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소뇌에 발생한 전이성 종양 1예 : Case Report
최휴진,김형동,심재홍 대한신경외과학회 1982 Journal of Korean neurosurgical society Vol.11 No.1
A case of metastatic cerebellar tumor associated with hydrocephalus is reported. Computerized tomography scans revealed a markedly obstructive hydrocephalus and relative well demarcated low density in the right cerebellar hemisphere. The tumor was totally removed, containing about 35cc of yellowish cystic fluid and scanty solid mass.
정연성,최휴진,권영민 대한척추신경외과학회 2012 Neurospine Vol.9 No.1
Objective: Recurrent herniation following disc excision has been reported in 5-15% of patients. There have been numerous studies of recurrent disc herniation, but these have analyzed mixed patient populations. We designed this study to analyze the factors that influencing the clinical results, and efficiency of repeat discectomy for recurrent lumbar disc herniation occurring at the same level and on the same side after primary discectomy. Methods: Between 1990 and 2011, a total of 52 patients who underwent repeat discectomy for recurrent lumbar disc herniation were retrospectively analyzed. Clinical outcomes were measured with Macnab criteria and visual analog scale(VAS score). Clinical parameters were also analyzed for influencing factors for outcome. Results: Based on Macnab criteria, an excellent surgical outcome was achieved in 28 cases (54%), a good outcome in 22 cases (42%), a fair outcome in 1 case (2%), and a poor outcome in 1 case (2%). Based on VAS score, 47 of 52 patients(90%) showed more than 4 score improvement. Age, sex, diabetes mellitus, smoking, time interval between repeat and primary discectomy, duration of recurrent symptoms, and extent of disc herniation did not significantly affect Macnab criteria and VAS score. However, a traumatic event showed less VAS score improvement whereas not affecting on Macnab criteria. Conclusions: Conventional open lumbar discectomy performed as repeat surgery for recurrent herniation showed satisfactory results. Based on the results of this study, repeat discectomy can be recommended for the management of recurrent lumbar disc herniation. Further study is needed to evaluate factors related to the outcomes of repeat discectomy.
만성 척수손상 환자에 대한 대망전위수술 : 예비보고 Preliminary Report
허재택,김형동,최휴진,김기욱 대한신경외과학회 1991 Journal of Korean neurosurgical society Vol.20 No.7
The omentum has been used over the years for a variety of clinical problems. Recently it has shown that placing the omemtum on the brain and spinal cord can lead to an extensive development of vascular connections at the omental/CNS interface. Success with omental transposition to the human brain has led to increasing intreast in placing the omentum onto the human spinal cord. One paraplegic patient was chosen to enter into a feasibility study to see if omental transposition to their spinal cord might result in clinical benefit. The length of time from injury was about 21 months respectively. This patient had little, if any, motor and sensory function below umbilicus level. The operation required surgical lengthening of the pedicled omentum followed by its placement into a subcutaneous tunnel created backward along the lateral chest wall up to T-10, 11 level. An extensive thoracic laminectomy was then performed followed by a wide opening of the dura. In our case the cord showed segmental shrinkage of the spinal cord consistent with previous trauma. The omentum was laid directly onto the underlying spinal cord. Our observation for five months has shown that placement of the omentum onto the chronically injured spinal cord allowed for subsequent improvement in neuroelectrical activity, as manifested by reproducible somatosensory evoked potentials, and, more importantly, in moter function. It is considered that placing the omentum directly upon the brain or spinal cord may have the effect of either improving local vascular perfusion or, possibly, exerting some biochemicals(neurotransmitter), or as yet unknown, influence. But further observation is warranted to determine whether this improvement will be continued and will be observed in another cases.
조철민,김형동,김기욱,최휴진,김규홍 대한신경외과학회 1996 Journal of Korean neurosurgical society Vol.25 No.10
It is well Known that the prognosis of spontaneous SAH(subarachnoid hemorrhage) of undetermined cause is generally favorable. Yet. the natural history and pathogenesis of SAH of undetermined cause remain controversial and patients management is largely empirical. 42 cases of non-traumatic SAH of undetermined cause of a total of 415 cases of SAH treated during a 5-year period(1991-1996) were available for this stydy. What should be done when angiography is negative after SAH? This study was undertaken to present a more definitive menagement in preventing rebleeding after SAH of undetermined cause. This study show that explorative craniotomy for aneurysmal operation is warranted. despite negative cerebral panangiograms. if the patient manifests the classical signs and symptoms of SAH and definite subarachnoid blood in CT(computed tomogram) or durect kynbar oybctyre and any suspicious lesions in cerebral panangiography. particularly the ACoA(anterior communicating artery) region.
김규홍,김형동,김기욱,최휴진,조철민 대한신경외과학회 1996 Journal of Korean neurosurgical society Vol.25 No.7
Internal carotid-posterior communicating artery aneurysms are frequently related to third nerve palsy which is reversible after the clipping of aneurysm. The authors had analyzed 61 cases in 52 patients who have posterior communicating artery aneurysm and evaluated the factors affecting the development of third nerve palsy and its recovsry after clipping of the aneurysm. The results are followings. 1) Oculomotor nerve palsy was noticed in 10 patients(16.4%) among 61 cases of posterior communicating artery aneurysm. of which 6 had complete and 4 had partial patsies. 2) Posterolateral inferior direction of the aneurysm seemed to be closely related to the development of ophthalmoplegia. 3) Development of ophthalmoplegia was not related to the clinical status of the patient on admission. but to the amount of subarachnoid hemorrhage on initial CT scan and size of the aneurysm. 4) Preoperative degree of third nerve palsy and the timing of operation are not definitely related to the recovery of ophthalmoplegia. 5) The recovery of third nerve palsy are normalization of ptosis. normalization of EOM limitation and normalization of pupiliary change in order.
최봉식,김기욱,김형동,최휴진,하상수 대한신경외과학회 1995 Journal of Korean neurosurgical society Vol.24 No.4
Many of the thoracolumbar spine fracture may be managed conservatively by postural reduction. But postural reduction alone connot treat all the patient with thoracolumbar spine fracture properly. Recently, more patients with thoracolumbar spine fracture are managed surgically with the advance of surgical technique and instrument. Surgery may be performed by either anterior or posterior approach according to many factors. Generally initial management of patient with thoracolumbar spine fracture is conservative and surgery is delayed for spinal fusion, but early surgery with decompression of spinal cord and fusion of the vertebral body seems to be more proper in unstable fracture with compression of spinal cord by bony fragment and incomplete neurological deficit. Authors analyzed 52 cases of thoracolumbar spine fracture and made a proper management plan and proper surgical approach.