감마나이프 CP 개발과 적용

조경기,김세혁,조경기,윤수한,안영환,양경아,한정숙,정승철,권경수,김연정,김경태,임연희,오지영,정명숙,천정희 한국의료QA학회 2009 가을학술대회 Vol.2009 No.3

요추부 디스크의 내압과 형태학적 변화와의 상관관계

조경기,박현선,정상섭 대한신경외과학회 1994 Journal of Korean neurosurgical society Vol.23 No.11

We studied the intradiscal pressure in order to understand the biophysics of the lumbar intervertebral disk. We evaluated the relationship between disk morphology and intradiscal pressure in 90 lumbar intervertebral disks of 64 patients. The intrinsic intradiscal pressure in the ruptured disks was much lower than that in the normal or bulging disk, but intrinsic intradiscal pressure alone did not correlate in a statistically significant way to the absence. or presence and/or type of disk herniation. The elastance of normal disks was statistically significantly higher than that of the protruded disk(p<0.05) however, the elastance of lumbar disk was not affected by type of disk protrusion. Factors affecting disk elastance were the degeneration and the integrity of the annulus fibrosus and the posterior longitudinal ligament The authors experienced no complication during the procedure. The measurement of the intradiscal pressure to evaluate the biophysical function of lumbar intervertebral disks is only a simple and risk-free procedure. Also it is suggested that patients with buldging disks of high elastance may be treated by reducing intradiscal pressure with percutaneous procedures such as chemonucleolysis, and automated discectomy using Nucleotome.

두개인두종에 관한 임상적 고찰

조경기,이규창,정상섭,김영수,최중언,이헌재 대한신경외과학회 1979 Journal of Korean neurosurgical society Vol.8 No.2

The present study involves 30 craniopharyngioma patients who were admitted to the Department of Neurosurgery, Yonsei Medical college from April, 1965 to December, 1978. All 30patients received surgery, the results of which were analyzed and evaluated as follows. 1. They consisted of 22 male and 8 female patients. Sixty percent of all patients were under 20 years of age. 2. Chief complaints were as follows: headache(80.0%), decreased visual acuity(80.0%), visual field cut (46.3%), nausea and vomiting(40.3%), papilledema(40.0%), optic atrophy(33.3%), diabetes insipidus(27.0%), and mental disturbance(27.0%). 3. They were diagnosed mainly by cerebral angiography until 1977, at times combined with pneumoencephalography, isotope brain scan, and Conray ventriculography. Since 1978 using the CT brain scan we have been able to reduce risk during and after neuroradiological study, and accurately determine location, size, shape and invasiveness of the tumor. 4. Surgical procedures were performed in 32 cases of craniopharyngioma using several approaches; transfrontal approaches; transfrontal approach: 29cases, transsphenoidal approach: 2 cases, and sterotaxic cyst puncture: 1 cases. In 8 cases (27.0%) total resection of the tumor was performed, subtotal resection in 23 cases (71.9%), and aspiration of the cyst in one case(3.1%). 5. In the above 32 surgeries, 24 cases(75.0%) of craniopharyngioma were performed by microsurgery, 8 cases involved total resection and 16 cases subtotal removal. As a result of microsurgery, it was possible to remove the tumor from the surrounding structures with less damage. 6. To manage hydrocephalus during the operation, extraventricular drainage was applied in 8 cases(27%) and in 7 cases(23.3%) ventriculoatrial or ventriculoperitoneal shunts were employed pre-or postoperatively. 7. Postsurgical radiation therapy was given to 8 patients in the dosage of 5000-7000 rad during 6 to 8 week period following surgery. 8. As a result of temporary hormonal dysfunctions after surgery, the following complaints were observed: diabetes insipidus, 16 cases(50.0%), hypernatremia, 7 cases(23.2%), and SLADH, 4 cases (12.5%). Three of the hypernatremia patients expired. 9. Evaluation of craniopharyngioma after surgery is as follows; improvement of preoperative symptoms and signs, in 22 cases(68.7%), no improvement of preoperative symptoms and signs in 4 cases(12.5%), aggravation of postoperative symptoms and signs in 3 cases (9.4%), and operative mortality in 3 cases(9.4%).

동위원소를 이용한 뇌종양의 내부방사선 치료

조경기 대한의학협회 1990 대한의학협회지 Vol.33 No.4

뇌손상으로 인한 지연성 뇌실질내출혈

조경기,이규창,정상섭,이헌재 대한신경외과학회 1979 Journal of Korean neurosurgical society Vol.8 No.1

The authors experienced a case of delayed traumatic intracerebral hemorrhage following a closed head injury. The patient had epidural hematoma at the right temporal area which was confirmed by the computed tomography. The hematoma was successfully evacuated and immediate postoperative course was uneventful. On the second day after operation the patient's condition deteriorated again and repeated computed tomography showed a large delayed intracerebral hematoma in the left occipital lobe. He was immediately treated surgically for the intracerebral hematoma with good result.

뇌교에 발생한 해면 혈관종의 수술적 제거 : 증례 보고 Case report

조경기 아주대학교 의과학연구소 1996 아주의학 Vol.1 No.1

The author presents a case of cavernous hemangioma of the pons which was successfully treated. The patient was an 18-year-old male who had right hemiparesis and dysarthria of 20 days duration. MRI revealed a 2㎝ sized round mass with irregular high signal intensity on Tl and T2 weighted image in the posterior portion of the pons near the floor of the 4th ventricle. It was totally removed via the floor of the 4th ventricle. The surgical indications for this lesion of the pans are briefly discussed with a review of the literature.

뇌종양에서 에스트로겐 및 프로게스테론의 수용체와 종양세포의 증식도와의 상관관계

조경기,신성혜,정상섭 대한신경외과학회 1992 Journal of Korean neurosurgical society Vol.21 No.1

Steroid receptors have been sugessted to play an important role in the synthesis of DNA and the growth of cells. Authors have estimated the concentrations of estrogen and progesteron receptors using the ELISA method, and the proliferative potential using immunohistochemical stain with the monoclonal antibody to bromodeoxyuridine(BUdR) in 46 human brain tumors(21 meningiomas, 12 astrocytomas, 7 schwannoma. 4 medullobastomas, and 2 pituitary tumors). In our studies, the concentration of receptors had no relationship with age and sex of patients, and tumor type, and the proliferative potential of the individual tumors.

경추 전방 추체간 골융합술시 철선을 이용한 이식 골편 고정술 : Technical Note

조경기,장진우,정상섭 대한신경외과학회 1992 Journal of Korean neurosurgical society Vol.21 No.3

One of the major complications in cervical anterior interbody fusion is slipping or dislodgement of grafted bone. Authors describe a simple wiring technique for prevention of slipping or dislodgement of grafted bone. Results are briefly discussed.

Hydroxylapatite를 이용한 두개골성형술

조경기,이광수 대한신경외과학회 1990 Journal of Korean neurosurgical society Vol.19 No.7

해양척추동물의 뼈에서 추출한 HA는 biocompatible하여 인체에 해가 없으며, 이물질반응이나 염증반응을 일으키지 않으며 골전도(osteoconductive) 작용이 있어 결손된 두개골과 직접 골융합을 일으키므로 두개골성형술 재료로서 이상적인 물질이다. 저자들은 HA를 사용하여 두개골성형술을 받을 11명의 환자를 1년7개월간 추적조사한 결과 만족할 만한 결과를 얻었기에 문헌고찰과 함께 보고하는 바이다. Repair of skull defects for brain protection and aesthetics is still a surgical problem for which there is no completely satisfactory solution. Material used for cranioplasty should ideally be incorporated into the surrounding skull bone with a blood supply. Hydroxylapitite is a dense pure ceramic material which is biocompatible, non-toxic, non-inflammatory, non-resorptive and osteoconductive. The authors had experienced good consmetic and functional results of cranioplasty Hydroxylapatite during 19 months of follow up period.

두개강내에 발생한 악성 신경교종에 대한 Iodine-125과 Iridium-192를 이용한 조직내삽입 방사선치료의 임상분석

조경기,정상섭,김영수,최중언,이규창,김수곤,서창옥 대한신경외과학회 1992 Journal of Korean neurosurgical society Vol.21 No.4

Twenty-nine patients haboring primary or recurrent malignant gliomas were treated with direct implantation of radioactive sources into the tumor in afterloaded, removable catheters using stereotatic technique between November 1987 and October 1990. Indine-125(I-125) was implanted in 22 patients and high dose rate(HDR) Iridium-192(Ir-192) in 7 patients. All patients had been treated with external radiation and most had been treated with chemotherapeutic agents. one or more sources were placed in each tumor to deliver 5000-8000 cGy to the tumor's periphery for I-125 and 3000 cGy for HDR Ir-192. Eleven of 13 patients with glioblastoma multiforme were alive at 35 weeks whose mean survival was 74 weeks, and remained two were expired at 35 and 78 weeks. respectively. All 5 patients with anaplastic astrocytoma were alive at 39 weeks whose mean survival was 74 weeks. Five of 9 recurrent glioblastoma were alive at 22 weeks whose mean survival was 44 weeks, and remained three were expired at 13, 17 and 22 weeks respectively. All two patients with anaplastic astrocytoma were alive at 22 and 52 weeks, respectively. Four patients with deep seated analplastic astrocytoma(3 in the thalamus and 1 in the third ventricle) were treated successfully by brachytheray without any surgical morbidity and mortality and they were still alive 38, 48, 74 and 123 weeks after brachytherapy. There were few minor postoperative complications including 3 meningitis. 2 leak of cerebrospinal fluid and 3 radiation necrosis without any mortality. The authors conclude that the brachytherapy with temporary implanted I-125 or Ir-192 sources may provide long-term survial in selected patients with primary or recurrent malignant gliomas.