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이승회,장혁,김요식 圓光大學校 醫科學硏究所 2002 圓光醫科學 Vol.17 No.1
배경: 급성 뇌경색에서 예후와 관계된 믿을만한 예측인자가 있다면 치료전략을 세우는데 매우 유용할 것이다. 그러나 신경학적인 상태의 악화와 관련된 인자 그리고 기전에 대한 연구는 충분하지 않고, 또한 잘 알려져 있지않다. 본 연구는 급성 열공성 뇌경색 환자의 신경학적인 악화와 예측할 수 있는 인자들을 조사하고자 한다. 방법: 열공성 뇌경색이 처음 발생하여 48시간 이내에 병원에 도착한 환자를 대상으로 하였다. 모든 대상환자에서 내원 당일, 발병 3일, 발병 7일째 되는 날 신경학적 검사와 카나다 신경학적척도를 측정하였다. 대상 환자들은 카나다 신경학적 척도에 따라서 진행성과 비진행성으로 분류하였다. 진행성은 발병 7일 이내에 카나다 신경학적 척도가 1점 이상 감소한 경우로 정의 하였다. 대상환자 모두에서 뇌졸중 위험인자를 조사하였고 뇌 자기공명영상을 촬영하였다. 그리고 진행성군과 비진행성군에서 뇌졸중 위험인자와 자기공명영상소견을 비교 분석하였다. 결과: 79명의 환자가 포함기준을 만족하여 연구대상에 포함되었다. 대상환자의 24%가 진행성이었고 76%가 비진행성 뇌경색이었다. 당뇨병과거 HDL 콜레스테롤 환자군이 더 빈번하게 카나다 신경학적 척토의 악화를 보였다. 진행성 환자군에서 비진행성 환자군 보다 뇌경색 위험인자가 많았다. 나머지 다른 위험인자들은 열공성 뇌경색 환자에서 카나다 신경학적 척도의 악화와는 연관이 없었다. 결론: 열공성 뇌경색의 진행성 여부를 예측하는데 있어서 당뇨병, 저 HDL 콜레스테롤 또는 뇌경색 위험인자의 숫자를 이용할 수 있을 것으로 여겨진다. Background: If there were reliable predictors related to prognosis of acute stroke, it would be useful to make therapeutic strategies of acute stroke. But predictors and mechanisms involved in aggravation of neurological status were poorly investigated. The purpose of this study is to find out some predictors related to progression of neurological deficits in the early phase of acute lacunar infarction. Methods: we enrolled first ever lacunar infarction patients who arrived at hospital within 48hours after clinical onset. All patients had neurological examination and were scored with Canadian neurological scale (CNS) on admission and at 3^rd, 7^th day after stroke. We grouped patients into progressive stroke (PS) and non-progressive stroke (NFS) by using CNS score. PS is defined when CNS score decrease more than one point during first 7 days. All patients had laboratory examination and brain MRI. We compared risk factors and MRI findings between PS and NPS. Results: Seventy-nine patients were fulfilled inclusion criteria. Twenty four percents of patients were PS and 76% were NPS. Patients with diabetes mellitus or low high density lipoprotein (HDL) cholesterol showed more frequent worsening of CNS score in early phase than patients without. PS group had more risk factors than NPS group. Other factors are not related to worsening CNS score of patients with lacunar infarction. Conclusion: This study suggests that history of DM, low HDL level and number of stroke risk factor can be possible predictors of progressive lacunar infarction.
척수 손상 흰쥐의 대장에서 테트로드톡신 민감성 억제 신경계의 변화
주민철,이승회,오정택,조향정,박효인,임유현,최석채,이문영 대한재활의학회 2010 Annals of Rehabilitation Medicine Vol.34 No.4
Objective: To investigate the effect of spinal cord injury (SCI) on contractions of whole colonic preparation isolated from rats under the inhibition of nitrergic inhibitory neural system using tetrodotoxin (TTX). Method: Twenty Sprague-Dawley rats were used. A complete spinal cord transection was performed surgically at the T10 cord level in spinal cord injured group. After 1 week of operation, sensory and motor functions were assessed and colon was removed under anesthesia for in vitro motility study. Whole colon was divided into four segments: proximal, two mid colon and distal colon. Each segment of colon was mounted with longitudinal direction in a 10 ml organ bath. After 1 hour of equilibration, frequency, area under the curve of spontaneous contraction and the response to acetylcholine (Ach), KCl and TTX were measured in each segment. Also the responses to Ach and KCl response under TTX pretreatment were measured. Results: Enhanced contractile response to KCl solution (40 mM), TTX (1 μM) and Ach (10−6 M) was observed in both group. There was no statistical difference in spontaneous, Ach and KCl induced contraction between control and SCI rats, but TTX induced contraction was decreased in SCI group than control group (p<0.05). In addtion, the Ach and KCl responses under the TTX pretreatment were significantly decreased in SCI group than control group (p<0.05). Conclusion: These results suggest that the change of colonic contractility after the SCI is caused by at least partly from the change of TTX related inhibitory neural system. (J Korean Acad Rehab Med 2010; 34: 387-393)
흰쥐 전정신경핵에서 전하소뇌동맥의 일시적 폐쇄에 의한 급성초기유전자 단백의 발현
이한샘,한형석,이승회,박성욱,박현영,장혁,김요식,조광호,김민선,최명애,박병림 대한신경과학회 2004 대한신경과학회지 Vol.22 No.4
Background: Anterior cerebellar artery (AICA) occlusion results in vestibular dysfunctions because the AICA supplies the vestibular nuclei (VN) in the brain stem as well as the peripheral vestibular organs in the inner ear. The purpose of this study was to evaluate the expression of immediate-early gene products, a metabolic marker of neural excitation in neurons, by AICA occlusion in the VN of Sprague-Dawley rats. Methods: After chloral hydrate anesthesia all animals were subjected to unilateral AICA occlusion by using a microsurgical clamp for 30 min to induce a transient ischemia. Unilateral labyrinthectomy was chemically undertaken to eliminate vestibular afferent activity. Immunohistochemical staining and image analysis for cFos, FosB, Krox-24, and JunB proteins were performed 2 hours after AICA occlusion. Results: There was a high expression of cFos protein in the bilateral medial and inferior VN 2 hours after AICA occlusion. AICA occlusion induced minimal changes in cFos protein expression in the lateral and superior VN. Mild to moderate expressions of FosB and JunB protein in VN was observed 2 hours after ischemic injury of the brain stem and inner ear. On the contrary, the number of cFos and FosB immunoreactive neurons significantly decreased in the medial vestibular nucleus ipsilateral to the injured labyrinth 2 hours after AICA occlusion in the UL group. Conclusions: These results suggest that ischemic afferent activity from the peripheral vestibular apparatus is essential for the expression of immediate-early gene products in the medial and inferior VN of rats following AICA occlusion.