후두와 뇌병변의 최소침습수술에서 Fibrin Glue의 사용

손은익,김일만,김동원,임만빈 계명대학교 의과학연구소 2000 계명의대학술지 Vol.19 No.1

The posterior fossa surgery(PFS) via lateral suboccipital craniectomy(SOCE) and partial mastoidectomy always has the potential cerebrospinal fluid(CSF) leakage and painful deformity in the suboccipital and retroauricular area. This study describes the efficacy of our mathods for dural closure and cranioplasty to prevent CSF leakage and suboccipital depression respectively after posterior fossa exploration using retrosigmoid suboccipital approaches. This techniques were performed in the consecutive 10 patients who underwent PFS in a park-bench position for different types of lesions. The SOCE and driling of the mastoid process were done minimally. Following intradural works, dura was closed in a watertight manner usually using a graft, thereafter reinforced with GelfoamR and biological human allogenic fibrin glue (GreenplastR). After augmentation of dural suture, opened mastoid air cells were bone-waxed and covered with fat graft by anchoring sutures. For the reconstructive cranioplasty, autologous bone chips and dust obtained at craniectomy were wrapped with SurgicelR. Then it was replaced to the site of suboccipital bone defect and GreenplastR was applied on and around the bone plate. The age of patients ranged from 33 to 61 years. Five cases of hemifacial spasm have been undertaken decompression of the facial nerve and four cases of cerebellopontine angle masses(meningioma, epidermoid, arachnoid cyst, and cerebellar metastasis) were treated by retrosigmoid approach. Computed tomography and plain cranial films taken a few month later showed successful and good appearance of the suboccipital and retromastoid area. All patients made a excellent recovery without any postoperative complications. Preliminary results of up to 10 months show no CSF leakage nor a persistent headache. There was no adverse reactions related to fibrin glue. We think that the present technique is a valuable method to minimize or avoid postoperative CSF leakage and to restore an autologous bone plate in a cranial defect by piecemal craniectomy.

측두엽간질에서 해마경화에 따른 치상회 태상섬유의 형태학적 관찰 - 해마의 수술중 뇌피질파(ECoG) 소견과 비교하여

손은익,김상표,김일만,김인홍 대한신경외과학회 1997 Journal of Korean neurosurgical society Vol.26 No.7

난치성 간질의 최근 수술적 치료

손은익 啓明大學校 醫科大學 1995 계명의대학술지 Vol.14 No.2

흰쥐 중뇌중심회색질내에서의 substance P, neurotensin 및 vasoactive intestinalpolypeptide 함유신경세포 및 축삭종말의 분포

손은익,조희중,홍해숙,주강 대한해부학회 1995 Anatomy & Cell Biology Vol.28 No.1

유산균을 이용한 과메기 산패 억제와 RSM 을 이용한 최적화

손은익,조두민,송예준,조경진,김영목 한국수산과학회 양식분과 2022 한국수산과학회 양식분과 학술대회 Vol.2022 No.5

소혈관기형의 파열에 의한 자발성 뇌내출혈

손은익,추우홍,임만빈,김인홍 대한신경외과학회 1984 Journal of Korean neurosurgical society Vol.13 No.1

Twenty-two patients who had evidence of spontaneous intracerebral hemorrhage in brain computerized tomographic(CT)scan specially with small vascular malformations who were angiographically verified and unknown causes, were reviewed. The majority of patients were in first and second decades of life. The duration of symptoms from onset to admission showed relatively short in verified cases and even distributed from 1 day to 1 month in unknown cases. The most common presenting symptoms and signs were headache, altered consciousness, seizure and paresis in verified cases, and were headache and papilledema in unknown cases. In brain CT scan, variable findings were seen as hematoma with surrounding evidence of vascular anomaly, hematoma only and blood-fluid level in verified cases, and tumor-like findings in unknown cases. The most common site of hematoma were parietal and occipital lobes in verified cases and were parietal and infratentorial area in unknown cases. The results achieved with excision of these cases were good. These small vascular malformations require special attention because of following view-points: 1) their relative frequent cause of intracerebral hematoma ; 2) their variable findings in CT scan; 3) more careful serial angiographical identification of anomalous vessels with subtraction and magnification; 4) their careful histopathological observation of operative specimen.

뇌신경교종의 악성도에 따른 p53 및 c-fos 단백의 발현양상

손은익,이장철,김동원,임만빈,김인홍,이상숙 대한신경외과학회 1994 Journal of Korean neurosurgical society Vol.23 No.4

암은 다단계 과정의 종산물인 것으로 생각되고 있으며, 각 단계에서 특정 암유전자가 중요역할을 하는 것으로 알려져 있다. 이에 원발성 뇌종양인 신경교종의 암화과정에서 c-fos와 p53의 영향을 알아보기위해 면역조직학적 염색으로 c-fos 종양단백 및 비정상적 p53 단백의 발현을 관찰한 결과, c-fos 암유전자의 활성은 종양생성의 초기단계의 분화 및 증식과 연관이 있으며, p53은 종양의 후기단계 및 악성화에 밀접한 관계가 있는 것으로 생각된다. 향후 많은 증례와 다른 암유전자에 대한 연구도 병행함으로서 악성도와 관계된 진단 뿐 아니라 유전자 치료에 대한 접근에도 도움이 될 것으로 사료된다. The epidemiology of cancer has long been suggested that cancer is a multistep disease. We suspect some of these steps might be related with activation of oncogenes and loss of tumor suppressor genes in primary brain tumors. Moreover, recent reports suggest that astrocytomas have shown alterations in chromosome 17p, and this chromosomal location that encodes the p53 protein, as well as c-fos gene may take an important role in the carcirlogeaesis of human primary brain tumors Expression of p53 protein was detected in 12 of 17 cases(70.6X of glioblastoma multiforme, 4 of 6 cases(66.6% of anaplastic astrocytoma with positive nuclear p53 staining All low grade astrocytomas and normal brain tissue failed to express p53. Correlation of p53 protein levels with mRNA alterations or genomic DNA alterations may help to guide future therapy or diagnosis of brain tumors. On the other hand, the level of c-fos oncoprotein expression may be correlated with the degree of cell dfierentiation and proliferation. The presence of these expression in low-grade astrocytoma suggest that activation of the c-fos gene is an early step in tumor development.

중증 미만성 뇌손상의 예후에 관한 분석

손은익,임만빈,김인흥 대한신경외과학회 1989 Journal of Korean neurosurgical society Vol.18 No.7-12

Computed tomography(CT) has enabled early recognition and treatment of focal injuries in patients with head trauma. However, CT has been less beneficial in identifying diffuse brain injury(DBI). The authors have analyzed retrospectively, a series of 132 patients with DBI observed for 2 years from Aug. 1986 to Jul. 1988 to evaluate the significance of the factors affectiong ourcome. Eighty-three patients were selected as being compatible with moderate and severe diffuse axonal injury(DAI) classified by Gennarelli, defined by coma without a CT lesion that is an obvious cause and coma greater than 24 hr with or without decerebration. The results are summarized as follows: 1) The 38(45.7%) out of 83 patients were found below age of 20, but there was no statistical significance between age distribution and outcome. 2) In case of initial Glasgow coma scale(GCS) of 7 or 8, 32(86.5%) out of 37 patients revealed good outcome, but 18(90%) of 20 patients with a score of 3 or 4 revealed poor outcome(p<0.001). 3) With regard to brain swelling in CT, there was significant statistical difference to outcome(p<0.05). 4) Small hemorrhages on corpus callosum, basal ganglia, basal cistern, peritentorial, lateral ventricle that is characteristic CT findings for DAI were showed 58(70%) out of cases. It might be concluded that initial GCS, brain swelling and small hemorrhages in CT were significant factors affecting outcome in DAI.

경추내에 발생한 신경장성 낭종 1례

임만빈,손은익 啓明大學校 醫科大學 1982 계명의대학술지 Vol.1 No.1

An isolated, cervical intraspinal neurenteric cyst in a 12-year old boy who had showed remission and exacervation of neurological symptoms and signs was treated successfully by laminnectomy, intradural exploration and excision. The cord compression by this congenital cyst is rare. No vertebral anomalies or congenital malformatons were demonstrated. Key words: intraspinal neurenteric cyst. remission and exacervation. excision. congenital cyst. vertebral anomaly. congenital malformation

인간 뇌 신경교종에 있어서 c-myc 암유전자 발현의 in situ hybridization 검색

손은익,임만민,이정교,권건영,김인홍,서민호,김동원 啓明大學校 醫科大學 1992 계명의대학술지 Vol.11 No.3

In order to elucidate the relationship between c-myc oncogene expression and tumor grade in human brain glioma, we studied two low grade gliomas, three high grade gliomas, and one normal brain tissue with in situ hybridization and biotin-labeled c-myc probe. All the specimens were formalin fixed and paraffin-embedded. Many cytoplasmic c-myc RNA grains were observed in low grade glioma, and numerous cytoplasmic c-myc RNA grains were observed in high grade glioma, but only a few were seen in normal brain tissue. In conclusion, these findings show that there is direct relationship between the degree of c-myc oncogene expression and grading of glioma.