일 노인요양시설 치매 환자의 사망률과 예측인자

이상걸(Sang Keol Lee),김대희(Dae Hee Kim),서국희(Guk-Hee Suh) 대한노인정신의학회 2009 노인정신의학 Vol.13 No.1

Objectives : To investigate mortality rates and predictors of mortality in dementia patients (prevalence cohort) resident at institution. Methods : We followed up a dementia cohort for 5 years. A total of 273 subjects with dementia were longitudinally assessed at baseline, 6 months and 12 months and then checked whether alive or dead every 1 year for 5 years. Their mortality was compared with sociodemographic and clinical variables using Cochran-Mantel-Haenszel test and independent sample t-test. Survival time quartiles were used to describe the time until when 25%, 50%, and 75% of patients died. Kaplan Meier log-rank tests were used for testing the equality of survival among groups when identifying some disruptive agitated behaviors as mortality predictors. Relative risk (RR) with 95% confidence intervals were calculated by the Cox regression analysis. Results : In this study, overall 5-year mortality rate was 63.0% (12.6% per year). Median survival after baseline evaluation was 2.85 years, whereas median survival after institutionalization was 6.42 years. Log-rank tests revealed that some disruptive behaviors (i.e., Cagras syndrome, screaming, trying to get to a different place, intentional falling) were significantly higher in the deceased group. Mortality in subjects with dementia depended on old age {over 85, relative risk (RR) : 1.04;95% confidence interval (CI) : 1.02-1.06}, male gender (RR : 2.04;CI : 1.28-3.25), lower MMSE-K score (RR : 1.03;CI : 1.00-1.06). Conclusion : We expect that this study may provide basic health information for health policy making in institutional care approaches in Korea.

척수팽대와 낭종을 동반한 척수-연수 연접부의 혈관아세포종 - 증례보고 -

박성진,정호,이상걸,박문선,하호균,양기화,Park, Sung-Jin,Jung, Ho,Lee, Sang-Keol,Park, Moon-Sun,Ha, Ho-Gyun,Yang, Ki-Hwa 대한신경외과학회 2000 Journal of Korean neurosurgical society Vol.29 No.6

Hemangioblastoma of the central nervous system rarely occurs in cervicomedullary junction. The unique pathologic features of the tumor involving midline structures are grossly solid in consistency and accompanying extensive spinal cord enlargement. A 63-year-old women presented with progressive right motor weakness and tingling sensation. The MR image showed a well enhancing mass having a cyst and diffuse cord enlargement in the cervicomedullary junction. A total surgical resection was performed and hemangioblastoma was histologicaly verified. Postoperative MR image showed the disappearance of cord enlargement. The right motor weakness was also improved. The authors report a rare case of hemangioblastoma in cervicomedullary junction and the pathophysiology of the spinal cord enlargement are discussed.

전방 경추 미세 추간공 확대술 : 경추증에 대한 최소침습적 전측방 접근법

박성진,하호균,정호,이상걸,박문선,Park, Sung-Jin,Ha, Ho-Gyun,Jung, Ho,Lee, Sang-Keol,Park, Moon-Sun 대한신경외과학회 2000 Journal of Korean neurosurgical society Vol.29 No.1

Objective : Various surgical approaches have been implemented to fulfill the ideal goals of treatment for cervical spondylotic lesions. Conventional approaches are represented by anterior approach with or without fusion and posterior approach. The authors has applied newly developed anterior cervical microforaminotomy for these lesions on minimally invasive basis. Materials and Method : Twenty-one patients, with cervical HIVD, or stenosis, or both, underwent anterior cervical microforaminotomy between March, 1998 and April, 1999. Fifteen patients underwent unilateral decompression, and 6 bilateral decompression via unilateral foraminotomy. Operation of one level was performed in 16 patients, 2 levels in 4 patients, and 3 in 1 patient. The foraminotomy was accomplished by resecting the uncovertebral joint. Through this hole, compressed nerve root was decompressed by removing the spondylotic spur or disc fragment, and diagonal removing of posterior osteophyte from foraminotomy site to begining of contralateral nerve root made spinal cord decompression. Results : The outcome was excellent in 17 patients(81%) and good in 4 patients(19%) based on Odom's criteria. No complication was encounterd, and average post-operation hospital stay was 3.7 days. Conclusions : These results indicate that anterior cervical microforaminotomy provide adequate neural decompression, minimum postoperative discomfort and fast recovery.

알코올 의존 환자의 혈중 탄수화물결핍 트랜스페린 변화에 대한 4주간 추적 연구

박병양(Byung-Yang Park),이상걸(Sang-Keol Lee),이병철(Boung-Chul Lee),함병주(Byung-Joo Ham),최인근(Ihn-Geun Choi) 한국중독정신의학회 2008 중독정신의학 Vol.12 No.1

This purpose of this study is to explore the factors influencing the change of plasma CDT after a 4-week abstinence in patients with alcohol dependence. The subjects were 79 alcohol-dependent inpatients whose % CDT was greater than 2.6% at the baseline. In the monitoring of % CDT at the 4-week follow-up, 35 patients (32 male and 3 female) showed lower than the cutoff value of 2.6%, and 44 patients (37 male and 7 female) showed still less than that. The change of %CDT was associated with the age that the patients started drinking, certain he-patic indexes such as AST, ALT, and GGT in the baseline, and alcoholic cirrhosis. Otherwise, baseline %CDT, mean amounts and duration of drinking, BMI, amount of daily smoking, alcoholic hepatitis, and fatty liver were not associated with the change of %CDT. Further extensive studies are needed.

외상성 뇌실질내 혈종에 대한 상측방 키홀을 통한 내시경적 혈종 제거

박성진,하호균,정호,이상걸,박문선,Park, Sung-Jin,Ha, Ho-Gyun,Jung, Ho,Lee, Sang-Keol,Park, Moon-Sun 대한신경외과학회 2000 Journal of Korean neurosurgical society Vol.29 No.2

Objective : As a minimally invasive strategy, endoscopic technique was introduced for removal of the traumatic intracerebral hematoma. Material and Method : A 54-year-old man with three-day history of seizure and progressive mental deterioration after traffic accident was presented. Computerized Tomography(CT) of the brain showed a huge intracerebral hematoma on the right frontal lobe and ventricle. The operation was performed via right frontal superolateral keyhole with 2cm eyebrow skin incision. Using 0-degree and 30-degree angled lens 4mm rigid endoscopes, nearly all of the hematoma was evacuated under the direct endoscopic visualization and a ventricular catheter was exactly placed into the frontal horn of the right lateral ventricle at the end of procedure. Results : The seizure was discontinued and neurological status had been improved during postoperative periods. Postoperative CT demonstrated that most of the hematoma was removed and the ventricular drainge tube was exactly placed in the right foramen of Monro. Conclusion : With endoscopic technique, the authors successfully evacuated traumatic intracerebral hematoma and exactly placed the ventricular drainage catheter under direct visualization. This technique may be considered as an another option for removal of traumatic intracerebral hematoma.

천·미골부위 피하조직에 발생한 점액유두 상의세포종 1례 : 증례보고 Case Report

이법종,이상걸,박미자 대한신경외과학회 1999 Journal of Korean neurosurgical society Vol.28 No.3

톡소포자충 배양시 약제투여에 따른 Toxoplasma P30 유전자의 발현

이상걸,이영하,김계영,나영언,신대환 충남대학교 의과대학 지역사회의학연구소 1996 충남의대잡지 Vol.23 No.2

To know the drugs effect on gene expression and its regulating mechanism by RT-PCR and southern blot hybridization assay based on detection of the P30 gene encoding the major surface antigen, P30 of Toxoplasma gondii and the DNA synthesis in T. gondii infected HeLa cells. The experiment was performed and the results were as follows. 1. The thymidine incooperation in DNA of HeLa cell and T. gondii infected HeLa cell reached peak level at 36 hours and suddenly decreased at 48 hours. The uracil incooperation in DNA of T. gondii reached peak level at 48 hours. 2. The decrease of P30 gene expression began from 24 hours after pyrimethamine treated and 36 hours after methotrexate treated in T. gondii. The results were some what different. Pyrimethamine was more sensitive and acted earlier to T. gondii than Methotrexate did. The decrease of P30 gene expression of T. gondii was regulated these drugs in dose dependent manner. 3. The effects of dibutyryl cyclic AMP on P30 gene expression increased peak at 24 hours and on contrary decreased at 60 hours after treatment in dose dependent manner, but at 10mM high concentration of dibutyryl cAMP, P30 gene expression was supressed. 4. Actinomycine D supressed the P30 gene expression of T. gondii in HeLa cell. As the results, we presume pyrimethamine acts more powerful and earlier to supresses P30 gene expression than methotrexate, and it is regulated at transcription level. The results of RT-PCR were in agreement with that of southern blot hybridization.

임상등급이 좋은 뇌동맥류 환자의 수술시기에 따른 결과 및 임상고찰

이상걸,박문선 凡石學術奬學財團 1999 凡石學術論文集 Vol.3 No.-

두개저 골절에 대한 임상적 고찰

이용행,이상걸,김승진,김병준 대한신경외과학회 1993 Journal of Korean neurosurgical society Vol.22 No.10

65 consecutive patients with basal skull fracture admitted to Eul-Ji General Hospital, between March 1990 and March 1993 was carried out to study it's clinical and radiological presentations, complications, and outcomes. 1) Two thirds of the patients were between 20 and 40 years old and 82% were male. 2) 78% of the injuried were by traffic accidents and 17% were by fall down. 3) The outcomes of treatment were related to initial GCS(Glasgow coma scale) of the patients. 4) Clinical features were ear bleeding -54%, Racoon's eye -35%, hemotympaneum -32%, hearing loss -25%. 5) The combined lesions were skull fractures -43%, facial bone fractures -31%, subdural hematoma -19%, epidural hematoma -14%, and pneumocephalus -14%. 6) The combined cranial nerves injuried were facial nerve -32%, vestibulocochlear nerve -12%, oculomotor nerve -12%, abducens nerve -12%. 7) The location of basal skull fracture according to clinical feature and CT bone window were middle cranial fossa -54%, on anterior cranial fossa -22%, anterior and posterior cranial fossa -12%, posterior cranial fossa 12%. 8) Clinical features associated with types of petrous bone fractures were analyzed. 9) The time of onset and the degree of facial palsy had a influence on recovery of facial nerve function and the types of hearing loss had a role in recovery of hearing function. 10) CSF leakage were present in 16 cases and immediate type was more than delayed type. 11) Three patients(4.6%) developed meningitis, especially associated with CSF leakage and it's rate was higher when CSF leakage persisted over 1 week.

두개강내 척색종 1례

이용행,이상걸,김승진,김병준 대한신경외과학회 1993 Journal of Korean neurosurgical society Vol.22 No.10

The authors present a case of intracranial chordoma in a 53-year-old woman who presented with gradual onset of dizziness, gait disturbance. Clinical features and various diagnostic findings are described.