• The Korean Journal of Physiology
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• 제25권2호
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• pp.211-221
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• 1991

Although the existence of nerve cells which determine the activity of sympathetic nervous system in ventrolateral medulla is advocated recently, there are wide varieties on the location and function of them according to authors. Present study aimed to identify and characterize the medullospinal tract cells in rostral and caudal medulla of cats .which branch to the lateral horn of the upper thoracic spinal cord. Cats were anesthetized with ${\alpha}-chloralose$. The upper thoracic spinal cord and floor of the IVth ventricle were exposed. Medullospinal tract cells in rostral and caudal medulla were identified by anti-dromic stimulation of the intermediolateral nucleus in the upper thoracic cord and then the location and physiological characteristics of these cells were studied. A total of seventy cells in medulla had constant latency and responded to high frequency stimulation to thoracic cord. Among them fifty-six cells were identified as medullospinal tract cells either by collision with spontaneous activities or activities evoked by sciatic nerve stimulation(27/56), or by determining the refractory period (29/56). Thirty-one of these cells branched to the contralateral thoracic spinal cord, twenty-one cells to the ipsilateral side and remaining four cells branched to both sides. The conduction velocity of cells branching to the contralateral side was $29{\pm}2.9\;m/sec$ and that of cells to the ipsilateral side was $39.1{\pm}6.0\;m/sec$. When medulla was devided into two by a horizontal plane at 3 mm rostral to the obex, fifty-one among seventy cells were in the rostral medulla and nineteen were in the caudal medulla. The conduction velocities of these two groups were $21.6{\pm}1.0\;and\;33.3{\pm}3.9\;m/sec$, respectively. In this study, we confirmed the existence of two groups of medullospinal tract cells in rostral and caudal ventrolateral medulla, which branch to the lateral horn of thoracic cord and these cells have relatively few spontaneous activities and rapid conduction velocity, so we concluded that these cells are different from the previously known sympatho-related cells in ventrolateral medulla.

• 대한수의학회지
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• 제35권4호
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• pp.671-681
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• 1995

This study was attempted to investigate the topographical distribution, shape and immunoreactivity of growth hormone-releasing factor(GRF)- and somatostatin(SOM)-immunoreactive neurons in the hypothalamus of the Korean squirrels(Sciurus vulgalis coreae). For the light microscopical examination of immunohistochemistry, the brains were fixed with 4% paraformaldehyde solution by means of intracardiac perfusion. And the frozen sections($40{\mu}m$ thick) were stained immunohistochemically by ABC method. Distribution of GRF immunoreactive neurons($12-17{\mu}m$) was highest in the paraventricular nucleus, moderate in the periventricular and supraoptic nuclei, and low in the arcuate nucleus and lateral hypothalamic area. Their immunoreactive fibers were found very high in the median eminence, moderately in the supraoptic, paraventricular and periventricular nuclei, and low in the arcuate nucleus and lateral hypothalamic area. SOM immunoreactive perikarya($14-18{\mu}m$) were found moderately in the periventricular nucleus near the subependymal layer of the third ventricle, and low in the arcuate and suprachiasmatic nuclei. SOM immunoreactive fibers were found high in the median eminence, and moderately or low in the arcuate and periventricular nuclei.

• Journal of Chest Surgery
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• 제31권5호
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• pp.472-480
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• 1998

서울대학교 어린이병원 흉부외과에서는 1990년부터 1996년까지 104례의 기능적 단심실을 가진 선천성심기형 환아에 대하여 심장내 외측통로술을 이용한 완전폰탄술을 시행하였다. 환아의 연령 및 체중분포는 각각 평균 35.9(범위 10-72) 개월, 12.8 (범위 6.5-37.8) kg이었다. 술전진단은 삼첨판폐쇄증(18), 단심실연결을보이는 중복개구심실(53) 및 기타 기능적 단심실을 동반한 복잡심기형(33)이었다, 50례의 환아에 대하여 체폐동맥 단락술 (37), 폐동맥밴딩(13), 외과적 심방중격절제술(15), 동맥전환술(2), 대동맥하 누두부제거술(2), 총폐정맥이상연결증(2), 폐동맥-대동맥봉합술(Damus-Stansel-Kaye, 1) 등의 고식술이 시행되었다. 완전폰탄술식전 19례의 양방향성 체정맥-폐동맥단락술과 1례의 전(全)체정맥-폐동맥단락술(Kawashima procedure)이 진행되었다. 술전 혈역학소견상, 평균 폐동맥압/폐혈관저항은 14.6 (범위 5-28mmHg) / 2.2 (범위0.4-6.9)wood.unit였으며, 폐혈류/체혈류비가 평균 0.9 (범위0.3-3.0)였다. 이완기말심실압은 평균 9.0 (범위 3.0-21.0) mmHg였고 동맥혈의 산소포화도는 평균 76.0 (범위 45.6-88.0) %였다. 수술은 분계능(terminal crest) 2cm 외측으로 우심이부터 우심방-하공정맥경계부에 종절개를 가하고 하공정맥개구부부터 상공정맥개구부 또는 우심이까지 Gore-Tex 인조도관을 이용하여 외측통동을 형성시키는 방법으로 시행하였으며 필요한 경우 통로상에 4-5.5 mm 직경의 구멍을 만들어 주었다. 동시에 시행한 술식은, 폐동맥성형술(22), 심방중격절제술(21), 폐정맥이상연결증 교정(4), 영구적인 인공심박동기거치(3) 등이었고, 32례에 대하여 통로내 구멍을 만들어 주었으며 그중 1례는 조절형(adjustable)으로 시행하였다. 심방-폐동맥 연결 방법으로 시행한 폰탄술 후 4년후에 발생한 재발성 난치성 상심실형 부정맥환아 1례에 대하여 외측통로형의 변환 폰탄술식이 시행되었다. 수술 직후 혈역학 소견상 평균 폐동맥압, 이완기말심실압, 실온에서 동맥혈의 산소포화도가 각각 12.7 (8-21)mmHg, 7.6 (범위4-12)mmHg, 89.9 (범위68-100) %였다. 병원사망율은 6.7 (7/104) %였고 술후 합병증으로 지속적인 늑막삼출(11), 부정맥(8), 유미흉(9), 중추신경계손상(5), 감염 및 염증(5), 급성신부전(4)이 발생하였다. 평균 27.2 (범위1-85) 개월동안의 외래 추적결과 5명의 만기 사망이 있었다. 저자등은 본연구결과를 토대로 심장내 외측통동폰탄술식이 기능적 단심실 환자에 대하여 비교적 낮은 사망율 및 합병증과 우수한 혈역학으로 시행될수 있는 수술방법이란 사실을 입증하였다.

• 대한약리학회지
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• 제16권2호
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• pp.1-7
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• 1980

As it has been reported that morphine induce antidiuresis, and antinatriuresis along with decrease in renal hemodynamics when given intracerebroventricularly[ivt], the renal action of nalorphine, a partial antagonist of morphine action, and its influence upon the morphine action were investigated in this study. $10{\mu}g/kg$ of nalorphine given into the lateral ventricle of the rabbit brain tended to decrease renal plasma flow and glomerular filtration rate and increase the reabsorption of free water in the tubules. $100{\mu}g/kg$ ivt significantly decreased urine flow rate and increased free water reabsorption, and tended to increase electrolyte excretion in spite of decrease in renal plasma flow and glomerular filtration, suggesting that ADH also involved in the antidiuresis. Morphine hydrochloride, $10{\mu}g/kg$, ivt, produced marked decrement in renal hemodynamics along with decreased excretions of sodium, potassium and water, and these morphine actions were alleviated by nalorphine given 20 min later. The natriuretic action of ivt nalorphine manifested itself uninfluenced by the morphine. These observations indicate that nalorphine ivt produces renal actions similar to those of morphine, though less potent, and that it can antagonize the latter action. It is suggested that morphine influences renal hemodynamics through nerve by stimulating the 'morphine receptor' in the brain, whereas nalorphine liberates ADH by the agonistic action on the 'nalorphine receptor'.

• 대한수의학회지
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• 제42권3호
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• pp.429-436
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• 2002

Hydrocepbalus may be an acquired or a congenital condition. We have studied the macroscopic and microscopic changes in the hydrocephalus of an inbred Sprague-Dawley rat at postnatal week 8. The animal suspected with the hydrocephalus showed clinical syndromes such as depression, severe ataxia, eye abnormalities, dome-shaped head, and persistent fontanelle. With the postmortem examination, the suspected animal was clearly revealed as a severe internal hydrocephalus. In this animal, severe ventriculomegaly was limited to the third and lateral ventricles, and cortical thining was most apparent in the parieto-occipital region. With the routine histological examination, brain tissue showed aqueductal obstruction, thinning of the cerebral cortex, severe ependymal damage, subependymal edema, damage of choroid plexus of fourth ventricle, enlarged cortical vessels, and expanded ventricles. Aqueductal obstruction was observed with the appearance of simple stenosis at the level of rostral colliculus. Subsequently, the other structures of brain such as septal nucleus, caudate nucleus, and hippocampus etc. were abnormally reconstructed by hydrocephalus. This study suggests that the hydrocephalus can be taken place by primary aqueductal obstruction and this type of hydrocephalus is classified as uncommunicating type. Though the mechanism of aqueductal obstruction is not clear, the morphological studies of this case may be helpful for the further study of hydrocephalus.

• 대한약리학회지
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• 제12권1호
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• pp.31-44
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• 1976

It has been reported that many of the effects of digitalis glycosides could be mediated partly through the central nervous system. In this study the effects of ouabain given directly into the lateral ventricle of the brain on the renal function of the rabbit were investigated. Intraventricular ouabain elicited antidiuresis in doses ranging from 0.1 to $3\;{\mu}g$, exhibiting a rough dose-response relationship, and decreased the renal plasma flow, glomerular filtration rate and urinary excretion of sodium and potassium, concomitant with the decrease of urine flow. These decreases in urine flow, excretory rate of electrolytes significantly correlated with the decrease in renal plasma flow or glomerular filtration rate, suggesting that the antidiuresis might have been induced by the hemodynamic changes. Intravenous ouabain in a dose of $1\;{\mu}g$ did not affect the renal function. Systemic blood pressure as well as cardiac activity was not affected by the intraventricular ouabain. Effects of the intraventricular ouabain on renal function were abolished by the intravenous phentolamine-pretreatment but not affected by intraventricular phentolamine-pretreatment. Neither vasopressin infusion nor hydration did affect the renal effects of intraventricular ouabain. From these observations, it is suggested that the antidiuresis of intraventricular ouabain is induced by the increased sympathetic influence to the kidney.

• 보험의학회지
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• 제2권1호
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• pp.245-252
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• 1985

Ultrasonographic examination in the obstetrics not only makes easy of the diagnosis of Hydrocephalus, placenta previa, anencephalus and ectopic pregnancy, etc, but also guaranteed its excellence in the diagnosis of women gynecology disease. Especially in case that it doesn't affect radiation hazard on the embryo, its efficiency keeps increasing and it is spotlighted to many clinic doctors. Even though in general hospital we often observe congenital hydrocephalus in Med. Dept. which entirly undergoes the medical examination to the insured, we don't observe even the women delivered with child and it is very difficult to find a rare congenital hydrocephlus throughout other present insurance companies. We inspected a congenital hydrocephalus, which other medical equipments of present insurance companies have many difficulties in the medical examination, accompanied by meningoencephalocele by ultrasonic diagnosis. We analyzed and compared the data by ultrasonic diagnosis with that of surgical diagnosis and the results are follows; 1) We could correctly describe meningoencephalocele by ultrasonic diagnosis. 2) It was able to be diagnosed in LMP 22 weeks. 3) BPD has about 10 mm higher than normal value in LMP 22 weeks. 4) Dilatation of lateral ventricle was observed in LMP 22 weeks. 5) As paralled with ultrasonic diagnosis in pregnancy medical examination, accepting declines including the risk rate can be restrained.

• Journal of Yeungnam Medical Science
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• 제5권2호
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• pp.175-181
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• 1988

임상적으로 뇌압 항진 소견을 보여서 시행한 뇌전산화 단층 촬영상 뇌수두증이 확인되어 뇌실 복막간 단락술을 시행하였으나, 단락 도관 기능 부전증이 크립토코스 뇌실염에 의해 초래된 것이 조직학적 검사로 확인된 한 예를 문헌 고찰과 함께 보고하는 바이다.

• Journal of Korean Neurosurgical Society
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• 제42권3호
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• pp.173-178
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• 2007

Objective : Hydrocephalus is one of the major complications following spontaneous subarachnoid hemorrhage (SAH). However, the risk factors of the hydrocephalus after SAH are not still well known. This study was focused on verification of the causal relationships between the development of hydrocephalus and SAH. Methods : The patients who developed hydrocephalus after rupture of aneurysms were studied. To obtain prognostic factors regarding to hydrocephalus, several parameters such as age, sex, hypertension, location of aneurysm, existence of intraventricular hemorrhage (IVH) and intracerebral hemorrhage (ICH), Glasgow coma scale (GCS), Hunt-Hess SAH classification & Fisher Grade on admission and the ratio of frontal harn of lateral ventricle diameter to skull inner table diameter at this level (FH/ID) were studied retrospectively. Results : The development of hydrocephalus following SAH is multifactorial. The age, IVH, FH/ID ratio were related to hydrocephalus in analysis. There is a low clinical correlation between sex, hypertension, location of aneurysm, existence of ICH, GCS, Hunt-Hess SAH classification, Fisher Grade on admission and hydrocephalus. Conclusion : Knowledge on risk factors related to the occurrence of hydrocephalus may help guide neurosurgeons in the long-term care of patients who have experienced aneurysmal SAH.

• Journal of Korean Neurosurgical Society
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• 제57권1호
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• pp.50-53
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• 2015

Usually fungal infections caused by opportunistic and pathogenic fungi had been an important cause of morbidity and mortality among immunocompromised patients. However clinical data and investigations for immunocompetent pathogenic fungal infections had been rare and neglected into clinical studies. Especially Cryptococcal brainstem abscess cases mimicking brain tumors were also much more rare. So we report this unusual case. This 47-year-old man presented with a history of progressively worsening headache and nausea for 1 month and several days of vomituritions before admission. Neurological and laboratory examinations performed demonstrated no abnormal findings. Previously he was healthy and did not have any significant medical illnesses. A CT and MRI scan revealed enhancing $1.8{\times}1.7{\times}2.0$ cm mass lesion in the left pons having central necrosis and peripheral edema compressing the fourth ventricle. And also positron emission tomogram scan demonstrated a hot uptake of fluoro-deoxy-glucose on the brainstem lesion without any evidences of systemic metastasis. Gross total mass resection was achieved with lateral suboccipital approach with neuronavigation system. Postoperatively he recovered without any neurological deficits. Pathologic report confirmed Cryptococcus neoformans and he was successively treated with antifungal medications. This is a previously unreported rare case of brainstem Cryptococcal abscess mimicking brain tumors in immunocompetent host without having any apparent typical meningeal symptoms and signs with resultant good neurosurgical recovery.