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문수현,김세훈,권택현,박윤관,정흥섭,서중근,Moon, Soo-Hyeon,Kim, Se-Hoon,Kwon, Taek-Hyon,Park, Youn-Kwan,Chung, Heung-Seob,Suh, Jung Keun 대한신경외과학회 2000 Journal of Korean neurosurgical society Vol.29 No.6
Intramedullary spinal hemagioblastomas usually develope in cervical or thoracic region of spinal cord, but rarely in conus medullaris. We report a case of hemangioblastoma developed in conus medullaris. The 19-year-old male patient presented with slowly progressing low back pain and paresthesia of both legs. MRI and spinal angiography revealed a well-vascularized mass lesion in the conus medullaris with syrinx formation. Total excision of hemangioblastoma was achieved via posterior approach. Postoperatively, patient's walking difficulty was worsened transiently, but it was improved at discharge.
해마 조직 절편 배양을 이용한 무산소 손상에 대한 MK-801, CNQX, Cycloheximide 및 BAPTA-AM의 효과
문수현,권택현,박윤관,정흥섭,서중근,Moon, Soo-Hyeon,Kwon, Taek-Hyon,Park, Youn-Kwan,Chung, Heung-Seob,Suh, Jung Keun 대한신경외과학회 2000 Journal of Korean neurosurgical society Vol.29 No.8
Objective : Glutamate induced excitotoxicity is one of the leading causes of cell death under pathologic condition. However, there is controversy whether excitotoxicity may also participate in the neuronal death under low intensity insult such as simple hypoxia or hypoglycemia. To investigate the role of NMDA receptor in low intensity insult, we chose anoxia as the method of injury and used organotypically cultured hippocampal slice as the material of experiment. Materials & Methods : The hippocampal slices cultured for 2-3 weeks were exposed to 60 minutes of complete oxygen deprivation(anoxia). Neuronal death was assessed with Sytox stain. Corrected optical density of fluorescence in gray scale, used as cellular death indicator, was obtained from pictures taken at 24 and 48 hours following the insult. The well-known in vivo phenomenon of regional difference in susceptibility of hippocampal sub-fields to ischemic insult was reproduced in HOSC(hippocampal organotypic slice culture) by complete oxygen deprivation injury. Results : $CA_1$ was the most vulnerable to complete oxygen deprivation in hippocampus while $CA_3$ was resistant. Oxygen deprivation for 10 and 20 minutes with glucose(6.5g/l) present was insufficient to induce neuronal death in the cultured hippocampal slice. However, after 30 minutes exposure under anoxic condition, neuronal death was able to be detected in the center of $CA_1$ area. The intensity and area of fluorescence indicating cell death correlated with the duration of oxygen deprivation. NMDA receptor and non-NMDA receptor blocking with MK-801(30 & $60{\mu}M$) and CNQX($100{\mu}M$) did not provide cellular protection to HOSC against damage induced by oxygen deprivation, but increased intracellular calcium buffering capacity with BAPTA-AM($10{\mu}M$) was effective in preventing neuronal death (p=0.01, Student's t-test). Cycloheximide($1{\mu}g/ml$, $10{\mu}g/ml$) provided no protection to HOSC against insult of complete oxygen deprivation for 60 minutes and combined therapy of MK-801(30 & $60{\mu}M$) and cycloheximide(1 & $10{\mu}g/ml$) was also ineffective in preventing neuronal death. Conclusion : The results of this study show that the another mechanism not associated with glutamate receptor(NMDA & non NMDA) may play major role in cell death mechanisms induced by complete oxygen deprivation and increased intracellular calcium during anoxia may participate in the neuronal death mechanism of oxygen deprivation. Further investigation of the calcium entry channel activated during oxygen deprivation is necessary to understand the neuronal death of anoxia.
허혈성 뇌혈관질환에서 자기공명혈관조영술의 가치에 대한 임상연구
임동준,조태형,정용구,김백현,김근회,김세훈,권택현,정흥섭,박정율,박윤관,이훈갑,이기찬,서중근,Lim, Dong-Jun,Cho, Tae-Hyoung,Chung, Yong-Gu,Kim, Baek-Hyun,Kim, Keun-Hoe,Kim, Se-Hoon,Kwon, Taek-Hyun,Chung, Heung-Seob,Park, Jung-Yul,Park, Youn-K 대한신경외과학회 2000 Journal of Korean neurosurgical society Vol.29 No.8
Objectives : To determine the contribution of cranial magnetic resonance angiography(MRA) for the evaluation of patients with ischemic cerebrovascular accident. Methods : Magnetic resonance image(MRI) and MRA studies performed on 34 patients with ischemic stroke were retrospectively reviewed with the clinical records. Results : There were 9 transient ischemic attacks and 25 completed strokes in our series. Twenty-three of 34 MRA examinations(68%) were positive for stenosis or occlusion. The distribution of stenotic or occlusive vascular lesions were correlated with the location of infarction in 22 of the 23 positive cases(96%). MRA provided additional information not obtained from the MRI in 19 cases(56%). Conclusions : Vascular lesions demonstrated on intracranial MRA show a high correlation with infarct distribution. MRA provided information adjunctive to conventional MRI in a majority of cases. We conclude that MRA is an important noninvasive component of the complete evaluation of ischemic stroke.
불완전하게 결찰된 뇌동맥류의 혈관내치료 - 증 례 보 고 -
임동준,정용구,조태형,이훈갑,김세훈,김근회,권택현,정흥섭,박정율,박윤관,이기찬,서중근,Lim, Dong-Jun,Lee, Hoon-Kap,Cho, Tae-Hyoung,Chung, Yong-Gu,Kim, Se-Hoon,Kim, Keun-Hoe,Kwon, Taek-Hyun,Chung, Heung-Seob,Park, Jung-Yul,Park, Youn-Kwan,L 대한신경외과학회 2001 Journal of Korean neurosurgical society Vol.30 No.4
Residual aneurysm is a challenging problem after clipping procedure for the aneurysms. The anthors describe one patient in whom endovascular treatment was sucessfully done to treat residual aneurysm after surgical clipping. We discussed the role of endovascular coil occlusion in case of incomplete surgical obliteration of aneurysms.
박철웅 ( Chul Woong Park ),권택현 ( Taek Hyun Kwon ),박윤관 ( Youn Kwan Park ),정흥섭 ( Heung Seob Chung ) 대한뇌종양학회·대한신경종양학회·대한소아뇌종양학회 2008 대한뇌종양학회지 Vol.7 No.2
The schwannomas from the lower cranial nerves have rarely been described, because the determination of lower cranial nerve`s origin is not always possible. The authors report a case of glossopharyngeal schwannoma, where the selective nerve origin was validated by microsurgical findings. A 35-year-old female presented with gait ataxia and headache. The preoperative MRI revealed a large cystic mass in the left cerebello-pontine angle, compressing the brain stem. Via the suboccipital route operation, it was demonstrated that the mass was adhered to the paper-like thinned glossopharyngeal nerve near the jugular foramen without association to other lower cranial nerves. In the cisternal portion, the glossopharyngeal nerve could be identified by its rostral entrance to the jugular foramen. A subtotal tumor removal was achieved to avoid damage of the paper-like thinned glosspharyngeal nerve. After surgery, the patient was discharged without any neurological symptoms and has received stereotactic radiation surgery for small remnant tumor.
정흥섭,이기찬 고려대학교 의과대학 1982 고려대 의대 잡지 Vol.19 No.1
X-rays films of the lumbosacral spine are necessary in the evaluation of all patients who are considered to have lumbar disc disease. Several positive X-ray film findings are of possible significance, and although not in themselves diagnostic, they are compatible with lumbar disc disease. Among patients treated and diagnosed by surgical operation for lumbar disc herniation from August, 1978 to February, 1981 at Korea University Hospital, 132cases with their simple lumbar spine X-rays available for study were selected. height of intervertebral disc space, spurrings, changes in facet joint, size of spinal canal, lumbosacral angle, and the congenital defect were studied and measured in simple films. Lumbar disc herniation was most frequent at L4-L5 intervertebral space (65.5%). The incidence of positive radiological findings were 85.6%. 1. Intervertebral disc space narrowing was found in 25%, 59.3% and 50% L3-4, L4-5 and L5-S1 lever respectively. 2. Peripheral osteophyte formations in the bodies of lumbar vertebrae were found in 44.7%. 3. Narrowing and/or sclerotic changes of facet joint were observed in 31.06%, subluxation in 14.39% and facet tropism in 5.3%. 4. The overall mean size of spinal canal at L4 vertebral level was 1:4.33 in male, 1:3.90 in female and at L5, 1:4.06 in male, 1:3.77 in female. (1:3.90) Narrowed spinal canal in this series were found in 25.6%, at L4 and 17.2% at L5. 5. The overall mean lumbosacral angle was 32.4 degree in male and 31.5 degree in female. 6. Spondylolysis was observed in 4.54%, spondylolisthesis in 3.03%, lumbarization in 8.3% and sacralization in 1.51%.