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간편한 제5요추 추경나사 상내방 삽입술 : 수술 수기 Technical Notes
이흥선,이경석,현동근,변박장 대한신경외과학회 1993 Journal of Korean neurosurgical society Vol.22 No.4
A simple technique for transpedicular screw fmation of L5 is presented. This percutaneous screwing allows up-and-in screw placement without exessive lateral stretching and lessens the length of incision.
이흥선,신원한,최순관,변박장,이인수 대한신경외과학회 1991 Journal of Korean neurosurgical society Vol.20 No.10-11
We present a series of 10 patients(seven men and three women with an average age of 53 years) who underwent decompressive craniectomy for treatment to massive brain swelling following acute cerebral infarction. Clinical signs of cerebral herniation(anisocoria of fixed and dilated pupil, and/or hemiplegia with decerebrate rigidity) were present in all patients. Computed tomography and magnetic resonance imaging showed the mass effect by cerebral edema through midline shift. All patients were treated with an extensive craniectomy and duroplasty. Among them, one recovered without neurological deficit, three were moderately disabled but functionally dependent, three remained in a persistent vegetative state and three died within 9 days after surgery(good recovery=1, moderate disability=3, persistent vegetative state=3, death=3). The results suggest that decompressive craniectomy can be an useful lifesaving procedure for massive cerebral edema following widespread hemispheric infarction.
이흥선,배학근,도재원,이경석,윤일규,이인수,배원경,김의한 대한신경외과학회 1990 Journal of Korean neurosurgical society Vol.19 No.8-9
Primary malignant melanoma arising from the leptomeninges is a rare entity. We report two cases of primary intracranial melanorna developed in one aged 65 years female and the other 70 years male. One case died 2 years after the operation, and the other case is still living more than 1 year after operation. Both cases seem to have a relatively long survival. The literature on this subject is briefly reviewed.
두부외상의 급성기에서 혈중 Aldosterone치의 변화
이흥선,이정훈,최순관,신원한,변박장,이인수 순천향대학교 1990 논문집 Vol.13 No.3
We measured plasma aldosterone levels to determine whether or not the values obtained reflect the degree of head injury. All 36 patients with head injury studied were diagnosed with CT & MRI, and they were classified into 4 groups according to the Glasgow coma score(GCS)-mild(GCS 14∼15), moderate(GCS 9∼13), Severe(GCS<8) and death group, and control group consisted of 10 patients, who were scheduled for elective lumbar laminectomy. Blood samples were taken on admission, the 3rd, and 7th hospital day. Aldosterone was measured by radioimmunoassay(normal values : below 150pg/ml). The results obtained were as follows. 1. Aldosterone levels in control group(n=10) were 128pg/ml(SD±21) on admission, 109pg/ml(SD±24) on the 3rd day and 102pg/ml(SD±18) on the 7th day after admission. 2. Aldosterone levels in mild group(n=8) were 200pg/ml(SD±32) on admission, 163pg/ml(SD±25) on the 3rd day and 134pg/ml(SD±28) on the 7th day after trauma. 3. Aldosterone levels in moderate group(n=10) were 220pg/ml(SD±43) on admission, 184pg/ml(SD±21) on the 3rd day and 163(SD±19) on the 7th day after trauma. 4. Aldosterone levels in severe group(n=12) were 304pg/ml(SD±21) on admission, 268pg/ml(SD±34) on the 3rd day and 200pg/ml(SD±19) on the 7th day after trauma. 5. Aldosterone levels in death(n=6) were 315pg/ml(SD±32) on admission, 267pg/ml(SD±26) on the 3rd day and 254pg/ml(SD±21) on the 7th day after trauma. The results of this study indicate that aldosterone levels on admisson, the 3rd, and 7th day were significantly higher in mild, moderate, severe and death groups than in control group and aldosterone may be useful as biochemical markers in the acute stage of head injury, especially in severe and death group.
1. 06㎛ Nd : YAG Laser를 이용한 요추간판탈출증의 경피적 수핵감압술
이흥선,변박장,최순관,신원한,권귀향,이인수,이경석,김범태 순천향대학교 1994 논문집 Vol.17 No.4
The 1.06㎛ Neodymium-YAG Laser(800 micron hemisherical) is revealed a useful tool for percutaneous laser disc decompression(PLDD). Especially PLDD would be applied to the management of lumbar disc herniation with minimal intervention. Total irradiated energy to one level of disc space was bout 1000 to 2000 joules. We performed this method at 10 levels, in 7 cases of patients, consisting of 4 males and 3 females with an average age of 37.7 years. Five cases showed excellent and good results, were observed. In two cases, open surgery was required because of unsatisfactory results. The best results were obtained in the protrusion type of disc herniation. We have summarized some advantages of PLDD: a) safe and simple procedure in an outpatient setting, b) avoiding general anesthesia, late spinal instability, c) possibility of repetitive use.
신원한,이흥선,최순관,변박장,이인수 대한신경외과학회 1990 Journal of Korean neurosurgical society Vol.19 No.7
We measured plasma aldosterone levels to determine whether or not the values obtained reflect the severity of cerebral stroke. All 36 patients with cerebral stroke studied were diagnosed with CT & MRI, and they were classified into 3 groups according to the Glasgow coma scale(GCS)-mild(GCS 14-15), moderate(GCS 9-13) and severe(GCS<8) group, and control of 10 patients, who were scheduled for elective lumbar laminectomy. Blood samples were taken on admission, the 3rd, and 7th hospital day. Aldosterone was measured by radioimmunoassay(normal values : below 150pg/㎖). The results obtained were as follows: 1) Aldosterone levels in control group(n= 10) were 128pg/㎖(SD±21) on admission, 109 pg/㎖(SD±24) on the 3rd day and 102pg/㎖(SD±18) on the 7th day after admission. 2) Aldosterone levels in mild group(n= 12) were 137.0pg/㎖(SD±137.4) on admission, 107.5pg/㎖(SD±89.9) on the 3rd day and 64.4pg/㎖(SD±65.4) on the 7th day after admission. 3) Aldosterone levels in moderate group(n= 6) were 195.1pg/㎖(SD±159.1) on admission. 153.1pg/㎖(SD±116.3) on the 3rd day and 85.7pg/㎖(SD±53.0) on the 7th day after admission. 4) Aldosterone levels in severe group(n= 18) were 230.3pg/㎖(SD±107.3) on admission, 219.7pg/㎖(SD±135.8) on the 3rd day and 267pg/㎖(SD±233) on the 7th day after admission. The results of this study indicate that aldosterone levels on admission, the 3rd, and 7th day were significantly higher in severe group than in control group and aldosterone may be useful as biochemical markers in the acute stage of cerebral stroke, especially in severe group.