두개강내 종양에 대한 통계학적 고찰

김헌대,임창수,이기찬 최신의학사 1984 最新醫學 Vol.27 No.3

지주막하 출혈후 합병되는 수두증에 대한 Intracisternal Urokinase의 효과

김헌대,박윤관,정용구,정흥섭,서중근,이훈갑,이기찬,주정화 대한신경외과학회 1990 Journal of Korean neurosurgical society Vol.19 No.8-9

The author has investigated the effects of intracisternal urokinase on the multihemorrhage canine model of chronic post-subarachnoid hemorrhage(SAH) hydrocephalus. Each of 16 adult mongrel dogs was assigned to one of two experimental groups. All animals received a total of 13㎖ of fresh unheparinized autologous blood via three cisternal injections. Eight animals were treated by intracisternal injection of 20,000 IU of Urokinase every 12 hours for 3 days, and the remaining were not treated. The changes in ventricular volumes were measured by computed tomography(CT) before and 3 months after the initial subarachnoid blood injection. To compare the changes of hydrodynamic properties in chronic phases of post-SAH hydrocephalus, the pressure-volume index(PVI) technique of bolus manipulation of cerebrospinal fluid(CSF) was used to measure the volume-buffering capacity of neural axis and the resistance to the absorption of CSF(before SAH, post-SAH 1 month, 3 month). The final ventricular volume at 3 months of control group was 4 times greater than the initial volume, but Urokinase group less than two times. The mean measured PVI values of control group and Urokinase group were 3.98±0.76㎖(± standard deviation(SD)) and 4.01±0.82㎖ in baseline study, 3.09±0.96㎖ and 3.70±0.84㎖ in post-SAH 3 month. The mean resistance of CSF outflow of control group and Urokinase group were 10.30± 2.24㎜Hg/㎖/min), and 10.34±1.98㎜ Hg/㎖/min in baseline study. At I month and 3 months after SAH, control group maintained high absorptive resistance(29.54±11.50㎜Hg/㎖/min, 22.43±3.82㎜ Hg/㎖/min), whereas the resistances of Urokinase group were slightly increased and then returned to the original levels(16.04±4.87㎜ Hg/㎖/min. 12.87±3.06㎜ Hg/㎖/min). The results described in this experimental study indicated that if fibrinolysis of the subarachnoid blood clot can be achieved rapidly after SAH, the complicating chronic hydrocephalus might be prevented.

자발성 수액비루와 합병된 접형동 점액종 : 1예 보고 Case Report

김헌대,정용구,이훈갑,이기찬 대한신경외과학회 1983 Journal of Korean neurosurgical society Vol.12 No.4

Mucocele is commonly found in frontal sinus. Mucocele of sphenoid sinus is rare and only 100 cases have been reported since Burg's description in 1889. Their etiology is still conjectural. These lesions are potentially more serious and are often misdiagnosed as pituitary tumor. The author experienced a case of sphenoid sinus mucocele developed headache, fever and CSF rhinorrhea. Plain skull, cisternography brain CT scan help the diagnosis of sphenoid sinus mucocele. A transnasal approach is considered best for case with extensive sphenoid sinus mucocele with bone destruction in the floor of sella turcica. The headache, fever and CSF rhinorrhea improved after surgery.

지주막하출혈후 합병되는 수두증에 대한 Itracisternal Urokinase의 효과

김헌대,박윤관,이훈갑,이기찬,주정화 고려대학교 의과대학 1990 고려대 의대 잡지 Vol.27 No.1

The author has investigated the effects of intracisternal urokinase on the multi-hemorrhage canine model of chronic post-subarachnoid hemorrhage (SAH) hydrocephalus. Each of 16 adult mongrel dogs was assigned to one of two experimental groups. All animals received a total of 13 ml of fresh unheparinized autologous blood via three cisternal injections. Eight animals were treated by intracisternal injection of 20,000 IU of Urokinase every 12 hours for 3 days, and the remaining were not treated. The changes in ventricular volumes were measured by computed tomography (CT) before and 3 months after the initial subarachnoid blood injection. To compare the changes of hydrodynamic properties in chronic phases of post-SAH hydrocephalus, the pressure- volume index (PVI) technique of bolus manipulation of cerebrospinal fluid (CSF) was used to measure the volume-buffering capacity of neural axis and the resistance to the absorption of CSF (before SAH, post-SAH 1 month, 3 month). The final ventricular volume at 3 months of control group was 4 times greater than the initial volume, but Urokinase group less than two times. The mean measured PVI values of control group and Urokinase group were 3.98±0.76ml(±standard deviation(SD)) and 4.01±0.82ml in baseline study, 3.09±0.96ml and 3.70±0.84ml in post-SAH 1month, 3.58±0.65ml and 3.82±0.73ml in post-SAH 3 month. The mean resistance of CSF outflow of control group and Urokinase group were 10.30±2.24mm Hg/ml/min and 10.34±1.98mm Hg/ml/mifi in baseline study. At 1 month and 3 months after SAH, control group maintained high absorptive resistance(29.54±11.50mm Hg/ml/min, 22.43±3.82mm Hg/ml/min, whereas the resistances of Urokinase group were slightly increased and then returned to the original levels(16.04±14.87mm Hg/ml/min, 12.87±3.06mm Hg/ml/min). The results described in this experimental study indicated that if fibrinolysis of the subarachnoid blood clot can be achieved rapidly after SAH, the complicating chronic hydrocephalus might be prevented.

제 4뇌실에 발생한 거대한 맥락총 유두종 1예

김헌대,주정화,이훈갑,이기찬 대한신경외과학회 1980 Journal of Korean neurosurgical society Vol.9 No.2

Papilloma of the choroid plexus is a rare tumor with an incidence of 0.4% to 3.9% among all intracranial tumors. This tumor, which is typically located in the lateral ventricles of young children, while most of the tumors- in adults were located in the 4th ventricle, is amenable to surgical removal. We report a case of choroid plexus papilloma of the 4th ventricle in 17 years old boy with complaints of occipital headache, progressing ataxia and decreased visual acuity. The tumor occupying 4th ventricle and cisterna magna was a hen's egg sized pinkish globular mass with irregular papillary surface. Microscopically there are monotonous pattern of branching fibrous stroma, containing many blood vessels, radiating from a single area and covered with simple columnar epithelial cells.

후두에 발생한 신경내분비종양 4예

이용식,김광일,김헌대,권영조 대한이비인후과학회 2004 대한이비인후과학회지 두경부외과학 Vol.47 No.12

Neuroendocrine neoplasms of the larynx arise from APUD (amine precursor uptake and decarboxylase) cels. Neuroendocrine neoplasms of the larynx canbe divided into those of epithelial or neural origin. The later consists of paragangliomas while the group of the epithelial origin can be further divided into typical and atypical carcinoids, and small cel neuroendocrine carcinoma, which consist of the oat cel type, the intermediate cel type and the combined cel type. There are now over 500 cases of neuroendocrine neoplasms of the larynx reported in the literature. The diagnosis is primarily based on light microscopy and; in ultrastructural investigation. The diferent biological behavior of neuroendocrine neoplasms of the larynx makes a specific diagnosis of paramount importance, since treatment depends on accurate diagnosis. We experienced 4 cases of neuroendocrine carcinoma of the larynx, and which we report with a review of literatures.

요추간 수핵탈출증 환자에 대한 방사선학적 고찰

정흥섭,이기찬,이훈갑,김헌대,주정화 대한신경외과학회 1981 Journal of Korean neurosurgical society Vol.10 No.2

X-ray films of the lumbosacral spine are necessary in the evaluation of all patients who are considered to have lumbar disc disease. Several positive X-ray film findings are of possible significance, and although not in themselves diagnostic, they are compatible with, lumbar disc disease. Among patients treated and diagnosed by surgical operation for lumbar disc herniation from August, 1978 to February, 1981 at Korea University Hospital, 132 cases with their simple X-rays availuable for study were selected. Height of intervertebral disc space (Hurxthal method), spurrings, changes in facet joint, size of spinal canal (Johnes & Thomson method), lumbosacral angle (Ferguson method), congenital defect were studied and measured in simple films. Lumbar disc herniation was most frequent at L4-L5 intervertebral space (65.5%). The incidence of positive radiological findings were 85.6%. 1, Intervertebral disc space narrowing was found in 25%, 59.3% and 50% at L3-4, L4-5 and 2nd L5-S1 level respectively. 2. Peripheral osteophyte formations in the bodies of lumbar vertebrae were found in 44.7%. 3. Narrowing and/or sclerotic changes of facet joint were observed in 31.06%, subluxation in 14.39% and facet tropism in 5.3%. 4. The overall mean size of spinal canal at L4 vertebral level was 1 : 4.325 in male, 1 : 3.898 in female and at L5, 1 : 3.772 in female. Narrowed spinal canal in this series were found in 25.6%. at L4 and 17.2% at L5. 5. The overall mean lumbosacral angle %as 32.4 degree in male and 31.5 degree in female. Spondylolysis was observed in 4.54%. spondylolisthesis in 3.03%, lumbarization in 8.3% and sacralization in 1.51 %.

두경부 암의 예후인자로서의 SUV 측정의 분석

이병철,심윤상,이용식,이국행,성낙윤,홍성출,김헌대,김병일,정광윤 대한이비인후과학회 2003 대한이비인후과학회지 두경부외과학 Vol.46 No.11

Background and Objectives:Previous studies have shown that uptake of 18Fluoro-2-deoxy-glucose in head and neck cancer, as determined by the standardized uptake value (SUV) on positron emission tomography scan (PET scan), is associated with the biology of tumor. The aims of this study were to confirm the association with the biology of tumor and to establish whether a high SUV had prognostic significance. Materials and Method:Thirty patients with the head and neck cancer diagnosed as squamous cell carcinoma underwent a PET scan before treatment. SUVs were analyzed for possibility correlated with disease-free survival. Results:In univariate survival analysis, when patients were divided into two groups based on the SUV cut-off (p= 0.029). Corelation analysis demonstrated that SUV provided prognostic information independent of the tumor size, pathologic differentiation and stage. Conclusion:We conclude that high FDG uptake on PET (SUV >8 in pre-treatment PET scan) is an important prognostic indicator for poor outcome. Identified patients are thought to require intensive treatment protocol and more careful follow up.(Korean J Otolaryngol 2003 ;46 :955-8)

갑상선 고분화 암종의 재발 양상에 대한 고찰

성낙윤,이용식,심윤상,이국행,이병철,김광일,김헌대 대한이비인후과학회 2003 대한이비인후과학회지 두경부외과학 Vol.46 No.10