經上膊動脈腦血管撮影法

沈輔星(Bo Sung Sim),朱正和(Chung Wha Chu),宋斗灝(Du Ho Song),徐英煥(Yung Whan Suh),金周完(Chu Wan Kim) 대한외과학회 1962 Annals of Surgical Treatment and Research(ASRT) Vol.4 No.1

요추간 수핵탈출증 환자에 대한 방사선학적 고찰

정흥섭,이기찬,이훈갑,김헌대,주정화 대한신경외과학회 1981 Journal of Korean neurosurgical society Vol.10 No.2

X-ray films of the lumbosacral spine are necessary in the evaluation of all patients who are considered to have lumbar disc disease. Several positive X-ray film findings are of possible significance, and although not in themselves diagnostic, they are compatible with, lumbar disc disease. Among patients treated and diagnosed by surgical operation for lumbar disc herniation from August, 1978 to February, 1981 at Korea University Hospital, 132 cases with their simple X-rays availuable for study were selected. Height of intervertebral disc space (Hurxthal method), spurrings, changes in facet joint, size of spinal canal (Johnes & Thomson method), lumbosacral angle (Ferguson method), congenital defect were studied and measured in simple films. Lumbar disc herniation was most frequent at L4-L5 intervertebral space (65.5%). The incidence of positive radiological findings were 85.6%. 1, Intervertebral disc space narrowing was found in 25%, 59.3% and 50% at L3-4, L4-5 and 2nd L5-S1 level respectively. 2. Peripheral osteophyte formations in the bodies of lumbar vertebrae were found in 44.7%. 3. Narrowing and/or sclerotic changes of facet joint were observed in 31.06%, subluxation in 14.39% and facet tropism in 5.3%. 4. The overall mean size of spinal canal at L4 vertebral level was 1 : 4.325 in male, 1 : 3.898 in female and at L5, 1 : 3.772 in female. Narrowed spinal canal in this series were found in 25.6%. at L4 and 17.2% at L5. 5. The overall mean lumbosacral angle %as 32.4 degree in male and 31.5 degree in female. Spondylolysis was observed in 4.54%. spondylolisthesis in 3.03%, lumbarization in 8.3% and sacralization in 1.51 %.

국소 저온에 대한 실험적 연구

정용구,이기찬,주정화 대한신경외과학회 1984 Journal of Korean neurosurgical society Vol.13 No.1

A study of effect of local hypothermia upon the paravertebral muscles which also become sensitized during spinal cord cooling was performed using cats. With a cuff, a cooler, to which was attached tubes connected to a refirgerator, the experimental technique was deviced to cool the paravertebral muscles locally at cervical and lumbar level. Cold, liquid saline at a temperature of 2.8±0.6℃ was circulated in closed system through the tube into the cuff which was snugly rested on the surface of paravertebral muscles as a heat exchanger. The temperature was measured at intervals of ten minutes with thermocouples before and during cooling for thirty minutes. In the muscle surface underneath the cuff, the mean precooling temperature of 30.1℃ in the normal muscle was lowered to 15.4℃ at the end of the first 10 minutes of cooling. After this initial rapid drop in temperature, there was a further gradual decrease of temperature to 13.6℃ at the end of 20 minutes of cooling. In the muscle 1 ㎝ beneath the cuff, the mean precooling temperature of 31.4℃ in the normal muscle was lowered to 17.3℃ at the end of first 10 minutes of cooling. After this initial rapid drop in temperature, there was a further gradual decrease of temperature to 16.2℃ at the end of 20 minutes of cooling. For comparison, the temperature in the clipped muscle and nonclipped muscle were also measured. The temperature in the clipped muscle surface was lower than that of non-clipped. Topical ice application resulted in rapid drop of temperature from 31.2℃ to 13.9℃ in skin, 32.3℃ to 13.1℃ in subcutaneous layer and 32.5℃ to 13.9℃ in muscle, simultaneously. Another aspect of this experiment was an evaluation of the protective effect of local hypothermia with respect to muscle injury associated with clipping, of muscles. The injured (clipped) muscles with or without local hypothermia was biopsied and stained with Hematoxylin Eosin and Hematoxylin Basic Funchsin Picric acid and sectioned specimens were observed under the light microscope. The clipped muscle examined thirty minutes after release of clipping showed 20∼30% of red stain in HBFP stain. The normal muscle showed less than 5% of red stain in the field. In intermittent hypothermia, 2 minute cooling group showed 20% of red stain in the field. The clipped muscle with local hypothermia showed less red stain than that of non- hypothermia. The results of this study confirmed the belief that the cold liquid and ice of physiologic saline can be used in clinical neurosurgery for extravascular local cooling of scalp and paravertebral muscles and for irrigating or perfusing operative field.

실험적 뇌경색에 미치는 Insulin, 2-Deoxyglucose 및 Dichloroacetate의 효과에 대한 연구

정흥섭,박윤관,이훈갑,이기찬,주정화 대한신경외과학회 1991 Journal of Korean neurosurgical society Vol.20 No.5

Hyperglycemia has been reported to worsen the tolerance of the brain to ischemia, and it has therefore been recommended that patient undergoing neurosurgical procedures not receive glucose-containing solutions. Since ischemic events lead to increased lactate production and accumulation and hence neruonal damage, the present study was designed to test the effect of insulin-induced hypoglycemia and decreased lactate accumulation by 2-Deoxyglucose and Dichloroacetate on focal cerebral ischemia in rats. Although the pre and post-ischemic blood glucose level of 2-Deoxyglucose group showed a significant increase (p=0.001), and insulim group a significant decrease(p=0.004). The reducing effects on the infarct zone in these three treated groups were found with statistical significance. As compared with control group, the tissue lactate levels of treated groups were decreased in both infarct zone and border zone but these data did not show statistical significance. From these observations, it is suggested that reduction of lactate production and accumulation could be beneficial by affording neuronal protection in ischemic tissues.

경축에 대한 척수강내 Baclofen 효과

정용구,임창수,정흥섭,이훈갑,이기찬,주정화 대한신경외과학회 1989 Journal of Korean neurosurgical society Vol.18 No.1

9 patients with spasticity of cerebral or spinal cord origin have been maintained for upto 2 months with intermittent bolus spinal intrathecal infusion of baclofen. Prior to treatment, all of patients had severe rigidity in extremties & had frequent & extensive spontaneous spasms, all of which greatly interfered with their activities of daily living. Oral antispasmodic medications were ineffective. Within days of intrathecal baclofen infusion, the muscle tone was reduced remarkably & spasms were eliminated. The greatest benefits to the patients were improvement in activities of daily living & better sleep due to reduced spasms. Complications were not observed.

제 4뇌실에 발생한 Oligodendroglioma : 1예 보고 Case Report

정용구,이훈갑,이기찬,주정화 대한신경외과학회 1982 Journal of Korean neurosurgical society Vol.11 No.4

The authors present a case of oligodendroglioma in the 4th ventricle which is extremely rare in occurrence. The patient is 11 year-old male whose complaints were severe headache and vomiting. In the brain computed tomogram, hyperdense mass seated in the 4th ventricle with marked hydrocephalus. The patient had operation for removal of the tumor. In the operating field, there are no relation of the choroid plexus and specific vessels but the tumor attached firmly on the floor of the 4th ventricle. The tumor was removed totally. The pathologic specimens were verified oligodendroglioma.

두개내 발생한 지주막낭종 치험 2예

정흥섭,이훈갑,이기찬,주정화 대한신경외과학회 1979 Journal of Korean neurosurgical society Vol.8 No.1

The intracranial arachnoid cysts are benign lesions in nature which thin walled cysts lying in relation to or enclosed by the subarachnoid space, filled with clear fluid. They may be due to developmental defects of the brain or meninges and secondary to inflammation, vascular occlusion or trauma but etiology of a large percentage is not well understood. In general, locations are near primary fissure and cisterns of the cerebral cortex and cerebellum. The clinical features and courses are unusual. Preoperative diagnosis is unlikely to be made but treatment is followed by good result. We had experienced two cases of intracranial arachnoid cysts which occures in middle cranial fossa, and cerebral hemisphere. Pathologic diagnosis are arachnoid cysts.

실험적 뇌경색에 미치는 Insulin, 2-Deoxyglucose 및 Dichloroacetate의 효과에 대한 연구

정흥섭,박윤관,이훈갑,이기찬,주정화 고려대학교 의과대학 1991 고려대 의대 잡지 Vol.28 No.1

Hyperglycemia has been reported to worsen the tolerance of the brain to ischemia, and it has therefore been recommended that patient undergoing neurosurgical procedures not receive glucose-containing solutions. Since ischeruc events lead to increased lactate production and accumulation and hence neuronal damage, the present study was designed to test the effect of insulin-induced hypoglycemia and decreased lactate accumulation by 2-Deoxyglucose and Dichloroacetate on focal cerebral ischemia in rats. Although the pre and post-ischemic blood glucose levels of control group and Dichloroacetate group showed no change, the blood glucose level of 2-Deoxyglucose group showed a significant increase(p=0.001), and insulin group a significant decrease(p=0.004). The reducing effects on the infarct zone in these three treated groups were found with statistical significance. As compared with control group, the tissue lactate levels of treated groups were decreased in both infarct zone and border zone but these data did not show statistical significance. From these observations, it is suggested that reduction of lactate production and accumulation could be beneficial by affording neuronal protection in ischemic tissues.

Tissue Plasminogen Activator in Chronic Subdural Hematoma & Its Relationship with CT Findings

Chung, Yong Gu,Kim, Han Kyeoum,Park, Young-Kwan,Kim, Bong Ryung,Chung, Heung Seob,Lee, Hoon Kap,Lee, Ki Chan,Chu, Jung Wha 대한신경외과학회 1994 Journal of Korean neurosurgical society Vol.23 No.1

저자는 고려대학교 병원에 입원하여 수술치료를 받았던 17례의 만성경막하 혈종의 환자에서 immunoperoxidase assay를 이용하여 tissue plasminogen activator의 존재유무와 출현정도, 그리고 CT 영상소견과의 연관관계를 추적하였다. t-PA 면역염색은 경막하혈종의 외막 혈관벽(모세혈관과 정맥)에 국한되어 나타났다. CT상 5례에서 mixed density소견을 보였으며 이중 3례는 최근에 출혈이 발생되었다는 중거가 되는 층형태(layering type) 소견이었으며, 이 층형태의 CT소견을 보이는 경우에 t-PA 면역염색의 정도가 뚜렷이 나타났다. t-PA 면역염색이 진하고 뚜렷이 보이는 6례 중 4례에서 CT 영상소견에서 막의 대조강화(enhancement)가 뚜렷이 보인 반면, 면역염색이 약하게 나타난 10례중 3례에서 CT 영상소견상 막의 강화소견을 보였다. CT소견상 종괴효과는 t-PA면역염색이 진하고 넓게 보이는 예에서(4/6) 연하고 국한되게 나타나는 예보다(3/11) 뚜렷이 나타났다. 만성경막하혈종의 혈액양은 t-PA의 염색정도에 따라 비교하여 보면, 염색이 가장 약하고 국한되게 나타난 경우에서 평균 26cc, 중간정도로 염색되는 경우에서 평균 35cc, 가장 진하고 넓게 되는 경우에 평균 61cc로 나타났으나, 임상례의 숫자가 적어 조금더 연구가 필요할 것으로 사료되나, t-PA가 혈종의 증대에 중요한 역할을 하는 요소중의 하나가 될것이라는 추측을 가능하게 한다고 사료된다.

흉수에 발생한 상의신경세포종 1예

정홍섭,임창수,이훈갑,주정화 대한신경외과학회 1978 Journal of Korean neurosurgical society Vol.7 No.2

We have recently experienced a case of intramedullary ependymoma in the upper thoracic spinal cord. A 46 years old man was admitted to our Department of Neurosurgery because of spastic paraplegia and disturbance of .urination since 6 years ago when the disability developed rather abruptly. Myelogram showed a subtotal block of the dye column at the level of T2-3 intervertebral space about where a fusiform enlargement of the cord was shadowed. Opening the duramater after total laminectomy performed through C7 to T3, a markedly swallen and enlarged spinal cord was under a great pressure. Spinal cord was paper thin and fully filled with a massive tumor inside of it. The intrameduallary tumor was mushroomed out on dorsal myelotomy. Histological study was verified to be ependymoma. The patient has not shown any improvement of neurological deficits in postoperative period.