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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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