뇌질환에 대한 CT 소견의 분석고찰

김예철,강영철,문석배,김국기,이봉암,이영근 대한신경외과학회 1978 Journal of Korean neurosurgical society Vol.7 No.2

Only a few years following its original development by the English Physicist G.N. Houns-field at 1971, cranial computed tomography has proved to be of revolutionary importance for the diagnosis of brain disorders. This is reflected not least by the almost immediate and worldwide acceptance of the diagnostic method. First in Korea, The EMI Scanner (CT 5005/7, 160×160 matrix) was introduced at Kyung Hee University Hospital on October 1977. Since then, we reviewed 444 CT scans for 1 year. 216 representative examples of abnormal CT findings among these have been chosen from this group of cases for more detailed discussion and illustration. The results were as follows; 1) 216 abnormal CT findings were subdivided into brain neoplasm 50, orbital tumor 6, AVM 1, intracerebral hemorrhage 44, occlusive CVD 30, craniocerebral trauma 46, cerebral abscess 3, meningoencephalitis 8, hydrocephalus 13, atrophy 16, parasite 4. 2) In most brain tumor cases the tissue undergoes a change of density. Vascularized tumors were enhanced after contrast infusion. Solid tumor area are well differentiated against cystic area and necroses, and hemorrhage in tumor is also well visualized. Tumor type is often surmised, exact classification is not possible. Thus a glioblastoma multiforme of the ring type can not lie differentiated from a metastatic tumor with central necrosis. But tumor density, appearance of contrast enhancement, predilection site of tumor, relation to adjacent structure, a degree of perifocal edema and clinical data are aid to identify the tumor type. 3) Spontaneous intracerebral hemorrhage can be identified with certainty because of high absorption values. Extent of hemorrhage and invasion of the ventricle are usually exactly visualized. Blood filling of basal cisterns and interhemispheric fissure is also well demonstrated. As opposed to spontaneous intracerebral hemorrhage, cerebral infarction shows as a region of low absorption values as early as 6 to 8 hours after ictus, which is often poorly defined with irregular borders and having mass effect during the 1st week thereafter. Sharper margins and more homogenous low density are developed 1 to 2 weeks after ictus and surrounding edema subsides with shrinking of hypodense area. Ipsilateral ventricular dilatation, homogenous low density area and sharp margins are usually found in older infarcts. 4) CT is the best method of assessing craniocerebral injuries. Since extravascular blood is set off by its high density and edematous tissue by its lower density from normal brain tissue, sequelae from injuries whose existence could only be suspected on account of the clinical symptoms but escaped detection regardless of the method used, can now be visualized directly in the CT. 5) Brain abscess has a charcateristics but non specific appearance as CT, consisting of a ring configuration of the abscess capsule which .shows marked enhancement after injection of contrast material. In acute stage of the meningoencephalitis, routine CT scan may be normal. During the course of illness, diffuse enhancement of the basal cisterns and varying degree of ventricular dilatation may be found. 6) Brain atrophy is diagnosed by an enlargement of internal and external CSF spaces. Using standard sections a classifications of the grade and form of the atrophy is made. The diagnosis of cysticercosis is made primarily calcification and multiple solid dense mass or cystic lesion surrounded by edema which may become enhanced following infusion of contrast media.

眼窩部에 發生한 筋芽細胞腫 1例 : A Case Report

김예철,김국기,이봉암,이영근 대한신경외과학회 1978 Journal of Korean neurosurgical society Vol.7 No.1

Granular cell myoblastoma is a relatively uncommon lesion of debatable history appearing as a small, solitary but occasionally multiple neoplasm and usually benign course. Most granular cell myoblastoma have been observed tongue, skin and subcutaneoues tissue and in the breast but only rarely in the orbit and we know of only 12 well-documented orbital myoblastoma at present. We have recently seen a orbital granuloma cell myoblastoroa occuring in a 39 year-old woman, the tumor was firmly attached to the muscle cone and caused exophthalmos with exodeviation of the left eye and was totally removed from the transcranial-orbital unroofing procedure.

카메라와 라이더 센서를 이용한 3차원 물체 인지 기술

김예철(Yecheol Kim),김재겸(Jaekyum Kim),고준호(Junho Koh),최준원 한국자동차공학회 2019 한국자동차공학회 부문종합 학술대회 Vol.2019 No.5

CT를 이용한 척추 생검 1예 : Case Report

강영우,김예철,김국기,이영근 대한신경외과학회 1978 Journal of Korean neurosurgical society Vol.7 No.2

The accuracy of percutaneous needle aspiration and biopsies in related to localization of pathology and of the needle tip. Localization methods of percutaneous needle aspiration currently in use are fluoroscopy, ultrasound and angiography. The authors believe that localization by computed tomography is the most accurate method for performing biopsies. The authors have performed the biopsy of the paravertebral lesion under the CT-scan using EMI-5005 on Aug. 23, 1978, at the Department of Neurosurgery, Kyung Hee University Hospital.

Commissural Myelotomy 1예 보고 : Case Report

김태성,김예철,김국기,이영근 대한신경외과학회 1978 Journal of Korean neurosurgical society Vol.7 No.2

The commissural myelotomy in the treatment of bilateral intractable pain was first reported by Armour in 1927. Used sparingly since its introduction it has recently met with renewed interest due to use of the operating microneurosurgical operating technique. We performed the commissural myelotomy in 40 years old male patient who complained of bilateral intractable pain in the lower extremities due to metastatic tumor. After total laminectomy from T_(10) to L₁, employing with magnifying glasses we performed commissural myelotomy about 70 mm in length (T_(10)-S₂ segment) and 5 mm in depth on June 26, 1978. After operation, we had good result.

마미강 후방으로 탈출된 요추간핵탈출증 1례

김승진,김예철,김국기,이영근 慶熙大學校 醫科大學 1978 慶熙 醫大 論文集 Vol.3 No.1

Cerebrovascular Accident와 유사한 대뇌전이 융모막암

강영철,김예철,문석배,김국기,이영근 대한신경외과학회 1977 Journal of Korean neurosurgical society Vol.6 No.1

Choriocarcinoma, a rare malignant neoplasm of trophoblastic tissue, is characterized by early blood borne metastasis to distant organs such as lung, liver and brain. Involvement of central nervous system by metastatic choriocarcinoma may be manifested as acute or subacute apoplexy due to vascular invasion with tumor emboli. Therefore the diagnosis of cerebral choriosarcinoma should be suspected in women of child bearing age presenting the signs of acute or subacute intracranial pathology. We present and discuss 2 cases of intracerebral metastatic chorioiarcinoma simulating cerebrovascular accident. One case, a 35 years old Korean housewife, was admitted to the department of neurosurgery, Kyung Hee University Hospital, with the chief complaints of headache, vomiting, focal seizure and right sided hemiplegia for 2 weeks' duration. She had a history of irregular vaginal bleeding from 3 months before admission. On admission, there were flaccid paralysis of the right extremities with right sided facial palsy, central type and neck stiffness in moderate degree. Gynecologically, round tumor mass about 1.5㎝ in size at vagina was palpable and urine HCG was positive. Chest X-ray film showed scattered multiple nodular densities at both lung fields. Carotid angiogram showed vascular tumor in the fronto-parietal region. Brain scan revealed increased uptake in the parietal area. She died suddenly 3 days later at home. Another case, 39 years old housewife, was admitted to the hospital with unconscious state. Although she had an operation of hysterectomy 5 months before admission due to massive vaginal bleeding, she was quite well till several hours prior to admission when she complained of headache and vomiting followed by sudden loss of consciousness. Neurologic examination revealed deep comatose state with full dilated and fixed pupil. Chest film showed several nodular densities at both lung fields. Carotid angiogram revealed avascular space occupying lesion at right posterior parietal region. On operation, Dura was tense and scanty subdural hematoma and massive brain swelling were identified and intracerebral hematoma estimated 80cc was evacuated. Atypical trophoblast was found microscopically from biopsy material. She died on the 2nd postoperative day.

뇌경막하 혈종의 CT 소견 : Analysis of 5 Cases

김국기,김예철,강영철,문석배,이봉암,이영근 대한신경외과학회 1978 Journal of Korean neurosurgical society Vol.7 No.1

Computed tomography (CT) is a new and innovative radiologic technique, the diagnostic value of which has been well established by many reports. On account of its rapidity and non-invasiveness, CT has become the diagnostic procedure of choice for the initial evaluation of head trauma patients. The authors have performed CT scan Eusing EMI-5005 on 5 cases of subdural hematoma during the period of 8 months from October 1977 to May 1978 at the Department of Neurosurgery, Kyung Hee University Hospital. Various attenuation coefficients of hematoma such as hyperdense, hypodense, isodense and of mixed density were observed by the CT images. One case of isodensity hematoma were clearly identifiable by delayed enhancement technique, which had been confused by ordinary, noninfused method.

수아종과 공존된 후두와 다발성 지주막낭종 1례 : Case Report

문석배,김승진,김예철,이봉암,이영근 대한신경외과학회 1977 Journal of Korean neurosurgical society Vol.6 No.1

Arachnoid cysts are usually classified as developmental anomaly, inflammatory and traumatic in origin. Arachnoid cyst in posterior fossa occur frequently in the midline posterior to the cerebellum. These cyst usually present symptoms and signs due to increased intracranial pressure and may be confused with cerebellar or fourth ventricular tumor. Recently we had experienced a case of multiple retrocerebellar arachnoid cysts coexisted with pathologically confirmed desmoplastic medulloblastoma in eight months old infant and reviewed the literatures.

두부외상환자에 동반된 부외상의 임상적 관찰

강영철,문석배,김예철,김국기,이영근 中央醫學社 1976 中央醫學 Vol.31 No.6

The ever-growing traffic on the roads is one of the main causes of the rise in the number of head injured patients, fall and violence are also increasing constantly, so that more and more people are suffering from head injuries. These many present-day accidents frequently result in the victims receiving multiple complex injuries beside head injuries and the prognosis of such patients become unfavorable. For example, it is well, known that the combination of head injuries and chest injuries is hazardous. This paper is concerned with the problem of associated injuries , in 575 head injured patients admitted to Department of Neurosurgery, Kyung Hee University Hospital from January to December. in 1975. The results were as follows; 1) In head injured patients, males outnumbered females by almost 2 to 1. The age incidence was greatest in 3rd decade. 2) The head injuries were caused by traffic accident(72.8%), falls from heights (18.2%), direct blow(8.7%) and bullet injury(0.35%). 3). Significant associated injury was present in 24% of the total patients and the most frequent nature of the associated injuries was fracture. 4) The sites of the associated injuries were distributed as limbs(39. 7%.), chest (15.4%), pelvis(11.6%) and abdomen(8.5% in order. 5) Each, mortality rate of the associated injuries was as follows; 25.0% for abdomen, 24. 1% for chest and 13.6% for pelvis. 6) Overall mortality rate of head injured patients was 8.3%, in contrast, that of the patients with, associated injuries was 10.9%.