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      • SCOPUSSCIEKCI등재

        대칭성 4개 뇌동맥류 2례 보고

        조병일 대한신경외과학회 1991 Journal of Korean neurosurgical society Vol.20 No.1-3

        Two cases of 4 Multiple Intracranial Aneurysms are presented. The author believes that patients who have had a subarachnoid hemorrhage should have four-vessel arteriography to identify all aneurysms. and that all surgically accessible aneuryms should be treated. Surgery of multiple aneurysms should be performed at the same craniotomy if they are within reach. Hower, if the asymptomatic or incidental aneurysm is in the opposite side or cannot be reached in the initial surgical procedure, it should be treated at a later craniotomy.

      • 활성산소의 독성과 그 임상응용

        조병일 건국대학교 의과학연구소 1993 건국의과학학술지 Vol.3 No.-

        Acute, servere increases in arterial blood pressure cause sustained cerebral arteriolar dilation, abnormal reactivity to carbon dioxide and to changes in blood pressure, abolition of the endothelium dependent dilation from acetylcholine, discreate morphological lesions of the endothelium and vascular smooth muscle, and breakdown of the blood-brain barrier to plasma proteins. The dilation, abnormal reactivity, and morphological abnormalities are inhibited by tase-inhibitable reduction of nitroblue tetrazolium applied to the brain surface was detectable both during hypertension and one hour after hypertension subsided. Nitroblue tetrazolium reduction is also reduced by topical application of arachidonate. The results are consistent with the view that acute hypertension induces generation of superoxide anion radical in association with accelerated arachidonate metabolism via cyclooxygenase. This radical enters cerebral extracellular space via the anion channel and gives rise to hydrogen peroxide and hydroxyl radical. All three radicals are capable of causing vasodilation by relaxation of cerebral vascular smooth muscle. The hydroxyl radical is the most likely candidate for vascular wall damage. The significance of this mechanism in chronic experimental hypertension or its relevance to human disease is not known.

      • SCOPUSSCIEKCI등재

        두개척추 접합부 20예 병변에 대한 수술 분석

        조병일 대한신경외과학회 1990 Journal of Korean neurosurgical society Vol.19 No.3

        Author proposes the surgical management of symptomatic abnormalities of the cranio-cervical junction, prelimiarily. Experience with 20 case is presented. Simple X-ray, myelography, tomography and CT revealed etiology and mechanism of compression of the cervicomedullary junction, as well as it's reduciblity. Stabilization was the goal in the treatment of reducible lesions. Decompression of the cervico-medullary junction followed by stabilization was paramount in irreducible cases.

      • SCOPUSSCIEKCI등재

        계속적 및 간헐적 뇌견인에 의한 국소적 뇌혈류변화와 뇌부종

        조병일,정철구,이상원,박영섭,김영,박춘근,김문찬,윤석훈,강준기,송진언,장상근 대한신경외과학회 1987 Journal of Korean neurosurgical society Vol.16 No.4

        Retraction of any part of the brain may damage the cortex as well as the parenchyma, so it is advisable to retract the brain with the least force necessary and for the shortest time as possible. The purpose of this study was to examine in cats the damage caused by retraction of the brain by measuring the regional blood flow and brain edema, and to determine which of two methods, continuous or intermittent brain retraction, is less harmful to the brain. Twenty five adult cats weighting 2.5 to 4.0㎏, were used in this study. The twenty five cats were divided into three groups ; control (n=5), continuous retraction(n=10) and intermittent retraction groups (n=10) respectively. The brain retraction was produced by applying the lead weight with the stainless retractor on the right frontal lobe through a craniectomy at the right frontal bone. The weight(20g) was supported throught the pulley so that its long axis was perpendicular to the cortical surface. In the continuous retraction group, the brain was retracted for 180 min with a retraction force of 20g and in the intermittent retraction group, a 15 min period of retraction was applied, followed by a 5 min release, repeated nine times. The regional cerebral bloods flow(rCBF) and brain specific gravity measurements were carried out in each animal before and immediately after brain retraction, at the 30th min, 60th min, 90th min, 120th min, 150th min and 180th min after retraction. The rCBF was measured by hydrogen clearance method and the brain edema was measured by gravimetric technique. The results were as follows : 1) After the brain retraction, there were rise in blood pressure, intracranial pressure and bradycardia in 60 min. 2) Normal control cerebral blood flow(rCBF, ㎖/100g/min) were 38.7±1.9 in right frontal, 38.7±1.7 in left frontal 38.6±2.3 in right parietal and 38.2±2.3 in left parietal lobes. 3) A considerable reduction in rCBF at the retraction site, has been demonstrated with continuous brain retraction in 60 min after retraction. A reduction in rCBF to 30% of control(RF ; 28.2±5.1㎖/100g/min) in 180 min after continuous retraction of the right frontal lobe, however, intermittent retraction resulted in a reduction of flow to 12% of control(RF ; 37.5±2.9㎖/100g/min) at retraction site in 180 min after retraction. 4) The changes of brain specific gravity relatively began to notice at rCBF less than 23.0㎖/100g/min. It might be inferred from these results that intermittent retraction was less harmful to the brain, which indicate adequate arterial blood flow under the retractor was vital for the preservation and return of the neuronal function following brain retraction.

      • SCOPUSSCIEKCI등재

        경막외 혈종에서의 시야결손과 CT소견

        조병일,하영수,강준기,송진언 대한신경외과학회 1982 Journal of Korean neurosurgical society Vol.11 No.4

        The evidence of infarction within the territory of the posterior cerebral artery could be diagnosed clinically using follow-up CT scan in while it has been pathologically well proved entity when the tentorial herniation occurred particularly in cases of head trauma with intracranial hematoma, although its incidence was generally within 10%. Visual field defects in traumatic intracranial surface hematomas have been proposed as result of the compression of posterior cerebral artery or anterior cheroidal artery and directly optic tract or visual cortex. Authors experienced the infarction of occipital and temporal lobe on CT scans and the homonymous hemianopsia in 3 cases of 20 epidural hematomas after CT was available. The case histories and CT findings of the infarction were detailed and discussed. It may be stressed that the careful examination and frequent follow-up CT scan are performed even in epidural hematoma.

      • SCOPUSSCIEKCI등재

        소아 치상돌기 골절로 인한 제 1-2 경추골 탈구에 대한 강철선 고정에 의한 치험 1예

        조병일,이재수,백민우,강준기,송진언 대한신경외과학회 1982 Journal of Korean neurosurgical society Vol.11 No.3

        Although most patients with cervical fractures have damaged the lower cervical spine, there remain a significant whose injury involve the atlanto-axial level. Since the diagnosis of fracture of the odontoid process was initially missed frequently, it is worth emphasizing the importance of adequate radiological studies for this potentially lethal lesion in head injury patient. The treatment for fractures of the odontoid process has consisted of reduction followed by immobilization using skeletal traction, a plaster cast or halo device, or internal fixation by surgical intervention. The advantages of early surgical treatment to minimize external immobilization or prolonged bed confinement are generally accepted but the surgical techniques have varied widely. The authors have managed a case of traumatic atlanto-axial dislocation in a child combined with severe brain injury by internal fixation using wire only after reduction of the dislocation was accomplished by skeletal traction. The available literature regarding this injury is reviewed.

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