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성우현,이일우,조태훈,송진언 대한신경외과학회 1986 Journal of Korean neurosurgical society Vol.15 No.4
Intracranial lipomas are rare tumor which are usually found at or near the mid saggital plane, especially in the corpus callosum. 3 cases of intracranial lipomas, diagnosed by CT scanning, are presented. The first case was a lipoma involving the midline of occiput to the bilateral occipital lobes through the skull defect. There was a calcified area in this tumor. The second case presented a generalized convulsive seizure as clinical manifestation, and the lipoma was found to be located in the corpus callosum. In the third case, the lipoma was located near the third ventricle and the tumor was found incidentally after head trauma. The first case was operated and the tumor was completely removed, the others were managed with symptomatic treament. The literature on this rare tumor is reviewed and discussed.
완전 적출 후 조기 재발된 양성 뇌수막종 1례 : Case Report
성우현,박춘근,김문찬,김달수,강준기,송진언 대한신경외과학회 1986 Journal of Korean neurosurgical society Vol.15 No.1
The average interval from first operation to recurrence is about 4 years and the reported shortest interval of malignant meningioma is about 6 months. The authors reported a case of rapidly regrowing benign meningioma. located on the outer 1/3 of the right sphenoid wing. The patient was free of recurrence only at 4 months after the first surgery in spite of macroscopic complete removal of the tumor. Factors associated with recurrence of meningioma are also discussed.
실험적 간질을 유발한 흰쥐에서 선택적 편도핵절제술의 효과
성우현,성기원,이재수,최창락 대한신경외과학회 1991 Journal of Korean neurosurgical society Vol.20 No.5
In order to study the effects of stereotaxic destruction of distinct epileptogenic focus, the amygdala was destroyed with radiofrequency coagulator. A total of twenty Sprague-Dawley rats were divided into two groups : the control group which underwent craniectomy on the biparietal area and was instilled crytal penicillin solution into the right amygdala on the basis of sterotaxic coordinates(n=10), and the amygdalectomy group which was performed selective amygdalectomy with radiofrequency coagulator after confirmation of clinical and electroencephalographic epileptic features after proceeding same methods of control group(n=10). The experimental epileptic models in rats were obtained by selective instillation of crystal penicillin solution into the right amygdala. The effects of amygdalectomy were investigated by observation of the canges in behavior and electroencephalographic recordings. The results were as follows; 1) A typical behavioral seizure was shown in the control group and epilepticform discharge was prominent in crystal penicillin solution instilled side, but there was no bilateral synchronous epileptic discharges during ictal stages. 2) In comparision to two groups, the severity and the frequency of behavioral seizure were more decreased in the stereotaxic amygdalectomy group. 3) The amygdalectomy group was shwon a significant decrease in amplitude and frequency of spikes, especially during interictal stages, compared to the control group. From the results of electroencephalographic and behavioral analysis, selective amygdalectomy with radiofrequency coagulator seemed to be an effective method to treat the crystal penicillin solution induced epileptic rats.
Clinical Results of Radiosurgery in CUMC
성우현,윤세철,최창락,최규호,강준기,서태석,전신수,박춘근,김문찬 가톨릭중앙의료원 가톨릭암센터 1995 암심포지움 Vol.- No.1
가톨릭대학교 의과대학 강남성모병원에서는 1988년부터 진단방사선과, 치료방사선과 및 신경외과의 공동연구로서 Radiosurgery를 실시하였으며, 지난 7년간에 137예의 환자에 대해 6 McV Lincar accelerator를 이용한 치료를 시행하였다. 이중 67예에 대해 그 치료결과를 분석하였다.
혈액투석 중인 말기 신질환 환자에서 대사성 산증과 칼슘대사 장애의 연관성
현상훈,한성우,구자룡,채동완,김근호,박우정,노정우,김형직,전노원 대한내과학회 2000 대한내과학회지 Vol.58 No.4
목적 : 혈액투석 중인 말기 신질환 환자에서는 지속적인 혈액투석에도 불구하고 경도의 대사성 산증이 발생한다고 알려져 왔으나 이로 인한 임상적 결과에 대해서 알려진 바는 거의 없다. 저자들은 혈액투석 중인 말기 신질환 환자에서 대사성 산증의 분포와 정도를 측정하고, 칼슘 대사와 관련하여 그 의의를 평가하고자 하였다. 방법 : 2개월 이상 지속적으로 혈액투석 중인 124명의 환자를 대상으로 투석전 동맥혈가스분석, 혈액화학검사, 부갑상선호르몬 농도 등을 측정하여, 대사성 산증 환자군의 임상적 특성을 분석하고 정상 산-염기평형 환자군과 비교하였다. 결과 : 투석전 동맥혈가스분석 결과 124명 중 92명(74.2%)에서 대사성 산증이 있었고, 12명(9.7%)은 정상 산-염기평형을 보였다. 대사성 산증 환자군은 정상 산-염기 환자군에 비해 투석기간이 길었으나(34.3±2.8 vs. 17.2±4.3개월, p$lt;0.05), 투석액의 종류, 주간 투석시간 및 KT/V는 차이가 없었다. 대사성 산증 환자군은 정상 산-염기 환자군에 비해 혈청 칼슘이 낮고(7.90±0.16 vs. 8.68±0.17 mg/dL, p$lt;0.05), 인(4.96±0.16 vs. 3.68±0.39 mg/dL, p$lt;0.05), 알칼리포스파타제(233.6±22.7 vs. 145.9± 13.7 U/L, p$lt;0.05) 및 었으나, 초산염 투석액군에서 혈청 총칼슘(7.28±0.25 vs. 7.96±0.17mg/dL, p$lt;0.05) 및 이온화칼슘 농도(0.85±0.05 vs. 1.08±0.04 mmol/L, p$lt; 0.05)가 낮았고, 혈청 알칼리포스파타제(457.1±170.2 vs. 209.4±15.9 U/L, p$lt;0.05) 와 부갑상선호르몬 농도(364.4±83.7 vs. 155.4±23.6 pg/mL, p$lt;0.05)는 높았다. 결론 : 현재 시행 중인 혈액투석방법에서 말기 신질환 환자의 대사성 산증은 현저하게 진행되고, 이는 체내 칼슘평형의 악화와 관련이 있을 것으로 생각한다. Background: Mild metabolic acidosis is frequently found among the stable patients treated with maintenance hemodialysis. However, its clinical effects have yet to be clarified. This study was undertaken to estimate the prevalence of metabolic acidosis in the patients undergoing chronic hemodialysis and to evaluate the clinical significance of metabolic acidosis, especially in relation to calcium metabolism. Methods: In 124 patients undergoing maintenance hemodialysis, analysis of arterial blood gas and measurement of various biochemical markers and parathyroid hormone were carried out with predialysis blood obtained from arterial side of arteriovenous fistula. Results: Ninety two patients(74.2%) had metabolic acidosis. Their arterial pH was 7.32±0.01, arterial bicarbonate concentration 17.1±0.3 mEq/L, and PaCO2 33.1±0.5 mmHg. The patients with metabolic acidosis showed a lower calcium(7.90±0.16 vs. 8.68±0.17 mg/dL, p$lt;0.05), and higher phosphorus(4.96±0.16 vs. 3.68±0.39 mg/dL, p$lt;0.05), alkaline phos(233.6±22.7 vs. 145.9±13.7 U/L, p$lt;0.05) and parathyroid hormone(176.5±23.7 vs. 52.8±14.4 pg/mL, p$lt;0.05) levels compared to those with normal acid-base balance. In the patients with metabolic acidosis, PaCO2 level showed a positive correlation with arterial bicarbonate concentration(r=0.62, p$lt;0.001). The lower arterial bicarbonate was, the higher serum potassium(r=-0.24, p$lt;0.05), phosphorus(r=-0.42, p$lt;0.001) and anion gap(r=-0.28, p$lt;0.01) were. When the patients were divided into two groups according to the dialysate buffer used, the lower calcium-acetate group showed lower total calcium(7.28±0.25 vs. 7.96±0.17 mg/dL, p$lt;0.05) and ionized calcium(0.85±0.05 vs. 1.08±0.04 mmol/L, p$lt;0.05) levels and higher alkaline phosphatase(457.1±170.2 vs. 209.4±15.9, p$lt;0.05) and parathyroid hormone (364.4±83.7 vs. 155.4±23.6 pg/mL, p$lt;0.05) levels compared to the higher calcium-bicarbonate group. Conclusion: Current hemodialytic practice is less than ideal, as evidenced by a high prevalence of metabolic acidosis. Thacidosis in maintenance hemodialysis is associated with abnormal calcium metabolism, suggesting that a more aggressive correction of metabolic acidosis may be required by individualizing dialysis prescription.(Korean J Med 58:420-429, 2000)