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정상아 및 소아 뇌막염환자의 뇌척수액당량과 혈당량과의 관계에 관한 연구

Title
정상아 및 소아 뇌막염환자의 뇌척수액당량과 혈당량과의 관계에 관한 연구
Other Titles
Study of the relationship between glucose level in cerebrospinal fluid and in blood of normal children and patients with mening
Issue Date
1971
Publisher
연세대학교 대학원
Description
의학과/석사
Abstract
[한글] STUDY OF THE RELATIONSHIP BETWEEN GLUCOSE LEVEL IN CEREBROSPINAL FLUID AND IN BLOOD OF NORMAL CHILDREN AND PATIENTS WITH MENINGITIS Jae Seung Lee Department of Medical Science, The Graduate School Yonsei University (Directed by Prof. Duk Jin Yun) Meningitis, despite the development of effective antibiotics, is still a disease of high mortality and morbidity in pediatrics (Light, 1967). It is a disease attracting a great deal of attention by pediatricians. Sometimes meningitis in childhood shows atypical clinical symptoms and signs. The occurrence of bacterial meningitis in the neonatal period and infants creates special problems in early diagnosis, because the signs of meningeal irritation are often minimal or nonexistent (Weliman, 1967). Examination of the spinal fluid is the only method for immediate confirmation of the diagnosis of meningitis. One of the most characteristic abnormalities of cerebrospinal fluid in patients with bacterial and tuberculous meningitis is a decrease in glucose content (Menkes, 1969). Even though the reading of the cerebrospinal fluid may be abnormal (i.e. below 40mg%) no definite diagnosis can bemade by this examination alone. Futhermore in general practice the clinical symptoms and laboratory data are often obscured because of the indiscriminate use or poor administration of antibiotics. Studies were carried out on 58 meningitis patients and 33 normal or non-meningitis patients as control whose age ranged from birth to 15 years old divided into 4 experimental groups as follows: Group Ⅰ. normal or non-meningitis patients………… 33 cases Group Ⅱ. purulent meningitis patients…………………20 cases Group Ⅲ. tuberculous meningitis patients…………… 30 cases Group Ⅳ. aseptic meningitis patients……………………8 cases Spinal tapping was performed before treatment in all patients. The glucose concentration was measured by Nelson-Somogyi micromethod (Nelson, 1944, somogyi, 1945). The following results were obtained: 1. Blood glucose concentration in all experimental groups was around 86 mg%.. 2. Glucose concentration of cerebrospinal fluid was normal in group Ⅳ as compared to 55.73±2.23 mg% in group Ⅰ but was significantly decreased to 18.28±2.00 and 24.61±2.03 mg% in group Ⅱ and group Ⅲ, respectively. 3. In group Ⅰ glucose concentration of cerebrospinal fluid and blood was closely related (r=0.755) but in group Ⅱ, Ⅲ and Ⅳ the relationship was markedly dissociated. 4. The ratio of glucose concentration of cerebrospinal fluid to that of blood was 0.65±0.01 in group Ⅰ, 0.22±0.02 in group Ⅱ, 0.28±0.01 in group Ⅲ and 0.64±0.02 in group Ⅳ. On the basis of the above results it may be concluded that the glucose concentration of cerebrospinal fluid in meningitis is a good index of diagnosis and the relationship between blood and cerebrospinal fluid glucose concentration can be a helpful index for its diagnosis as well.
[영문] Meningitis, despite the development of effective antibiotics, is still a disease of high mortality and morbidity in pediatrics (Light, 1967). It is a disease attracting a great deal of attention by pediatricians. Sometimes meningitis in childhood shows atypical clinical symptoms and signs. The occurrence of bacterial meningitis in the neonatal period and infants creates special problems in early diagnosis, because the signs of meningeal irritation are often minimal or nonexistent (Weliman, 1967). Examination of the spinal fluid is the only method for immediate confirmation of the diagnosis of meningitis. One of the most characteristic abnormalities of cerebrospinal fluid in patients with bacterial and tuberculous meningitis is a decrease in glucose content (Menkes, 1969). Even though the reading of the cerebrospinal fluid may be abnormal (i.e. below 40mg%) no definite diagnosis can bemade by this examination alone. Futhermore in general practice the clinical symptoms and laboratory data are often obscured because of the indiscriminate use or poor administration of antibiotics. Studies were carried out on 58 meningitis patients and 33 normal or non-meningitis patients as control whose age ranged from birth to 15 years old divided into 4 experimental groups as follows: Group Ⅰ. normal or non-meningitis patients………… 33 cases Group Ⅱ. purulent meningitis patients…………………20 cases Group Ⅲ. tuberculous meningitis patients…………… 30 cases Group Ⅳ. aseptic meningitis patients……………………8 cases Spinal tapping was performed before treatment in all patients. The glucose concentration was measured by Nelson-Somogyi micromethod (Nelson, 1944, somogyi, 1945). The following results were obtained: 1. Blood glucose concentration in all experimental groups was around 86 mg%.. 2. Glucose concentration of cerebrospinal fluid was normal in group Ⅳ as compared to 55.73±2.23 mg% in group Ⅰ but was significantly decreased to 18.28±2.00 and 24.61±2.03 mg% in group Ⅱ and group Ⅲ, respectively. 3. In group Ⅰ glucose concentration of cerebrospinal fluid and blood was closely related (r=0.755) but in group Ⅱ, Ⅲ and Ⅳ the relationship was markedly dissociated. 4. The ratio of glucose concentration of cerebrospinal fluid to that of blood was 0.65±0.01 in group Ⅰ, 0.22±0.02 in group Ⅱ, 0.28±0.01 in group Ⅲ and 0.64±0.02 in group Ⅳ. On the basis of the above results it may be concluded that the glucose concentration of cerebrospinal fluid in meningitis is a good index of diagnosis and the relationship between blood and cerebrospinal fluid glucose concentration can be a helpful index for its diagnosis as well.
URI

http://ir.ymlib.yonsei.ac.kr/handle/22282913/126912
Appears in Collections:
2. 학위논문 > 1. College of Medicine (의과대학) > 석사
Yonsei Authors
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