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切斷性 神經腫痛에 對한 새로운 治療法 : Ⅰ. 實驗的 觀察
沈輔星,金永基,尹金重,崔吉洙 서울대학교 1966 서울대학교 論文集 Vol.17 No.-
In an effort to supress pain from amputation neuroma, the neuroma bearing nerve was transected and re-sutured at various points proximal to the neuroma, and obtained very satisfactory results in eight patients. In this study the unilateral sciatic nerves of dogs and rabbits were severed at three points, each one cm. apart, and resutured, and the opposits sciatic nerves were simply amputated, in order to obesrve the regenerative process of the nerve fibers thorough the cut-resutured lines and formation of neuroma. These experimental animals were observed for two months, and under Nembutal general anesthesia each specimen was removed. For microscopic examination these specimens were stained with hematoxilin-eosin, Trichrom and silver staining methods. Results were as follows: 1. All animals subjected to the experiments developed sings of sciatic nerve palsy. During the observation period of two months, there were no evidence of substantial recovery of the lost function. 2. The proximal stumps of all severed nerves formed neuroma of slight to marked degree and except in two dogs the distal stumps were seen to have formed gliomas. On microscopical sections, many fibers were seen to be growing through the scartissue which occupied 1.5 cm. gap between cut ends. The distal nerve fibers underwent advanced Wallerian degeneration, as expected. 3. There were evidences of active regeneration of axons far beyond the segments, which were severed and resutured in three points at interval of one cm. However, comparing with mother fibers, regenerating daughter fibers were reduced in number and size and their architectures were disorganized, the number of daughter fibers regenerated through third sutured line was reduced to one-third that of original fibers, and the structural completion was less. It is probable that this ratio would be more reduced if the distances between transections were more farther apart, or performed in human