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요추부 수술후 경막외 Morphine Sulfate와 Bupivacaine의 지속적 주입에 의한 통증 조절의 효과
신문수,이병희,최훈규,노재섭,안정용,신승훈,이병희,정봉섭,Shin, Moon Soo,Lee, Byung Hee,Choi, Hun Kyu,Noh, Jae Sub,Ahn, Jung Young,Sheen, Seung Hun,Lee, Byung Hee,Chung, Bong Sub 대한신경외과학회 2000 Journal of Korean neurosurgical society Vol.29 No.5
Objective : The purpose of this non randomized prospective study was to verify the effect of pain control in small doses of epidural morphine and bupivacaine through continuous infusion for 48 hours. Patients and Methods : Thirty-five patients who underwent spine surgery including laminectomy, fusion with fixation were assigned into two groups ; pain control group(n=20) and control group(n=15). Pain score was measured on a visual analogue scale(VAS). A continuous infusor was used to give morphine and bupivacaine continuously via indwelling epidural catheter which was placed before closure of muscles in pain control group. Results : Mean scores(VAS) of pain control group were between 1.3 and 2.1 from the 30 min to the 72 hour, but the lowest mean score in the control group was about 2.6 at the 72 hour. Although a number of extra-analgesics were used in control group, differences of mean scores were statistically significant till 24 hour in pain control group. The patients in pain control group was less painful than the patients in control group from 24 hour till 72 hour, but it was statistically insignificant. There were some side effects such as nausea/vomiting, pruritus, urinary retention which existed transiently, but there was no respiratory depression. Conclusion : It was concluded that the early postoperative pain can be easily and safely controlled with continuous infusion of epidural morphine and bupivacaine in small doses.
뇌하수체졸중 환자에서 나타난 안검하수를 동반한 고립된 제 3 뇌신경 마비 -증례보고-
이현구 ( Hyun Goo Lee ),노재섭 ( Jae Sub Noh ),임종국 ( Jong Kook Rhim ),정봉섭 ( Bong Sub Chung ) 대한뇌종양학회·대한신경종양학회·대한소아뇌종양학회 2011 대한뇌종양학회지 Vol.10 No.1
Pituitary apoplexy is an acute ischemic or hemorrhagic vascular accident of a pituitary adenoma. Clinical features of pituitary apoplexy include sudden onset of headache, nausea, vomiting, visual symptoms, ptosis, altered mental status, and endocrinologic dysfunction. However, isolated third cranial nerve palsy with ptosis as the presenting sign of pituitary apoplexy is very rare. We describe one case of pituitary apoplexy presenting as sudden-onset unilateral ptosis and diplopia. So we suggest that pituitary apoplexy should be included in the differential diagnosis of patients presenting with isolated third cranial nerve palsy with ptosis and recommend that early surgical decompression should be considered for preservation of third cranial nerve.
자발성 뇌실질내 혈종에 대한 Hematome과 Urokinase를 이용한 뇌정위적 혈종 흡인술에 대한 임상적 분석
노재섭,변진수,허철,홍순기,김헌주,한용표 대한신경외과학회 1995 Journal of Korean neurosurgical society Vol.24 No.4
We had tried to perform mechanical aspiration using Hematome and fibrinolytic drainage with Urokinase for treatment of spontaneous intracerebral hematoma(SICH) in 24 patients. Mean initial volume of SICH was 53.65 26.34㎖, mean evacuated amount of SICH after Hematome procedure was 46.25 23.64%, and mean evacuated amount of SICH after fibrinolytic drainage after Urokinase was 74.15 20.89%, compared with pre-operative status. We could aspirate more than 50% of hematoma if the Hematome procedure had been performed within 18 hours after ictus(p=0.0306). The rebleeding rate after Hematome procedure was 8.3%, and overall mortality rate was 12.5%. These results seem to indicate mechanical aspiration using Hematome and fibrinolytic drainage with Urokinase might be one of the useful method for treatment of SICH.
신경피부멜라닌증 환자의 두개강내에 발생한 원발성 악성 흑색종 : Case Report
노재섭,황금,한용표,김헌주,홍순기,허철,변진수 대한신경외과학회 1992 Journal of Korean neurosurgical society Vol.21 No.10
An unusual case of neurocutaneous melanosis is presented. The patient had congenital dermal nevi, and displayed multicentric malignant cerebral melanoma associated with hydrocephalus and seizure in adult life. This suggests that a patient with congenital dermal nevus or marked generalized cutaneous pigmentation should be closely observed for the development of malignant melanoma of the nervous system.