뇌실내 지주막 낭종

박해관,김달수,박춘근,송진언,강준기,최창락 대한신경외과학회 1991 Journal of Korean neurosurgical society Vol.20 No.9

Two rare cases of intraventricular arachnoid cyst location in the posterior portion of the third ventricl are presented. A diagnosis was based on the radiological and operative findings and the microscopic features. Cyst wall fenestration by a direct approach resulted in good outcome. The origin and the management of arachnoid cyst are discussed.

척추골 전전위증의 외과적 치료

박해관,나형균,이길송,최창락,송진언,안명수 대한신경외과학회 1989 Journal of Korean neurosurgical society Vol.18 No.4

We have operated on 13 Patients with Spondylolisthesis over recent 3 years. The age of Patient was from 4th decade to 7th decade, with the largest number in 6th decade. The method of operation were Posterior lumbar interbody fusion(PLIF) in 7cases, anterior interbody fusion in one case, Hrrington application in one cases, Facet joint reconstruction with wiring in one case, PLIF+Harrington in one case, and Roy-Camille Pedicular screw in 2cases. The result of operation were considered excellent in 8 cases, fair in 4cases and poor in one case. On the selection of operating method for the patients with spondylolisthesis, we suggest that. 1) In cases of the isthmic type or dysplastic type without disc protrusion, one method among bilateral intertransverse fusion, fixation by wiring or Harrington rod application could be used. 2) In case that extensive laminectomy is needed such as associated with spinal stenosis or disc protursion, PLIF is considered to be good method. 3) If displacement is severe(especially in case of severe unstable spine due to spinal trauma), pedicular screw could be placed because it can reduce and immobilize the displaced spine. 4) In cases of simple spondylolysis or mild spondylolisthesis with isthmic defect, if symptom is continued, bone graft in the defect are and fixation by wiring is good method.

경추부 Dumbbell Tumor의 완전적출을 위한 Lincoln Highway Transuncodiscal Approach

박해관,박춘근,강준기,최창락 대한신경외과학회 1991 Journal of Korean neurosurgical society Vol.20 No.8

A combined anterior and lateral approach to the anterior cervical canal was performed on 2 patients with cervical dumbbell-shaped tumors. The procedure consists of anterior discetomy and ispsilateral uncectomy, and removal of the posterolateral corners and posterior transverse ridges of the upper and lower verterbral bodies at the level of the tumor. In one case of a large tumor in the spinal canal, additional removal of a limited segment from the lateral part of the vertebral body was performed and the bone defect was filled with a T-shaped bone graft. The higest level of the operation was C-2 and the lowest was C-4. The authors believe that any cervical dumbbell-shaped tumor below the C-2 level can be removed via anterolateral approach as long as no more than 3 levels of the spine are involved.

Collagen/poly(d,l-lactic-co-glycolic acid) composite fibrous scaffold prepared by independent nozzle control multi-electrospinning apparatus for dura repair

박해관,주원일,구본강,하미연,유수정,전흥재 한국공업화학회 2018 Journal of Industrial and Engineering Chemistry Vol.66 No.-

The objective of the present study was to evaluate non-woven collagen/poly(lactic-co-glycolic acid) fibrous scaffold (Col/PLGA FS) prepared by a co-electrospinning process using a novel multi syringe electrospinning system for dura repair. The morphological and mechanical properties of the fibrous scaffolds (FSs) were assessed by scanning electron microscopy (SEM) and a universal testing machine (UTM). The changes in chemical composition due to the incorporation of collagen into PLGA were determined by Fourier transform infrared spectroscopy-attenuated total reflection mode (FTIR-ATR). The biocompatibility of the FSs was also evaluated in vitro in cultures of mouse fibroblasts and in vivo by subcutaneous implantation studies in rats. SEM images of the samples showed that the fiber size distribution of Col/PLGA FS became narrow compared to that of PLGA FS due to the incorporation of collagen with small fiber diameter. The FTIR-ATR spectrum of Col/PLGA FS revealed the characteristic bands of collagen and PLGA, indicating the co-existence of two fibrous structures. The poor mechanical properties of collagen FS were improved by co-electrospinning with PLGA. In vitro L929 cell proliferation assay revealed that the cyto-compatibility of Col/PLGA FS was increased compared to that of PLGA FS. In addition, Col/PLGA FS showed increased hydrophilic properties sufficient to absorb the exudates at the interface with mild foreign body reactions. In animal studies using a traumatic brain injury (TBI) model, the incorporation of collagen induced increased macrophage chemotaxis, and the post-inflammatory reaction of these cells led to remarkable brain tissue regeneration.

미세혈관감압술 및 감각신경 근 부분절제술로 치료한 삼차신경통 환자 154예의 치료결과

최창락,박해관,조정기,박성찬,조경근,이경진,나형균 대한신경외과학회 1999 Journal of Korean neurosurgical society Vol.28 No.9

두개골에 발생한 고립성 형질세포종 - 증례보고 -

한정훈,박해관,민창기,조정기,박성찬,조경근,이경진,나형균,최창락,강준기,Han, Jeong Hoon,Park, Hae Kwan,Min, Chang Ki,Cho, Jung Ki,Park, Sung Chan,Cho, Kyung Keun,Lee, Kyung Jin,Rha, Hyoung Kyun,Choi, Chang Rak,Kang, Joon Ki 대한신경외과학회 2000 Journal of Korean neurosurgical society Vol.29 No.5

Solitary plasmacytomas are rare and account for 5-10% of all plasma cell disorders. These tumors are categorized as solitary plasmacytomas of bone(osseous) or extramedullary plasmacytomas(non-osseous). About a half of solitary plasmacytomas of bone occur in the spine but rarely in the skull. We report a case of solitary plasmacytoma of the skull presented with a painless palpable left parietal calvarial mass in an otherwise asymptomatic 38- year-old man. Skull radiographs showed a large radiolucent lesion with well defined non-sclerotic margins. Computed tomograph scan demonstrated a markedly enhancing mass extending from the epidural to the subcutaneous space. The patient underwent surgery and tumor was completely excised. Pathological examination showed tumor to be a plasmacytoma synthesizing IgG. Postoperatively, the patient received radiotherapy. There was no evidence of systemic involvement on postoperative laboratory wokups. Our recommended treatment is a complete surgical excision combined with postoperative radiation therapy. The patient should be follwed carefully for more than 10 years because of either local recurrence or possible progression to multiple myeloma.

의료 관련 종사자들의 약물음독에 대한 고찰 -2곳의 응급의료센터 경험을 토대로

이미진,박해관,박규남,최승필,이원재,김세경,Lee Mi Jin,Park Hae Kwan,Park Kyu Nam,Choi Seung Pil,Lee Won Jae,Kim Se Kyung 대한임상독성학회 2004 대한임상독성학회지 Vol.2 No.2

Purpose: In recent review of physician suicides] the relative risk of physicians is higher than the general population. The majority of physician suicide were by poisoning. The purpose of this study was to analyse the medical personnels with suicide by poisoning compared with the general population. Methods: We reviewed medical records of 15 medical related personnels with suicide by poisoning who visited the emergency medical centers of St. Mary's and Kangnam St. Mary's hospitals from March 1998 to Aug 2004. For the comparison with general population in analysis] the collected data was acquired from medical records of 677 intoxicated patients in St. Mary's Hospital during the same period. Results: Fifteen suicides of physicians (n=7), nurses (n=4), medical students (n=2), pharmacist (n=1) and medical assistant technician (n=1) was evaluated with regard to the method of poisoning. Preferred methods were ingestion of medications orally ($54\%$) and by infusion/injection ($46\%$). The results were compared with the general population group (n=677: oral ingestion of medications $98\%$, inhalation $1.6\%$). Intoxications by infusion/injection predominated more clearly in physicians than in the total collective. Conclusion: Comparing with the general population, the tendency to a method of suicidal poisoning being typical of the profession rises among physicians and related occupations with the degree of specialization, caused by increasing knowledge, easier access to appropriate drugs and methods.

경막하 수종으로 오인된 중두개와 지주막 낭종을 동반한 대뇌궁륭부 지주막 낭종 - 증 례 보 고 -

김성림,박해관,박성찬,나형균,강준기,최창락,Kim, Seong-Rim,Park, Hae Kwan,Park, Sung Chan,Rha, Hyung Kyun,Kang, Joon Ki,Choi, Chang Rak 대한신경외과학회 2001 Journal of Korean neurosurgical society Vol.30 No.2

Arachnoid cysts are defined as duplicated arachnoids and their splitting with congenital, intra-arachnoid, and leptomeningeal malformations. They are most commonly located in the middle cranial fossa followed by suprasellar and quadrigeminal cisterns, posterior fossa, and very rare in cerebral convexities. They are often ruptured by trauma or spontaneously and cause subdural hygroma or subdural hematoma. Authors report a case of a 32-year-old woman with a convexity arachnoid cyst mimicking subdural hygroma associated with a separate middle fossa arachnoid cyst. Preoperatively, the convexity arachnoid cyst was misinterpreted as subdural hygroma resulted from a ruptured middle fossa cyst. The patient underwent craniotomy and cyst fenestration into the basal cistern. Two separate arachnoid cysts were found in the cerebral convexity and middle cranial fossa during the operation. Finally, cysts were resolved and she was discharged without any complication.

척수 공동증을 동반한 제 1 형 키아리 기형 환자에서 고막천공용 튜브를 이용한 공동절개술- 증 례 보 고 -

김일섭,박해관,조정기,박성찬,조경근,나형균,최창락,강준기 대한신경외과학회 2002 Journal of Korean neurosurgical society Vol.31 No.1

We describe a case of syringomyelia associated with type I Chiari malformation treated with syringostomy using myringostomy tube. The syrinx was found at C2 to C5 level, and the patient presented with quadriparesis and both shoulder pain. We performed extensive suboccipital craniectomy, C1 laminectomy, duroplasty, and then syringostomy using myringostomy tube. Postoperatively, the clinical and neurological improvement was noted and MRI showed reduced size of syrinx. Key words:Myringostomy tube;Syringostomy;Syringomyelia;Chiari malformation.

Gerbil에서의 일시적 전뇌허혈성 뇌손상 모형에서 저체온이 c-fos, c-jun 암유전자의 발현에 미치는 영향

박성찬,박해관,조경근,박영섭,김달수,최창락 대한신경외과학회 1996 Journal of Korean neurosurgical society Vol.25 No.3

Increased release of excitatory neurotransmitters leading to activation of signal transduction has been noted after cerebral ischemia. One of the biochemical events in the signaling processes is an alteration of gene expression, that is, increased expression of immediate early genes(IEGs) such as the protooncogenes, c-fos and c-jun. Recent studies have shown that hypothermia has a beneficial protective effect on hippocampal neuronal loss during or after cerebral ischemia. In this study, we investigated the expression of c-fos and c-jun by immunohistochemical stain at the hippocampal CA1, CA3 and parietal cortex(PC) along the changes by body temperature in a transient global cerebral ischemia model of gerbil in order to check the effect of hypothermia. The experimental groups were divided into control(36∼36.5℃), normothermic(36∼36.5℃), hypothermic(32∼33℃) and hyperthermic groups(38∼39℃) and a transient global cerebral ischemia was made by clipping of both common carotid arteries for 10 minutes, followed by reperfusion for 120 minutes. The results were as follows : 1) in all ischemic groups, the expressions of c-fos and c-jun were increased compared with the control group. The expression of c-fos was markedly enhanced and that of c-jun was also enhanced in a similar pattern, but lower in count than that of c-fos. 2) The expression of c-fos at the hippocampal CA1 was enhanced significantly in all three ischemic groups compared with the control group(P<0.01). At the hippocampal CA3 and parietal cortex(PC), the expression was enhanced significantly in the normothermic and hypothermic groups(P<0.01), but not in the hyperthermic group compared with the control group. 3) The expression of c-jun at the hippocampal CA3 was enhanced in hippocampal CA1 and PC. 4) In the aspect of location in each experimental group, the expressions of both protooncogenes were increased in CA1<CA3<PC in that order in all ischemic groups except the control group(P<0.01). In conclusion, the expressions of protooncogenes would be increased as a stress response for cell survival from ischemic insult during the early post-ischemic stages and c-fos, not c-jun, may play a major role in upregulating other genes in response to exogenous stimuli. These results also suggest that the parietal cortex is more resistant to ischemic injury than the hippocampus and hypothermia may have a beneficial neuroprotective effect by enhancing the expression of these protooncogenes in the early stage of cerebral ischemia.