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이선호,김현집,한대희,최길수,노재규,명호진 대한신경외과학회 1988 Journal of Korean neurosurgical society Vol.17 No.5
The authors analyzed the stroke patients admitted to department of neurosurgery and neurology of Seoul Natioal University Hospital between 1980 and 1987. Among the 883 ischemic stroke patients angiography was performed in 158 cases. Twenty-two cases of atherosclerotic carotid occlusive disease were detected. The peak incidence of carotid occlusive disease was in the 6th decade and sex ratio of male to female was 2.7 : 1. Most of patients had a long history of repeated ischemic attacks and the common symptoms and signs on admission were motor weakness, speech disturbance, sensory change and visual disturbance. The associated diseases were hypertension(40.9%), hyperlipidemia(31.8%), hyperuricemia(27.3%), dysrhythmia(22.7%), heart disease(27.2%) and diabetes mellitus(13.6%). CT findings showed lesions on the middle cerebral artery(MCA) territory most frequently(40.9%) then watershed zone infarct(18.2%) and diffuse brain atrophy(18.2%). Angiographic findings showed multiple lesions in 50% and lesion sites were proximal internal carotid artery(ICA) in 51.9% then cavernous portion, supraclinoid portion, petrosal portion and extracranial distal ICA in order of frequency. Clinical outcomes after the medical or surgical treatment were improved in 45.5%, stable in 45.5% and late worsening in 9.1%.
뇌수막종의 수술전 색전술시 발생한 종양주위 출혈 : 증례보고 Case Report
이선호,한대희,장기현,최길수 대한신경외과학회 1986 Journal of Korean neurosurgical society Vol.15 No.4
A case of rare complication in preoperative embolization of intracranial meningioma is reported. A 42 - year old man who was diagnosed as left parietal convexity meningioma underwent embolization of feeding vessels through the selective angiography. In the process of embolization of middle meningeal artery, after superficial temporal artery occlusion, there was sudden dye leakage around the tumor on the fluoroscopy suggesting the peritumoral bleeding. On the operation we could find the large hematoma around the mass. We are reporting this rare complication with the discussion of the possible etiology.
급성 뇌경색발생시 뇌기능 해리 현상에 관한 실험적 연구
이선호,김영규,정희원,김현집,한대희,심보성,최길수 대한신경외과학회 1990 Journal of Korean neurosurgical society Vol.19 No.4
To demonstrate the effect of diaschisis and to evaluate its possible mechanism in acute unilateral infarction, the changes of regional cerebral blood flows(rCBF's) on the both MCA territories and both cerebellum were measured by the hydrogen clearance method using the unilateral cerebral and cerebellar infarction model. Cerebral infarction model was made by left middle cerebral artery (MCA) occlusion through the transorbital approach and cerebellar infarction was made by coagulation of cerebellar vessels through retromastoid craniectomy. Experimental groups consisted of left MCA occlusion group-12cats, left MCA occlusion with callosal section group-15cats and cerebellar infarction group-13cats. After measurement of rCBF for 8 hours at fixed intervals the animals were sacrificed and immediately thereafter 50㎖ of 2% triphenyl tetrazolium chloride(TTC) solution was immediately injected in order to examine the size of infarction. The results were as follows: 1) After occlusion of left MCA, the rCBF of ipsilateral MCA territory decreased abruptly and significantly (p<0.001), reaching unmeasurable value I hour after occlusion. The rCBF of contralateral cerebellum decreased 25.5∼32.6% of control value. On the ipsilateral MCA territory the rCBF decreased 18.5∼41.0% and the rCBF of ipsilateral cerebellum decreased 19.0∼30.0% of control value(p<0.01). 2) In the group of left MCA occlusion with callosal section, the rCBF of contralateral MCA territory decreased 4.8∼16.4% of control value but it is less marked and not significant statistically(p>0.05). 3) In the group of cerebellar infarction, the rCBF of contralateral cerebellum and both MCA territories did not decrease significantly in either group of cerebellar blood flow less than 10㎖/100g/min or 10∼20㎖/ 100g/min. 4) In the experimental group of left MCA occlusion, infarction revealed 40.2±2.8% of coronal plane through the optic chiasm showing high percentage of infarction yield with small standard deviation. In the cerebellar infarction model the extent of infarction was 36.0±10.0% of horizontal planes of cerebellum in the group of rCBF below 10㎖/100g/min. In the group of rCBF 20㎖/ 100g/min the extent of infarction was 22.0±12.0%. These findings show the crossed cerebellar as well as interhemispheirc diaschisis and support the importance of neural pathway in the mechanism of diaschisis. However further studies for long-term results and mechanism of diaschisis are needed.
뇌동맥류에 대한 임상분석 : Sep. 1957-Jun. 1988
이선호,한대희,김종수,김현집,심보성,최길수 대한신경외과학회 1989 Journal of Korean neurosurgical society Vol.18 No.3
In order to have the statistical basis of intracranial aneurysms, the authors analysed the cases of angiographically proven intracranial aneurysms which were admitted to the department of neurosurgery, Seoul National University Hospital from Sep. 1957 to June 1988. The results of analysis were summarized as follows ; 1) Total number of patients was 564 and 64 patients had multiple aneurysms, so total number of aneurysms was 647. Peak age incidence was in the 5th & 6th decades and male to female ratio was 1 : 1.2. 2) Location of aneurysms were anterior communicating artery(32%), posterior communicating artery(28.1%), middle cerebral artery(21.5%) in the order of frequency. Posterior circulation aneurysms comprised 7.1% and multiple aneurysms were 11.3%. 3) Among 647 aneurysms, 368 aneurysms were neck-clipped(56.9%), and operative mortality was 4.9%. 4) After 1983, 300 patients of 344 aneurysms were admitted to the neurosurgical department. The size of aneurysm was most frequent in 6-10㎜ in diameter(49.4%) and 5 giant aneurysms were detected. 5) Among 344 aneurysms, 253 aneurysms were neck-clipped(73.5%) and operative mortality were lowered to 2.4%. 6) Among 300 patients 287 patients had ruptured aneurysm. Angiographic spasm was detected in 32.1% and symptomatic spasm was in 19.5%. 7) Hydrocephalus was detected in 36.2% during the period of admission and follow-up. 8) Anterior communicating artery aneurysms ruptured most frequently among the multiple aneurysms. 9) Clinical state on admission was an important factor for the outcome and preoperative clinical state was related to the operative outcome and mortality.
우측 전두엽에 발생한 혼합 배세포종 : 태생암과 배아세포종 증례보고 Embryonal Carcinoma With Germinoma
이선호,김현집,심보성,지제근 대한신경외과학회 1983 Journal of Korean neurosurgical society Vol.12 No.4
Primary intracranial germ cell tumor is rare. The majority of these tumors are germinoma and teratoma of varying degree of differentiation with much less frequent occurrence of embryonal carcinoma, choriocarcinoma and endodermal sinus tumors. These may occur in various mixture. These are almost exclusively situated in the midline with the pineal or parapineal and hypothalamus. We are presenting a case of embryonal carcinoma mixed with germinoma component, which occurred to a 20 year old man who underwent operation and radiation therapy 6 months previously and the tumor mass was located at the right frontal area extending to the base of frontal lobe. We removed the mass near totally and radiation therapy was performed. The result was successful so far.