뇌 동맥류 파열로 인한 두개강내 혈종의 임상적 의의

서면,김영수,박철완,고용,오성훈,오석전,김남규,김광명 대한신경외과학회 1994 Journal of Korean neurosurgical society Vol.23 No.12

The intracranial hematoma following cerebral anelllysmal rupture makes patient' s clinical status and outcome worse by pressure effect on the brain structure. It's incidence has vaned with authors between 5 - 30 % of patients with ruptured cerebral aneurysms. Several authors emphasized the importance of early operation to obtain better results by early removal of hematoma and reducing intracranial pressure. The authors retrospectively evaluated seventy-six patients with intracranial hematomas in 370 patients with ruptured aneurysms from Jan. 1987 to Dec. 1992. The incidence of hematoma resulting from ruptured aneurysm was 20.5 %. The most frequent site of aneurysm which was accompanied by intracranial hematoma was the middle cerebral artery, and the next was the anterior cerebral artery. The amount of hematoma andor evidence of midline shift were the important factors in predicting the clinical outcome. The most favorable outcome was found in cases with intracerebral hematoma only, and the worst was in cases with intracerebral hematoma associated with intraventricular hemorrhage. Fifty out of 76 patients with intracranial hematomas were operated on. Their outcomes were more favorable than in the patients who were not operated on. Aggressive surgical intervention was especially effective in patients with poor Hunt & Hess grades(Ⅳ or Ⅴ).

척추부 결핵의 수술적 치험례

서면,조기홍 최신의학사 1995 最新醫學 Vol.38 No.7

퇴행성 척추 전전위증의 임상적 분석

서면,오성훈,김영수,고용,오석전,김남규,정환영,김광명 대한신경외과학회 1993 Journal of Korean neurosurgical society Vol.22 No.3

The author has studied 60 patients of degenerative spondylolisthesis diagnosed and operatively treated at Hanyang University Hospital from January 1987 to June 1992, and analized the outcome. The results were summarized as followings : 1) Male to female ratio was 1 : 4, showing female predominance. Average peak ages were 5th and 6th decades. 2) "Pedicle-Facet Angle" and the degree of slipping had directly proportional relationship(Y=0.58X+110). The wider the angle is, the more slipping develops. 3) The significant symptom and sign were neurogenic intermittant claudication and negative straight-leg-raising test. 4) The degenerative spondylolisthesis developed most frequently at L4-5 level(74%), L5-S1(15%), L3-4(8%), 57 cases(95%) fell into Grade by Meyerding classification. 5) Complete or incomplete block on myelogram was present in 59%, and pseudodisc and lumbar spinal stenosis were noticed on CT. 6) Laminectomy with P.L.I.F. were done in 50 cases(83%) and total laminectomy and medical facetectomy and foraminotomy were done in only 4cases(7%). In the comparison on the slipping degree before & after operation, in 55 cases(92%), slipping degrees showed no great change less than 2㎜, but the almost showed excellent & good results. So we considered decompression & fusion without excessive reduction was sufficient. 7) Threaded fusion cage(T.F.C) had the several benifits that 1) stability was good, 2) osteosynthesis through threaded was possible and 3) postoperative ambulation was possible earlier. Therefore recently, P.L.I.F, using T.F.C in the treatment of degenerative spondylolisthesis were used in many cases and further evaluation for T.F.C. should be considered.

高入選拔考査와 中學校 學業成績間의 相關關係 硏究

徐冕洙 건국대학교 교육대학원 1982 敎育論叢 Vol.2 No.-

두부 못총상의 치험례

서면,김영태,하호균 건국대학교 의과학연구소 1996 건국의과학학술지 Vol.5 No.-

The authors report a rare case of gunshot injury to the head by a nail-gun which was treated by stereotactic surgery. The patient was arrived at our emergency room by 119 rescue. He was 23 years old with semicomatose mentality and decerebrated rigidity. On simple skull series and Brain CT scan, the large nail was located in the 3rd ventricular area in the mid-line with vertical stature. The entry point was identified 1 cm anterior to the coronal suture line and just lateral to the sagittal suture line. We planned stereotactic removal and the stereotactic frame was introduced to the patient. The foreign body was removed stereotactically with the guidance of C-arm fluoroscope. The # 8 L EVD drain was placed into the 3rd ventricle. Intensive care was performed to the young patient, but he died due to initial severe brain damage at # POD 6.

요천추부 결핵의 후방접근에 의한 병소제거후 재발에 따른 전방융합술에 의한 치험례

김영태,서면,조기홍,하호균 대한신경외과학회 1996 Journal of Korean neurosurgical society Vol.25 No.2

In the treatment of spine tuberculosis, anterior spinal fusion has been a widely accepted procedure since Hodgson and Stock in 1956 because of its many advantages. Posterior approach is a simplier & safer procedure. However the destructed vertebral body can not be removes completely by this procedure. A 50 years old female patient was admitted with lumbosacral tuberculosis showing massive destruction of the L5 & S1 vertebral body and abscess formation. We initially performeda curettage and debridement by the posterior approach, combined with chemotheraphy. A anterior fusion was a more risky procedure to the patient with poor general condition, severe adhesion and long destruction of the entire L5 & upper S1 vertebral body. Occured 35 days after first operation. Curettage and debridement were again undertaked by the posterior approach on the second operation. However 45 days late, it recurred again. Therefore, we performed the anterior fusion as the third procedure and had a successful outcome. We believe that in some cases, the advantages of posterior approach and fusion may be a pitfall and should be carefully applied in the treatment of spine tuberculosis.

고혈압성 기저핵부 - 시상부 뇌내출혈 환자의 예후 인자 : Thalamic Intracerebral Hemorrhage

손형권,서면,조기홍,김재민,하호균 대한신경외과학회 1996 Journal of Korean neurosurgical society Vol.25 No.5

The authors carried out various treatment modalities in 74 consecutive patients with hypertensive basal ganglionic-thalamic intracerebral hemorrhage and were admitted to the Department of Neurosurgery. Konkuk University Hospital. from Jan. 1991 to Dec. 1993 A variety of prognostic factors that influence mortality were observed. The location of hematoma was at the basal ganglia in 47 cases and at the thalamus in 27 cases. The prognosis gets poorer as the hematoma extended wider and deeper. The prognosis was unfavorable when the hematoma was over 30cc(P<0.001). The mortality rate was higher in cases with IVH than in cases without IVH(P<0.005). In cases with IVH. 19 cases(26%) showed dilated 4th ventricular hemorrage and a higher mortality rats(P<0.001). Cases in which the GCS were less than 9 on admission showed higher mortality rate(P<0.0001) The mortality rats was also higher if the midline shift was more than 10mm on the initial brain CT scan(P<0.005). The group where the unilateral or bilateral pupillary light reflex was unreactive(35cases) showed poorer prognosis than the group where the bilateral pupillary light reflex was reactive(P<0.0001). The ventriculocranial ratio(VCR). hydrocephalus. surrounding edema around the hematoma. and treatment modality were not related to the prognosis. The significant prognostic factors in patients with hypertensive basal ganglionic-thalamic intracerebral hemorrhage were location and type of hematoma. whether or not the volume of hematoma is more than 30cc. IVH, dilated 4th ventricular hemorrhage. Graeb's score of more than 7. GCS of less than 9. midline shift of more than 10mm. and reactivity of pupillary light reflex

일측성 원위전대뇌동맥 및 중대뇌동맥의 다발성 동맥류 : 증례보고

임성준,서면,하호균 건국대학교 1996 學術誌 Vol.40 No.2

The authors report a rare case of multiple aneurysm at left dismal anterior cerebral artery aneurysm and left middle cerebral bifurcation aneurysm which were treated by clipping. The left distal anterior cerebral artery aneurysm was ruptured in type and the left muddle cerebral artery bifurcation aneurysm was unruptured in type. We clipped the two aneurysms in early one stage operation(interhemispheric approach for the left distal anterior cerebral artery aneurysm and Pterional approach for the left middle cerebral artery bifurcation aneurysm). Key Words : Multiple aneurysm, Ruptured aneurysm, One-stage operation

흉·요추부 압박골절에 대한 수술 전후의 3차원 영상진단상의 변화에 대한 비교 분석

박한준,김영태,서면,하호균 대한신경외과학회 1997 Journal of Korean neurosurgical society Vol.26 No.6

못총에 의한 두부총상의 뇌정위적 수술 치험례 : 증례보고 Case Report

박한준,김영태,서면,하호균 대한신경외과학회 1996 Journal of Korean neurosurgical society Vol.25 No.9

The authous report a rare case of gunshot injury to the head by a nail-gun which was treated by stereotactic surgery. In the case a 23-year-old male patient, presented with semicomatose mentality and decerebrated rigidity. The large nail was located in the 3rd ventricular area in the mid-line with vertical stature. The entry point was identified 1㎝ anterior to the coronal suture line and just lateral to the sagittal suture line. The foreign body was removed stereotactically with the guidance of fluoroscope. But he died of initial severe brain damage.