前交通動脈瘤에 關한 腦血管造景術像의 觀察

여형태,박연묵,김승래 慶北大學校 醫科大學 1983 慶北醫大誌 Vol.24 No.1

저자등은 1978년 1월부터 1981년 3월까지 경북대학 병원 신경외과에 입원된 뇌 지주막하 출혈을 일으킨 40명의 전교통 동맥류 환자에서 전교통 동맥에 유입되는 전대뇌 동맥(A_1)의 기형(hypoplasia) 및 혈류 순환의 양상과 함께 동맥류의 크기, 모양 그리고 성장 방향을 뇌 혈관 조영술상으로써, 분석 관찰하였다. 성별 분포는 남자가 60%, 여자가 40%로서 남, 녀의 비는 1.5 : 1이었으며 연령별 빈도는 40-59세층에서 72.5%를 차지하였다. 출혈에 의한 혈관 연축은 47.5%에서 나타났으며 국소 연축이 32.5% 광범위 연축이 15%였다. 동맥류의 모양은 lobulation형이 42.5%로서 가장 많았고 다음으로 Spherical 형, Egg 형 및 Bar 형의 순이었다. 동맥류의 최장 직경은 4㎜에서 22.5㎜ 까지 분포되어 있었으며 4-7.9㎜ 크기의 동맥류가 47.5%로서 가장 많았다. 동맥류의 성장은 전방 성장이 57.5%로써 가장 많았다. 전교통 동맥류에서 A_1의 hypoplasia 빈도는 32.5%로서 대부분이 우측에서 나타났으며 대조군인 내경동맥-후교통 동맥류에서는 3.3%였다. 전교통 동맥류의 발생은 좌측 A_1 의 말단 분지부에서 발생이 57.5%로서 우측에서의 40%에 비하여 높은 빈도를보였으며 A_1에 hypoplasia 가 있는 환자에서는 좌측에서의 발생이 69.2%로 더욱 높은 빈도를 나타내었다. Willis환 전반부의 비정상 혈류 순환은 전교통 동맥류 환자에서의 30%로 나타난 대조군에서의 16.6%에 비해 높은 빈도를 나타내었다. Authors have evaluated the following: the size, shape and original site of aneurysms, direction of aneurysmal growth, abnormal blood circulation in the anterior part of cirlce of Willis and the rate of hypoplasia of the proximal part of anterior cerebral artery (A_1) in the 40 patients of aneurysm of anterior communicating artery angiography. These subjects were inpatients of the department of neurosurgery, Kyungpook national university hospital from Jan. 1978 through Jan. 1981. The sex-incidence of the aneurysmal patients of anterior communicating artery was:male-60%, female-40% with 1.5:1 of male to female ratio. The highest incidence of age bracket was 72.5% between 40 and 59 years. The rate of vasospasm was 47.5%, 32.5% of local vasospasm and 15% of diffuse vasospasm. The most frequent incidence of aneurysm was found in the shape of lobulation at 42.5% and it was followed in the order of spherical, egg and bar shape. All aneurysms were found to range from 4mm to 22.5mm in diameter, with 4-7.9mm occupying 47.5% of all that were evaluated. Forward growth, accounting for 57.5% was found to be the highest, to be followed in order of down, up, central and backward. The rate of hypoplasia of A_1 in aneurysms of anterior communicating artery which was found mainly in the right side was 32.5%, which was higher than 3.3% found in aneurysms of posterior communicating artery (control group). The incidence of anerysm were originated 57.5% in the distal portion of left A_1 and 40% in the right. In cases of hypoplasia of A_1, 69.2% occurred in the left A_1, this showing a marked frequency. The abnormal blood circulation of anterior part of Willis'circle was found 30% in aneurysm of anterior communicating artery and it was 16.6% in aneurysm of posterior communicating artery (control group).

고령층의 중증 두뇌손상에 관한 임상적 관찰

여형태,박연묵,김승래 慶北大學校 醫科大學 1982 慶北醫大誌 Vol.23 No.1

저자등은 1977년 1월부터 1980년 12월까지 경북대학병원 신경외과에 입원된 60세 이상의 중증 두뇌손상 환자 86명을 대상으로 하여 연령 및 성별분포, 손상의 원인과 분류, 신경학적 장애 및 치료의 결과를 분석 관찰하였다. 성별분포는 남자가 62명(72.1%), 여자가 24명(27.9%)으로 남, 녀의 비는 2.6대1이었으며 연령별 발생빈도는 60세에서 69세까지가 전체의 76.7%를 차지하였다. 손상의 원인은 교통사고가 84.9%로써 가장 높은 빈도를 나타내었으며 다음의 추락사고로써 9.3%였다. 손상의 분류는 두개강내 혈종 혹은 수낭종이 합병된 뇌좌상이 49명(57.0%)이었고 뇌좌상만이나 두개골 골절이 함께 있었던 것이 각각 22명(25.6%) 및 15명(17.4%)으로서 37명(43.0%)이었다. Glasgow Coma Scale 에 의한 환자의 분포는 3점에서 5점에 속하는 군이 41.9%, 6점에서 8점에 속하는 군이 58.1%였다. 두뇌손상과 함께 동반된 두부외 손상은 39명(45.3%)에서 있었으며 부위별로는 장관골 및 관절이 가장 높은 빈도를 나타내었고 흉부손상이 다음 순이었다. 두뇌손상에 대하여 개두술을 시행한 군은 64.0%였으며 비수술군은 36.0%였다. 치료의 결과는 생존자가 44명으로서 51.2%였으며 일상생활의 영위가 가능한 Good Recovery 와 Moderate Disability 가 각각 13.9% 및 10.5%로서 24.4%였고 일상생활의 영위가 불가능한 Severe Disability 와 Vegetative State 가 각각 10.5% 및 16.3%로써 26.8%였으며 사망자는 42명으로 48.8%였다. To evaluate the age and sex incidence, causes, types of craniocerebral injuries, neurological disorders and clinical end results after surgical and, or nonsurgical treatments, a series of 86 cases of severe craniocerebral injuries over 60 years in age, admitted to the department of neurosurgery, Kyungpook National University Hospital, Taegu Korea, from 1977 through 1980, were studied with folliwing results; Among 86 cases, 62 males and 24 females were found resulting in male to female ratio 2.6 to 1 and 76.7% of the cases were occurred in the age group from 60 to 69 year-old. Main cause was traffic accident (84.9%), and fall down was next. The type of craniocerebral injuries revealed cerebral contusion only(25.6%), cerebral contusion with skull fracture(17.4%), and cerebral contusion with intracranial hematoma or fluid collection (57.0%). 39 patients (45.3%) had associated injuries consisting of long bone fracture and joint injuries (22.0%), chest injuries (14.0%), abdominal injuries (4.7%), facial bone fractures (2.3%) and spine injuries (2.3%). In clinical end results of 55 cases (64.0%) in surgical group and 31 cases (36.0%) in nonsurgical group, the number of cases of "Good Recovery and Moderate Disability" were 21 cases (24.4%) and "Severe Disability and Vegetative State" were 23 cases (26.8%). Fourty two deaths of eighty six severe craniocerebral injuries occurred, resulting in overall mortality rate of 48.8%.

아라비녹실란 섭취와 유산소성 운동 중재에 따른 혈중 면역글로불린 및 지질 농도의 차이 분석

여효성(Yeo, Hyo-Seong),권형태(Kwon, Hyeong-Tae),손희정(Son, Hee-Jeong) 한국체육과학회 2017 한국체육과학회지 Vol.26 No.3

Arabinoxylan extracted from rice bran has an impact on developing immune function and lipid metabolism. Regular aerobic exercise might improve serum immunoglobulin (Ig) concentration with B cell proliferation. Therefore, this study was planned to investigate the effect of arabinoxylan ingestion and regular aerobic exercise in rats for 4 weeks. Thirty-two Sprague-Dawley rats (aged 8wks) were divided into CON(control, n=8), ARA(arabinoxylan, n=8), EXE(aerobic exercise, n=8) and ARA+EXE (arabinoxylan+aerobic exercise, n=8) groups. ARA group was orally ingested with arabinoxylan for 4 weeks. EXE group ran on the rodent treadmill at 15m/min for 4 weeks (5d/w). ARA+EXE group performed both arabinoxylan ingestion and exercise for the same duration. Serum IgA, IgM, IgG concentration and TG, FFA, TC, HDL-C and LDL-C were anlayzed by ELISA kits. The concentration of IgA of ARA(p=.006), EXE(p=.027) and ARA+EXE(p=.013) were significantly higher than that of CON. However, IgM and IgG level had no differences between groups(p >.05). TC level of ARA and EXE were significantly lower than that of CON(p<.05), however there were no differences between groups in other lipid profiles(p>.05). Taken together, regular arabinoxylan ingestion and aerobic exercise can increase IgA concentration, which improves immune function of mucous membrane and upper respiratory system.

공복시간이 유산소 운동후 흰쥐 심장근의 미토콘드리아 생합성에 미치는 영향

여효성(Yeo, Hyo-Seong),손희정(Son, Hee-Jung),권형태(Hyeong-Tae) 한국체육과학회 2017 한국체육과학회지 Vol.26 No.3

Mitochondrial biogenesis is controled through the transcriptional regulation PGC-1α, NRF-1, mtTFA and AMPK. Activation of AMPK by food deprivation is linked to the changes in the protein expressions of PGC-1 and related genes. This study was performed to determine the effect of food deprivation on mitochondrial biogenesis during aerobic exercise in left ventricular muscle. To achieve this purpose, male SD-rats (12 wk) were randomly assigned into Control (feeding, n=7), 6hF (6h fasting, n=7), 1hF+Ex (1h fasting + exercise, n=7), 3hF+Ex (3h fasting + exercise, n=7), 6hF+Ex (6h fasting + exercise, n=7). The exercise group was sacrificed at the time of 3hour after acute exercise (75∼80% VO2max). Expression of related proteins were analyzed by SDS-PAGE and western blotting. From the results of this study, expression of AMPK(76%, p=.001), PGC-1α(137%, p=.001), NRF-1(84%, p=.001), mtTFA(129%, p=.001) and COX-IV(76%, p=.001) in 6hF+Ex(6h fasting + exercise) group were significantly greater than Control (feeding) group, as well as AMPK(68%, p=.001), PGC-1α(87%, p=.001), NRF-1(48%, p=.001), mtTFA(57%, p=.001) and COX-IV(67%, p=.001) in 3hF+Ex(3h fasting + exercise) group were significantly greater than Control(feeding) group. This study demonstrates that the aerobic exercise after 6h fasting has optimal effect on mitochondrial biogenesis in heart muscle.

임신중 출혈을 유발한 Moyamoya병 : 증례보고 Case Report

이광희,최기환,여형태,이상평 대한신경외과학회 1995 Journal of Korean neurosurgical society Vol.24 No.3

임신중 Moyamoya병에 의한 뇌실내 출혈을 동반한 뇌내출형을 1례 치험하고 그 처치에 있어 간단히 문헌고찰하였다. 임신과 관계없이 근치수술이 필요한 뇌동맥류에 비해 Moyamoya병의 경우 비교적 간단한 수술후 보존적 요법이 더 중요시 되고 분만시 제왕절개술이 위험성을 최소화하는데 도움이 될 것이라고 생각된다. Intracranial Hemorrhage due to Moya-moya disease in the pregnancy women is rarely documented. We present a 31-years old woman who had intracranial hemorrhage at 34 weeks of gestation. She had stuporous state(Glouscow coma scale 2-3-5) with normal blood pressure at emergency room. Computed tomography revealed intraventricular hemorrhage and scanty intracerebral hemorrhage at left paraventricular area. External ventricular drainage enabled her symtoms to improve gradually. Additional MRI and angiography revealed finding of Moya-moya descase at left middle cerebral artery. Generally, intracranial hemorrhage during pregnancy, caused by aneurysmal 겨pture and AVM, is treated extensively regardless of pregnancy. In Moya-moya disease intracranial hemorrhage should be removed with a simple and safe procedure as soon as possible. And cesarean section should be considered in selected cases who has hypertension during labor.

경흉추 척수에 발생한 원발성 흑색종 1예 : Case Report

최기환,류태희,여형태,박주형,이정길 대한신경외과학회 1984 Journal of Korean neurosurgical society Vol.13 No.1

The primary malignant melanoma of spinal cord is rare tumor cause of compression of the cord. We are reporting a case of malignant melanoma, apparently originating from leptomeninges, of with diffuse neoplastic process widely spreaded over the area of cervicothoracic spinal cord of 34-yr-old woman.

마미총의 과신전 신경근 증후군

김명섭,박문식,최기환,여형태,이정길 대한신경외과학회 1989 Journal of Korean neurosurgical society Vol.18 No.3

최근 본원 신경외과에서는 요추부 통증과 하지방사통 및 간헐적인 신경인성 파행을 주소로 내원한 환자에서 척수 조영술상 사행상의 조영 결손을 보인 마미총의 redundant nerve root syndrome 2례를 경험하고, 1례에서는 심한 수핵탈출증이 동반되고, 1례에서는 수핵탈출증과 위척추골전 전위증이 동반되어 1례에서 는 요추후궁 완전절제술 및 수핵제거술과 경막 성형술을 시행하였고, 1례에서는 요추후궁 완전절재술과 수핵제거술 및 경막 성형술과 골 이식술을 동시에 시행하여 증상의 호전을 보인 마미총의 Redundant nerve root syndrome 2례를 수술 치험하였기에 문헌 고찰과 함께 보고하는 바이다. Two cases of redundant nerve root syndrome of cauda equina in patient was described. The general clinical features was the intermittent neurologic claudication with improvement at rest, low back pain of long duration and radicular pain in one or both legs, sensory & motor change in one or both legs. Myelography revealed a partial to complete block with characteristic serpentine filling defects above or below the block simulating a vascular malformation. One case was associated with lumbar H.N.P and the other cases was associated with L-H.N.P and pseudospondylolothesis. In addition to, we reviewed the literature of redundant nerve root syndrome of the cauda equina.

급성 자발성 경추 경막외 혈종 1례 : Case Report

백재민,정훈,최기환,여형태,이정길 대한신경외과학회 1991 Journal of Korean neurosurgical society Vol.20 No.6

Spontaneous spinal epidural hematoma is a rare cause of spinal cord compression. Recently, at our hospital, the author et al had the opportunity of observing case with spontaneous cervical epidural hematoma in a 28 years old woman who had suddenly felt a strong pain in interscapular area. Rapidly after she noticed weakness in her legs and one day later she was completely paraplegia. The MRI of spine was done. There show tubular like low signal intensity at posterior epidural space of C_(7) level due to cord compression effect. In this article, we are adding one more rare case of spontaneous cervical spinal epidural hematoma confirmed by MRI.

뇌간을 점유한 결핵종 : MRI 소견 증례 보고 MR Imaging Case Report

정훈,김상근,김명섭,최기환,여형태,이정길 대한신경외과학회 1993 Journal of Korean neurosurgical society Vol.22 No.2

제 4뇌실, pons, aqueduct of sylvius, midbrain을 점유한 결핵종을 수술 치험하고, 수술 접근으로 신경학적 장애를 유발할 가능성이 높은 부위의 결핵종은 MRI 소견의 특징을 이용하여 진단되어진다면 항결핵제 요법으로 수술보다 더 좋은 결과를 얻을 수 있을 것으로 생각되어 보고하였다. A 39 years old healthy male patient with intracranial brain stem tuberculoma manifested hydrocephalic symtomes due to obstruction of aqueduct of sylvius is presented. Surgical excision was undertaken for obtaining histologic diagnosis and resolving hydrocephalus which made postoperative neurologic deficits. CT and Magnetic resonance(MR) imaging of intracranial tubercuroma were studied for approaching nonsurgical diagnosis of tuberculoma. MR imaging of tuberculoma shows low intensity on T2-weighted imaging with Magnevist ring enhancement. The MR imaging feature of the tuberculoma were found to be distinct from those of abscess metastasis and glioma. Antituberculous chemotherapy is thought to be better than surgical approach in managing brain stem tuberculoma if radiologic diagnosis was obtained

뇌동맥류 수술 후 발생항 경막하수종

이광희,이상평,최기환,여형태,이정길 대한신경외과학회 1995 Journal of Korean neurosurgical society Vol.24 No.5

저자 등은 최근 2년간 뇌동맥류 파열로 인한 뇌지주막하출혈 환자 중 개두술 후 CT상 경막하수종을 보이는 경우 대해 조사 분석하였다. 이를 요약하면 1) 술후 CT상 경막하수종을 나타낸 경우는 총 85례 중 33례로 38.8%였다. 2) 60세 이상의 older age group에서 그 미만의 younger age group에 비해 경막하수종의 빈도가 높았으나 유의 하지 않았고(p〉0.05) 두께와 소실에 필요한 시간은 유의하게 증가하였다(p〈0.05). 3) 지주막하출혈이 심함 group에서 미약한 group에 비해 경막하수종의 빈도가 높았으나 유의하지는 않았다(p〉0.05). 4) 뇌동맥류 수술까지의 시간에 있어 3일 이내에 조기 수술한 group이 그 이상의 지연 수술한 group에 비해 경막하수종의 발생 빈도가 낮았으나 유의하지 않았다(p〉0.05). 5) 경막하수종의 발견 당시 두통의 증가 3례 외에 그 자체로 임상적 변화를 보이는 경우는 없었다. 6) 대부분 전두부에 발생하였으며 양측성인 경우도 15례로 45.5%를 점하였다. 7) 8례(24.2%)에서 수술적 요법을 시행하였으며 대부분(7례)이 60세 이상의 older age group이었고, 이중 2례는 만성경막하혈종으로 수술을 시행한 경우였다. 8) 경막하수종의 호전과 함께 수두증을 보이는 경우가 8례(24.2%)였으며 이 중 2례에 있어 L-P shunt를 시행하였고 나머지는 자연경과 후 호전되었다. The clinical course of subdural fluid collection(SDFC) was studied in 32 cases of patients which underwent craniotomy for intracranial aneurysm analysed regard to patients age. sex degree of initial subarachnoid hemorrhage. the operating time of aneurysm. duration to appearance of SDEF from craniotomy. changes of clinical state. disappearance time. site. maximal thickness and changes of SDEF, management and prognosis. The results were summarized as followings. 1) SDEF was found in 33 of 85 patients(38.8%). 2) The older age group had higher incidence of SDEF than the youger age group. 3) The older age group had thicker SDEFC than the youger age group in the maximal thickness of SDEFC. and that was statistically significant. 4) The early surgery group of aneurysm had lower incidence of SDEFC compared with the delayed surgery group. 5) There were minimal changes of clinical states when SDEFC was diagnosed by brain CT. 6) The frontal area was involved in all cases and bilateral involvement was noted in 15 cases(45.5%). 7) Surgical procedures were needed in 8 cases(24.2%) of SDEFC. including 2 cases of chronic subdural hematoma. 8) Ventricular dilatation with spontaneous improvement of SDEFC were noted in 8 cases(24.2%) and lumboperitoneal shunt for hydrocephalus was needed in only 2cases of them.