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척수 신경초종을 동반한 결핵성 척추염 1례 - 증례보고 -
박종훈,김규홍,이운기,최정훈,이인창,배상도,Park, Jong Hoon,Kim, Kyu Hong,Lee, Woon Gi,Choi, Jeong Hoon,Lee, In Chang,Bae, Sang Do 대한신경외과학회 2001 Journal of Korean neurosurgical society Vol.30 No.10
The authors report a very rare case of tuberculous spondylitis combined with a schwannoma of spinal cord. A 39- year-old man was admitted because of paraparesis(G1/G2). MRI showed severe cord compression at two different levels. One was by the bulged soft tissue and subligamentous abscess extending from T7 to T9 and the other was by an intradural extramedullary cord tumor at the level of T1-2. At first operation, T8 corpectomy and T7-9 plate fixation with autogenous iliac bone graft were performed. After then, Paraparesis was improved(G2/G3) postoperatively. The second operation underwent two weeks later. The tumor was totally removed and shortly after second operation, paraparesis was markedly improved(G3/G4). Histological diagnosis were tuberculous spondylitis and schwannoma, respectively. The authors reviewed this case where good surgical outcome was obtained by two stage operation.
Treatment of Cerebral Arteriovenous Malformations by Preoperative Embolization and Microsurgery
김규홍,노명호,이운기,최정훈,이인창,배상도,Kim, Kyu Hong,Rho, Myung Ho,Lee, Woon Gi,Choi, Jeong Hoon,Lee, In Chang,Bae, Sang Do The Korean Neurosurgical Society 2000 Journal of Korean neurosurgical society Vol.29 No.4
Objective : To determine the role of preoperative embolization on postoperative neurological outcome in the treatment of cerebral AVMs, we retrospectively evaluated an effectiveness of combining preoperative embolization and microsurgery for arteriovenous malformations(AVM) of the brain. Method : Two groups(10 patients who underwent preoperative superselective embolization and surgery versus 27 patients who underwent surgery only) were compared and categorized by Spetzler-Martin grade, the size of AVM and postoperative clinical outcome using Glasgow Outcome Scale. The 37 patients included 23 males and 14 females, ranging in age from 11 to 74 years(mean 36 years). Results : The arteriovenous malformations in preoperative embolization and surgery group had a larger average greatest diameter(4.45cm versus 3.83cm) and were of higher Spetzler-Martin grade(80% versus 52% grade III through V). At 1 week after surgery, the preoperative embolization and surgery group represented a better outcome(60% versus 44% with Glasgow Outcome Scale score of 5). And over 6 months after surgery, the embolization and surgery group displayed more favorable clinical outcome(80% versus 63% with Glasgow Outcome Scale score of 5). Conclusion : Combined treatment with superselective preoperative embolization using N-butyl cyanoacrylate and direct surgery may help neurosurgeon treating the high grade AVMs thus improving the postsurgical outcome. 뇌동정맥기형의 치료에 있어 술 전 색전술과 미세뇌수술을 병합함으로서 얼마나 치료효과를 높일 수 있는지를 알고자 후향적조사를 시행하였다. 조사군은 수술 전 초선택적 색전술후 수술을 시행하였던 10명의 뇌동정맥기형 환자를 대상으로 하였고, 대조군은 술 전 색전술 없이 수술만으로 치료하였던 27명의 환자를 대상으로 하였으며 각각의 환자군은 Spetzler-Martin grade, 뇌동정맥기형의 크기 그리고 Glasgow Outcome Scale을 이용한 술 후 추적관찰 결과에 따라 나누어 비교하였다. 조사대상 37명의 환자중 남자가 23명, 여자가 14명이었으며 나이는 11세부터 74세(평균 36세)였다. 뇌동정맥기형의 크기는 술 전 색전술과 수술적 치료를 병합하였던 조사군에서 평균 4.45cm로 수술만 시행하였던 군의 3.83cm에 비해 크게 나타났으며, Spetzler-Martin grade도 조사군에서는 3, 4, 5등급이 80%이었으나 대조군에서는 52%로 술 전 색전술과 수술을 병합한 군에서 높은 등급의 환자가 많았다. 수술 후 일주일째 평가한 Glasgow-Outcome Scale 점수는 조사군에서는 5점인 경우가 60%로 대조군의 44%보다 높았으며, 수술 후 6개월만에 평가한 점수도 조사군에서 5점인 경우가 80%이었고 대조군은 63%로 술 전 색전술과 수술을 병합하였던 환자에서 더 좋은 예후를 보였다. 결론적으로 수술 전 N-butyl cyanoacrylate를 이용한 초선택적 색전술을 시행한 후 수술 적으로 뇌동정맥기형을 제거함으로서 비교적 등급이 높은 환자에서 치료가 용이하였으며 이전의 수술적 치료만 하였던 경우에 비해 더 좋은 예후를 보임을 알 수 있었다.
고성주,서재환,박흥규,이훈규,조승연,이운기,이정남,이영돈,조현이,Ko Seong Ju,Suh Jae Hwan,Park Heung Kyu,Lee Hoon Gyu,Cho Seung Yeon,Lee Woon Gi,Lee Jeong Nam,Lee Young Don,Cho Hyun Yee 대한위암학회 2001 대한위암학회지 Vol.1 No.3
Purpose: Submucosal gastric carcinomas metastasize to lymph nodes more often than the intramucosal gastric carcinomas. The objectives of this study are to clarify the characteristics of submucosal gastric carcinomas, especially in reference to the status of lymph node metastasis, and to explore the possibility of a minimally invasive operation. Materials and Methods: The clinicopathologic features of 88 patients with submucosal gastric carcinoma, all of whom were treated with a $D_{2}+\alpha$ gastrectomy between January 1994 and December 1999, were examined retrospectively with respect to the status of lymph nodes. The size, depth of submucosal invasion, histologic differentiation, location,and macroscopic finding of the tumor were investigated in association with the presence or the absence of lymph node metastasis. Results: Among the 88 patients, 15 ($17.05\%$) had lymph node metastasis, and the status of metastasis was significantly correlated with tumor size and depth of submucosal invasion. The frequency of metastasis was $0\%$ (0/7) of up to 1.0 cm and $18.5\%$ (15/81) over 1.0 cm in size (p=0.034) and $6.1\%$ (2/33) of up to 1.0mm and $23.6\%$ (13/55) over 1.0 mm in depth of submucosal invasion (p=0.042). Conclusion: The tumor size and depth of submucosal invasion are useful indicators of lymph node metastasis in submucosal gastric carcinoma. A minimally invasive operation can be applied for submucosal gastric carcinoma up to 1.0 cm in size Further studies are needed to limited surgery for depth of submucosal invasion.
증례 : 호흡기 ; 샅굴탈장으로 발견된 결핵성 요근 농양 1예
조현정 ( Hyon Joung Cho ),안창혁 ( Chang Hyeok An ),정성환 ( Seong Hwan Jeong ),이운기 ( Woon Gi Lee ),김하나 ( Ha Na Kim ),최수진 ( Su Jin Choi ) 대한내과학회 2009 대한내과학회지 Vol.77 No.5S
저자들은 폐결핵 발병 후 특별한 치료 없이 지내던 중 림프절을 통해 감염이 전파되어 결핵성 요근 농양이 발생한 것으로 추정되는 환자가 결국 샅굴탈장이 발생되어 발견된 증례 1예를 경험하였다. 척추 결핵의 동반 없이 림프절을 통한 결핵성 요근 농양의 발생은 드문 것으로 알려져 있으며, 더욱이 샅굴탈장으로 결핵성 요근 농양이 발견되는 경우는 국내외적으로 매우 드물어 보고하는 바이다. Tuberculous psoas abscesses are uncommon and are rare without tuberculous spondylitis, but can develop as a result of direct spread via a lymphatic or hematogenous route. The clinical presentation includes pain and weight loss, while a palpable mass is rare. Furthermore, an inguinal hernia is a very rare complication of a tuberculous psoas abscess. We report an unusual case of tuber-culous psoas abscess found in an inguinal hernia that may have spread from pulmonary tuberculosis via the lymphatics. The diagnosis was confirmed by computed tomography (CT) and culture of the abscess for Mycobacterium tuberculosis. The patient was treated with anti-tuberculous agents and was scheduled to undergo surgery for the inguinal hernia, but was transferred to a hospital nearer to home at her request. (Korean J Med 77:S1174-S1177, 2009)