, pointed out in the 1930 s the kinship of this early genus to the modem Monogilian race. This act has attracted the attention of many other scholars too, as shovel-shape upper incisiors are a dominant characteristic of the modern Mongolians. This is a feature especially obvious and prominent with omo fossils in China. Since Liukiang Man is now believed to be the earliest representative of Homo Sapiens known in ast Asia and a genus which had undergone a process of diffusion, then what is his relation to Upper Cave Man, who was also in the process of evolving into Homo Sapiens at time ? What I have presented in this paper represents only the level of understanding attained up to the present, and many problems await to be settled by more discoveries and farther research.

고구려 산성의 건축구조 연구

최무장 건국대학교 1997 學術誌 Vol.41 No.1

The mountain fortress wall of Koguryo is more than 100 sites in Liaoning and Kilin area in southeast China. It was constructed a ridge of mountain or on the mountain cliff. It situated along the river in the front and was behind the mountain. The mountain Fortress wall was contsructed of the stone of granite and aqueous rock. The type of the mountain fortress wall was oval, circular and rectangular. It includes a main gate, a seal casteled wall(pottery shaped wall), horse's face(it protects to main wall), comer building, a reservoir water and a drainging pipe. People of Koguryo created them. The technique of the construction of mountain fortress wall of Koguryo was the development in the world. Because people of Koguryo went to whereever to construct the mountain fortress wall what they want. It was divided into three size of the dimension as grand, middle and small. The grand was to be main, middle and small were as subsidiary. The age of the mountain fortress wall was divided into three period : 1) The begining of construction of Koguryo kingdom to Kuk-buk Sin Seng(國北新城), from 266 years to 276 years A. D. 2) King chang-su made 次at the capital moved From Kuk-nae Seng(國內城) to Pyongyong, from 267 years to 427 years A. D. )) After the capital was moved at Pyongyang to construct the Koryo Chang Seng(高麗長城), from 427 years to 628 years A. D. (After a reign of King Yonglieu 14 years).

新發見의 中國 舊石器文化

崔茂藏 건국대학교 사학회 1982 建大史學 Vol.6 No.-

전종인대 및 섬유륜 결핍시 요추간판탈출증 수술중 발생한 혈관손상의 기전

김동호,이무섭,민경수,이철 충북대학교 의과대학 충북대학교 의학연구소 1998 忠北醫大學術誌 Vol.8 No.2

연구목적 : 본 교실에서는 증상이 심한 요추간판탈출증 환자의 수술시 제4-5요추간, 제5요추-제1천추간에서 다량의 수핵을 제거하면서 우측 장골동맥 및 정맥의 혈관 손상이 의심되어 즉시 일반외파에서 개복술 후 이에 대한 혈관 재건술을 시행하면서 전종인대 및 섬유륜의 선천성 결핍이 인지되었던 희귀례를 경험하고 문헌고찰과 함께 동물실험을 통해 그 간접적 기전을 이해하고자 하였다. 대상 및 방법 : 토끼 5마리에 Ketmine 및 xylazine 마취후 개복한 다음 전종인대 및 섬유륜을 인위적으포 부분결핍상태를 만들고 결핍된 부위에서 지혈클립으로 대정맥에 표시를 하고 상처를 닫는다. 이틀후 토끼를 ketamine 및 xylazine 마취후 후궁절제술 체위로 놓고 정중선 피부절개후 척추주변근육을 젖히고 일측 후궁절제를 시행하고 경막을 견인하면서 후종인대에 십자절개를 가하고 수핵을 제거할 때 추간판강내에 음압이 털리는 지 관찰하였다. 결과 : 초기에 수핵제거용 감자로 조작할 때 구멍이 작은 동안은 계속 음압이 걸렸고 구멍이 커지면서 음압이 간헐적으로 걸렸다. 토끼 2마리에서 다량의 수핵제거후 지혈클립의 일부가 추간판강내로 후방이동을 보였고 3마리의 토끼에서는 지혈클립이 추체에 밀착되는 후방이동을 보였다 결론 : 선천적으로 전종인대나 섬유륜의 결핍이 있는 상태에서 복와위에서 다량의 수핵제거시 체위에 의한 압박 및 수핵제거용 감자 조작시 음압발생에 의해 복강내 구조물의 후방이동이 있을 수 있고 이 경우 수핵제거용 감자의 위치가 추간판강내에 있다하더라도 주요 혈관들의 손상을 초래할 수가 있다 Purpose : The authors report a case of severe multiple lumbar disc hernias in a 38years old woman, developed a complication of vascular injuries after meticulous discectomy. The operator performed the discectomy confirming the intradiscal space, feeling vertebral bodies up and down with pituitary forced. During the surgery any significant bleeding was not detected from the operative wound site. At the time of closure, the hypotension below 50 mmHg in systolic pressure was reported by anesthesiologist. Immediately we asked the general surgeon to do laparotomy for confirmation of vascualr injuries and repair them. The general surgeon suggested congenital defect of the anterior longitudinal ligament from the point of actual operative situation. We tried to elucidate the possible causes of vascular injuries even within intradiscal manipulation through the animal experiments. Materials and Methods : Artificial defects of the anterior logitudianl ligaments were made in five rabbits. Then we measured the movements of the vascular structures and changes in the intradiscal pressure during discectomy. Results : We failed to measure the absolute intradiscal pressure during discectomy with micropituitary forceps because the sensor was inserted tightly into the disc space and pressured by vertebral body. However, we confirmed some decrease of intradiscal pressure during discectomy in all rabbits. We applied a hemoclip in a great vein just in front of the defect of ligament. We took roentgenograms in erect and prone Position to show the hemoclip moved into intradiscal space or very close to the defect Conclusion : We concluded that vascular injuries can be resulted in a patient of lumbar disc hernia with congenital defect of anterior longitudinal ligament even though the surgeon performed meticulous discectomy within the disc sapce. We may need to study and detect the congenital defect of anterior longitudinal ligament preoperative.ly

뇌출혈로 내원한 성인 모야모야병 환자에서 응급 혈종제거술과 Encephalo-duro-arterio-synangiosis: 1예 보고

민경수,이무섭,김영규,김동호 충북대학교 의학연구소 2001 忠北醫大學術誌 Vol.11 No.2

출혈성 성인 모야모야병 환자에서 이상적인 치료법에 대하여 아직 많은 논란이 있으나 근본적으로는 허혈성 질환이며 이로 인해 뇌기저부 등에 측부혈관들이 발달하게 되고 여기에 발생한 미세동맥류나 측부혈관에 미치는 혈류역학적 과부하가 출혈을 일으킨다는 점에서 볼 때 허혈을 개선시키기 위한 수술적 요법이 재출혈을 예방하는 효과가 있을 것으로 판단된다. 저자들은 우측의 심한 뇌출혈로 내원한 43세 여자 모야모야병 환자에서 응급 혈종제거술과 동시에 encephalo-duro-arterio-synangiosis(EDAS)시술을 시행하여 양호한 치료결과를 얻었기에 문헌고찰과 함께 보고하며 향후 수술 시기나 방법 등에서 치료결과를 최적화하기 위한 연구의 필요성을 제기하고자 한다. There are many controversies over ideal treatment methods for adult hemorrhagic moyamoya disease, but because it is basically an ischemic disease leading to formation of collateral vessels and microaneurysms or hemodynamic stress on collateral vessels cause hemorrhage, revascularization procedures to improve ischemia seem to be effective in prevention of rebleeding. The authors report on good result of emergency hematoma evacuation and concurrent encephalo-duro-arterio-synangiosis(EDAS) in a 43-year-old woman moyamoya disease patient presented with massive intracerebral hemorrhage in the right hemisphere and suggest the necessity of further study to optimize the treatment result especially in regard to timing and specific methods of revascularization procedure.

만성 경막하혈종의 단순 천공 배액술후 재발 및 두개강내 합병증 발생과 관련된 요인

김영규,민경수,이무섭,김동호,복원길,홍석기,김호재 충북대학교 의학연구소 2001 忠北醫大學術誌 Vol.11 No.2

연구목적: 만성 경막하혈종은 두개골 천두술및 혈종배액으로 쉽게 치료될 수 있는 예후가 양호한 질환으로 알려져 있으나, 혈종의 재발 및 합병증이 드물지 않게 발생하기도 한다. 본 연구는 두개골 천두술 및 혈종배액으로 치료받은 102예의 만성 경막하혈종 환자들을 분석하여 혈종의 재발 및 수술후 합병증과 관련된 요인들을 분석하고자 하였다. 대상 및 방법: 만성 경막하혈종으로 진단되어 두개골 천두술 및 혈종배액술법으로 본원 신경외과에서 수술치료받은 102명의 환자를 대상으로 하였고, 입원진료기록 및 방사선소견을 후향적으로 분석하였다. 재발 및 합병증의 발생과 관련된 요인으로는 수술전 환자의 나이, 의식상태, 양측성여부, 뇌실질의 위축정도, 수술후 기뇌의 양, 전신질환여부에 대하여 분석하였다. 결과: 재발의 빈도는 9.8% 였으며 재발과 관련된 요인으로는 양측성, 고령, 수술후 뇌실질재팽창정도(뇌 실질위축, 잔여수액, 기뇌)가 관계가 있었으나 환자의 예후에는 영향이 없었다. 합병증의 종류에는 수술후 급성출혈 5예 및 경막하 농양 1예가 있었으나 이는 모두 출혈성전신질환 또는 면역결핍증이 동반된 환자에서 발생하였고 예후가 불량하였으며, 긴장성 기뇌가 1예발생 하였다. 결론: 전신질환의 동반여부가 합병증의 발생 및 환자의 예후에 가장 중요한 영향을 미쳤으며, 비록 예후에는 영향이 적으나 혈종의 재발의 빈도가 드물지 않으며 기뇌의 방지 및 배액방법의 개선으로 재발의 빈도를 줄일 수 있을 것으로 생각된다. Purpose : Most of chronic subdural hematomas(SOH) are amenable disease with simple cranoistomy drainage, but the recurrence of SDH or development of complications after surgery is not uncommon. To see the prognostic factors related to outcome the recurrence of chronic subdural hematoma and development of complication were analysed in 102 cases of chronic SDH after craniostomy drainage. Materials and Methods: We studied 102 chronic SDH patients treated with craniostomy drainage. Clinical and radiological records were reviewed retrospectively. We analysed the recurrence and complication rate, factors related to the development of recurrence and complications. Results: The rate of recurrence of chronic SDH was 9.8% and factors related to recurrence were bilaterality, old age, and postoperative intracranial environments for brain reexpansion(degree of brain atrophy, amount of residual fluid, amount of intracranial air). Intracranial complications after surgery were developed in 7 cases(6.9%), 5 postoperative bleedings, 1 tension pneumocephalus, 1 subdural empyema. Conclusion : Preoperative clinical condition and association of serious sytemic disease were of major importance in prognosis. The recurrence of chronc SDH was not uncommon, Even though the recurrence was not related to the outcome, great care should be paid on the patients with high risk group.

소뇌연수열 박리를 이용한 상부 뇌교종양의 절제 : 증례보고 a case report

김영규,민경수,이무섭,김동호,김호재 충북대학교 의과대학 충북대학교 의학연구소 2003 忠北醫大學術誌 Vol.13 No.2

뇌교 및 연수에서 발생한 병변은 뇌간에 중요한 신경구조물들이 밀집하여 수술적 적출에 따르는 심각한 신경학적 장애가 발생할 가능성이 매우 높다. 병변이 제 4뇌실 전방에 위치한 경우는 제 4 뇌실바닥을 통하여 뇌간조직을 절개하여야 하므로, 이 부위의 해부학적인 이해와 수술적 접근방법을 알고있어야 신경학적 손상을 최소화 할 수 있다. 저자들은 상부뇌교에서 발생한 낭성 양성 신경교종을 적출하기 위하여 소뇌충수를 보존하면서 좌측 소뇌연수열 접근법으로 제 4 뇌실바닥 상부까지 노출할 수 있었으며, suprafacial triangle을 절개하여 신경학적 후유증 없이 종양을 성공적으로 절제할 수 있어 증례보고와 함께 제 4 뇌실바닥 노출 방법의 하나인 소뇌연수열 접근법과 제 4 뇌실바닥 수술적 절개와 해부학적 특성에 대한 문헌 고찰을 하였다. Surgical removal of brain stem pathology causes high risks for neurologic deficits because of compact aggregation of important neural structures and complex anatomy. For the removal of pathologies which are located anterior to the floor of fourth ventricle in the brain stem, exposure of variable extents of the floor of fourth ventricle and incision of rhomboid fossa are necessary. In order to minimize postsurgery neurologic sequale for the removal of these pathologies, understanding of anatomy and surgical approach is very important. Authors successfully removed upper pontine benign cystic glioma by trans–medullary fissure approach without vermian incision to exposure floor of fourth ventricle and by incision of suprafacial triangle of rhomboid fossa without causing further neurologic deficit. Surgical technique of transcerebellomedullary approach and surgical anatomy of rhomboid fossa are discussed with report of a surgical case.