환축추의 불안정증을 동반한 경추부의 섬유성 이형성증 : 증례보고 Case Report

백광흠,고인관,김재민,김충현,김남규,태경 대한신경외과학회 1997 Journal of Korean neurosurgical society Vol.26 No.5

환추축성 불안정증에 대한 경관절 나사못 고정법의 임상적, 생체역학적 분석평가

백광흠,오성훈,신형식,김재민,김광명 대한신경외과학회 1996 Journal of Korean neurosurgical society Vol.25 No.2

Transarticular screw fixation augmented with interspinous wiring technique for atlantoaxial instability was analyzed to provide immediate multidirectional rigid fixation and increase likelihood of fusion of C1-2 for atlantoaxial instability in several biomechanical studies. Transarticular screw fixation eliminates anterior, posterior translation at C1-2 and reduce flexion and extension movement. Interspinous wiring eliminates the residual flexion and extension movement. 13 patients with atlantoaxial instability were operated with posterior atlantoaxial facet screws fixation augmented with an interspinous C1-2 strut graft and posterior wire fixation technique. One patient died postoperatively from cardiac problem. All surviving patients restored C1-2 alignment and stability without complication due to instrumentation and osseous unions have developed even 2 cases of screw breakage developed. This technique was analyzed to be superior to wiring or clamp fixation biomechanically and leads to success without external orthosis in several series. But precaution is needed to avoid the vertebral artery injury.

흉요추부 골절-탈구 환자의 치료 경험과 손상 기전에 따른 예후 분석

백광흠,정진환,김충현,오성훈,김재민,이철범 대한척추신경외과학회 2004 Neurospine Vol.1 No.1

Objective: The fracture-dislocation is the most unstable spinal injury with failure of all three columns and presents catastrophic neurological injury. The purpose of this study was to evaluate factors such as preoperative neurological status, causes of injury, time to operation, type of fracture-dislocation, and steroid therapy that might alter the prognosis of patients. Methods: A retrospective analysis on 26 patients of thoracolumbar fracture-dislocation was performed. Fracture-dislocation was classified into three different categories according to Denis' classification: flextion-rotation in 15 patients, shear in 5 patients, and flextion-distraction in 6 patients. The neurological status was classified according to Frankel's classification: A in 9 patients, B in 6, C in 5, D in 4, E in 2. Posterior reduction and transpedicular screw fixation with fusion was used in 18 cases, corpectomy and interbody fusion through retroperitoneal approach was used in 2, combined approach was used in 6. Results: Thirteen patients(54%) with neurological deficit improved after surgical treatment. Operations achieved reduction and neural decompression regardless of surgical approaches in most cases. The preoperative neurological status, type of fracture-dislocation, and interval between trauma and operation were closely correlated with the postoperative neurological status(p=0.001). But the causes of injury, mega-dose steroid therapy were not correlated with the neurological outcome statistically(p>0.05). Conclusion: Early surgical intervention should be considered for patients with thoracolumbar fracture-dislocation to achieve neurological improvement and early mobilization.

광용혈에 의한 Phenothiazine류의 광독성에 관한 연구

白光欽,金鳳姬,柳柄泰 충남대학교 약학대학 의약품개발연구소 1987 藥學論文集 Vol.3 No.-

To investigate the phototoxicity of phenothiazines, five phenothiazines and one thioxanthene derivative were examined by using a 40W BLB fluorescent tube in the buffered (phosphate buffered saline and veronal buffered saline) reaction system consisting of human RBC (20 V/V%) and the drugs in concentrations from 1㎍/㎖ to 100㎍/㎖. The extent of photohemolysis was examined by a spectrophotometer. It was also observed that toxic photoproducts were formed by perphenazine and chlorpromazine. All of the active compounds showed more potent photohemolyzing activities in veronal buffered saline than in phosphate buffered saline. Substitution in 2-position of phenothiazine structure is thought to enhance this capacity, and particularly so when the substituent is chlorine. Substitution in 10-position of phenothiazine structure may also augment the phototoxic activity, though to a lesser degree.

1318 Happy Zone 서대문

백광흠,Baek, Gwang-Heum 한국사회복지사협회 2006 Social workers Vol.12 No.-

최소 침습 전방 경유 요추부 추체간 골유합술

백광흠,김영수,김재민,김충현,고용,오성훈,오석전,김광명,김남규 대한신경외과학회 1998 Journal of Korean neurosurgical society Vol.27 No.6

The Effect of Repetitive Insertion and Pullout of Spinal Screws on Pullout Resistance : A Biomechanical Study

백광흠,김광진,김재민,김충현,Bak, Koang Hum,Ferrara, Lisa,Kim, Kwang Jin,Kim, Jae Min,Kim, Choong Hyun,Benzel, Edward C. The Korean Neurosurgical Society 2001 Journal of Korean neurosurgical society Vol.30 No.2

목적 : 최근 척추 수술에 나사못을 사용하는 빈도와 범위가 넓어 지고 있는데 때로 수술 중 한번 삽입하였던 나사못을 다시 사용하는 경우가 있다. 인체 골과 타이타늄의 탄성계수가 크게 차이 나지만 반복 삽입 과정에서 나사못의 이가 손상될 가능성이 있다. 저자들은 나사못의 반복 삽입이 나사못의 인출 저항에 미치는 영향을 조사하였다. 방법 : 각각 6개의 세가지 다른 종류 cortical lateral mass screw, cancellous lateral mass screw and cervical vertebral body screw의 나사못을 시험하였다. 나사못을 인체의 골과 비슷한 밀도의 인공합성골에 삽입하였으며 삽입 중 삽입력을 측정하였고 그 후 Instron(Model TT-D, Canton, MA)을 이용하여 2.4mm의 속도로 인출하여 인장항력을 digital oscilloscope에 기록하였다. 위의 과정을 3회 반복하여 기록한 뒤 나사못을 광학 현미경으로 확대하여 관찰하였다. 결과 : cortical lateral mass screws의 평균 인장항력(1회인장 시험 $185.66N{\pm}42.60$, 2회 인장시험 $167.10N{\pm}27.01$, 3회인장 시험 $162.52N{\pm}23.83$ : p=0.03)과 cervical vertebral body screws ($386.0N{\pm}24.1$, $360.2N{\pm}17.5$ and $330.9N{\pm}16.7$ : p=0.0024)은 반복하여 삽입, 인장 검사 할 때 마다 감소하였으나 cancellous lateral mass screws의 평균 인장항력($194.00N{\pm}36.47$, $219.24N{\pm}26.58$ and $199.49N{\pm}36.63$ : p=0.24)은 감소하지 않았다. 전자현미경 소견에서 나사이의 끝이 무디어지고 표면이 문드러진 것을 관찰할 수 있었다. 결론 : 일부 나사못을 반복하여 삽입한 후 나사못의 인장항력이 감소되었으므로 수술중 여러번 삽입하였던 나사못은 최종 구조물에 사용되지 않아야 한다. Object : The clinical uses of screws are increasing with broader applications in spinal disorders. When screws are inserted repeatedly to achieve optimal position, tips of screw pitch may become damaged during insertion even though there are significant differences in the moduli of elasticity between bone and titanium. The effect of repeated screw insertion on pullout resistance was investigated. Methods : Three different titanium screws(cortical lateral mass screw, cancellous lateral mass screw and cervical vertebral body screw) were inserted into the synthetic cancellous material and then extracted axially at a rate of 2.4mm/min using Instron(Model TT-D, Canton, MA). Each set of screws was inserted and pulled out three times. There were six screws in each group. The insertional torque was measured with a torque wrench during insertion. Pullout strength was recorded with a digital oscilloscope. Results : The mean pullout force measurements for the cortical lateral mass screws($185.66N{\pm}42.60$, $167.10N{\pm}27.01$ and $162.52 N{\pm}23.83$ for first, second and third pullout respectively : p=0.03) and the cervical vertebral body screws($386.0N{\pm}24.1$, $360.2N{\pm}17.5$ and $330.9N{\pm}16.7$ : p=0.0024) showed consecutive decrease in pullout resistance after each pullout, whereas the cancellous lateral mass screws did not($194.00N{\pm}36.47$, $219.24N{\pm}26.58$ and 199.49N(36.63 : p=0.24). The SEM after insertion and pullout three times showed a blunting in the tip of the screw pitch and a smearing of the screw surface. Conclusions : Repetitive screw insertion and pullout resulted in the decrease of pullout resistance in certain screws possibly caused by blunting the screw tip. This means screw tips suffer deformations during either repeated insertion or pullout. Thus, the screws that have been inserted should not be used for the final construct.

경막하 수낭종에 대한 임상적 고찰

백광흠,오석전,김광명,김남규,정환영 대한신경외과학회 1990 Journal of Korean neurosurgical society Vol.19 No.4

The author analysed 140 cases of subdural hygroma developed after head injury and various neurosurgical operations and was treated at Hanyang university hospital form 1983 to 1989. The results were analysed and summarized as follows. 1) The peak incidence was the age over 50 and under 10. 2) 104 cases (74.4%) were bilateral frontotemporoparietal lesions. 3) Causes were head injury (121 cases), operation for intracranial aneurysms (5 cases), ventriculoperitoneal shunt (5 cases), traumatic intracranial hematoma removal (4 cases), transcallosal tumor removal (2 cases), meningitis (2 cases), external ventricular drainage (1 cases). 4) Change in mental status without focal sign of brain damage was presenting symptom. 5) Operation was underwent if 63 cases and the reaccumulation rate was high (26.8%) after traphination but outcome was favourable. 6) Mortal rate in traumatic subdural hygroma was low (5.8%) because brain CT could detect subdural hygroma easily in early stage.

극외측 추간판 탈출증에 대한 복합 접근 수술법

백광흠,신형식,김재민,오성훈,김광명 대한신경외과학회 1996 Journal of Korean neurosurgical society Vol.25 No.2

A technique combining usual interlaminar approach and paraspinal intertransverse approach for exposing far-lateral disc herniations without disrupting the facet is described. This approach is useful because disc fragments can be removed from both intraspinal and paraspinal route with easy retraction and under short skin incision. This approach prevents reherniation by complete removing of residual nucleus pulposus. At the end of procedure the foramen can be explored in order to verify that foramen is opened. This approach is useful especially in operating the double herniations and extruded far lateral disc herniations.

추궁절제수술후에 발생한 의인성 가성수막척수류 : 증례보고 Report of Cases

백광흠,김용석,김재민,고용,오성훈,오석전,김남규,김광명,박동우 대한신경외과학회 1996 Journal of Korean neurosurgical society Vol.25 No.10

Two unique cases of delayed nerve root herniation and entrapment into the pseudomeningocele through an unrepaired dural laceration at lumbar laminectomy were reported. Both patients presented with recurred radiculopathy. 3 and 6 years after first operation respectively. Lumbar myelography showed an extradural pseudomeningocele pouch in case 1 while showing no abnormality in case 2. Lumbar MRI in case 1 showed tangled herniated nerve root in the pouch of pseudomeningocele. Lumbar myelographic CT of case 2 showed delayed partial filling of the pseudomeningocele pouch only.