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권양,김창진,임승철,권병덕,황충진 대한신경외과학회 1990 Journal of Korean neurosurgical society Vol.19 No.4
It is generally known that demonstration of absence of cerebral blood flow is necessry to confirm brain death. Transcranial Doppler(TCD) is an accurate method of monitoring the blood flow velocities of the cerebral vessels. We performed transcranial doppler(TCD) examinations on 15 patients in brain death. Anterior criculation was examined through the temporal window or transorbiral window and basilar arteries were examined through the suboccipital window. All of the patients fulfilled the criteria for determination of brain death by clinical criteria, EEG and/or Brainstem Auditory Evoked Response(BAER) or clinical criteria alone, were mechanically ventilated. A TCD waveform abnormality consisting of reversed diastolic components was found in all brain death patients. The net flow veloicties of <10 ㎝/sec were present in all brain death patients. TCD may be a rapid and convenient alternative to cerebral angiography for confirming brain death when institutional protocols require such comfirmation.
Hypothalamic Craniopharyngioma : CT and MR Findings
Lee,Seung Chul,Kim,Jong Sung,Rhim,Hyun Chul,Joo,Kyung Bin,Lee,Seung Ro,Hahm,Chang Kok 한양대학교 의과대학 1993 한양의대 학술지 Vol.13 No.2
두개인두종은 소아에서는 전형적으로 안상병번 (suprasellar lesion)으로서 관찰되나 성인에서는 비전형적인 위치에서 자주 관찰된다. 조직학적으로는 크게 에나멜 형 (adamantinous type)과 인유두형(squamous papillary type)으로 구분되며 같은 에나멜형 일지라도 소아와 성인간에 조직학적 차이가 다소 있고 인유두형은 소아연령에서는 거의 발견되지 않는다. 이러한 병리조직학적 관점에서 볼 때 이들간의 방사선학적 검사소견의 차이를 이해할 수 있으며 정확한 진단과 예후판정에 도움을 줄 수 있으리라 생각한다. 저자들은 남자 성인의 사상하부에서 발생한 인유두형의 두개인두종 1예를 경험하였기에 문헌고찰과 함께 보고하는 바이다.
Hyun, Seung-Jae,Kim, Yong-Jung J.,Cheh, Gene,Yoon, Seung-Hwan,Rhim, Seung-Chul The Korean Neurosurgical Society 2012 Journal of Korean neurosurgical society Vol.51 No.1
Thoracic pedicle screw fixation techniques are still controversial for thoracic deformities because of possible complications including neurologic deficit. Methods to aid the surgeon in appropriate screw placement have included the use of intraoperative fluoroscopy and/or radiography as well as image-guided techniques. We describe our technique for free hand pedicle screw placement in the thoracic spine without any radiographic guidance and present the results of pedicle screw placement analyzed by computed tomographic scan in two human cadavers. This free hand technique of thoracic pedicle screw placement performed in a step-wise, consistent, and compulsive manner is an accurate, reliable, and safe method of insertion to treat a variety of spinal disorders, including spinal deformity.
임승철,이규성,이규창 대한신경외과학회 1982 Journal of Korean neurosurgical society Vol.11 No.3
After the introduction of the Laser into clinical medicine in recent years, the Laser has become increasingly useful clinically, and has even proved, as a new surgical modality that utilizes high-intensity beams of radiant energy to vaporize or coagulate tissue, superior to conventional surgical techniques in selected procedures. Using the carbon dioxide Laser beam, the authors had experienced good results in 8 cases of brain tumor with its unique properties of tissue vaporization and nonmechanical bloodless excision.
6-aminonicotinamide를 투여한 마우스에 발생한 자발성 두개강내출혈에 관한 연구
임승철,민병국,최덕영,송계용 중앙대학교 의과대학 의과학연구소 1990 中央醫大誌 Vol.15 No.1
Spontaneous intracranial hemorrhages (so called, subdural hemorrhages) were produced in suckling mice (32 of the ICR strain and 100 of the non ICR strain) by injection of 6-aminonicotinamide (6-AN). The animals were sacrificed under ketamine anesthesia between Day 9 and 38 postinjection for morphological and histological study. The following observations were made: 1. Spontaneous intracranial hemorrhages were developed from Day 21 postinjection of 6-AN (mostly from Day 28 to 38 postinjection) and those incidences were 46.9% of the ICR strain comparing to 18.8% of the non ICR strain mice. 2. On light microscopic observation, the dura was divided into several cell layers, forming multiple compartments, in which blood clots were found in most cases. The innermost cell layer of dura, dural border cells, lining organized hematoma at it's inner surface could be identifiable. The blood clots were also found in subpial space in some cases, but not in subarachnoidal space. 3. Electron microscopic findings of inner membranes of organized hematoma showed layering of arachnoidal fibroblasts and cytoplasmic protrusions from proliferated capillary endothelial cells with tight junction between intercellular collagen fibers and macrophage. Therefore, it was thought that site of so called, subdural hemorrhage in this experiment would be intradural or subpial.
임승철,이규성,최중언,김영수,정상섭,이규창 대한신경외과학회 1983 Journal of Korean neurosurgical society Vol.12 No.2
To provide a guideline of accurate diagnosis and proper methods of treatment of meningioma, the most common benign intracranial tumor, the authors studied 94 cases of intra & extracranial meningioma who had been diagnosed and operated at the Department of Neurosurgery, Yonsei University College of medicine from November, 1966 to October, 1982. The results were as followings. 1) The ratio of male to female was 1 to 1.4 and 30.8% of the 94 patients were in the 4th decade of age and another 30.8% in the 5th decade. 2) The predilection sites were parasagittal and falx(37.2%), sphenoid ridge(15.9%), convexity(14.9%), and suprasellar(10.6%) area. 3) The common initial clinical features were headache(55.5%), visual disturbance(16.0%) and seizure(14.9%). In radiologic diagnostic tests, there were abnormal findings in over a half on plain skull X-ray, and brain CT scan was regarded as the most accurate and safe method. Cerebral angiography provided the informations such as vascularity, venous drainage and relationship with the venous sinus. 4) Among the 6 cases of basal posterior fossa meningioma, the surgical excision of the tumor could be performed totally in 2 cases and subtotally in 4. 5) In 8 recurrent cases, all the tumors except one were located at parasagittal area and they wery 3 hemangiopericytic, 2 hemangioblastic, 2 angiomatous and 1 meningotheliomatous type. 6) The Laser was thought to be very effective surgical tool to remove vascular tumor, such as meningioma, with its unique properties of non-mechanical bloodless evaportion of tumor and minimizing of brain edema.
Hyun, Seung-Jae,Kim, Yongjung J.,Rhim, Seung-Chul,Cheh, Gene,Cho, Samuel K. The Korean Neurosurgical Society 2015 Journal of Korean neurosurgical society Vol.46 No.4
Objective : To improve pedicle screw placement accuracy with minimal radiation and low cost, we developed specially designed K-wire with a marker. To evaluate the accuracy of thoracolumbar pedicle screws placed using the novel guide-pin and portable X-rays. Methods : Observational cohort study with computerized tomography (CT) analysis of in vivo and in vitro pedicle screw placement. Postoperative CT scans of 183 titanium pedicle screws (85 lumbar and 98 thoracic from T1 to L5) placed into 2 cadavers and 18 patients were assessed. A specially designed guide-pin with a marker was inserted into the pedicle to identify the correct starting point (2 mm lateral to the center of the pedicle) and aiming point (center of the pedicle isthmus) in posteroanterior and lateral X-rays. After radiographically confirming the exact starting and aiming points desired, a gearshift was inserted into the pedicle from the starting point into the vertebral body through the center of pedicle isthmus. Results : Ninety-nine percent (181/183) of screws were contained within the pedicle (total 183 pedicle screws : 98 thoracic pedicle screws and 85 lumbar screws). Only two of 183 (1.0%) thoracic pedicle screws demonstrated breach (1 lateral in a patient and 1 medial in a cadaver specimen). None of the pedicle breaches were associated with neurologic or other clinical sequelae. Conclusion : A simple, specially designed guide-pin with portable X-rays can provide correct starting and aiming points and allows for accurate pedicle screw placement without preoperative CT scan and intraoperative fluoroscopic assistance.