뇌막염으로 의심되었던 뇌종양 2예

최호익,주정화,이기찬,전동휘,김성학 대한신경외과학회 1976 Journal of Korean neurosurgical society Vol.5 No.2

Brain tumors are manifest in a limited variety of ways, presenting with symtoms of increased, intracranial pressure and of localized destruction or compression of nervous tissue. Two cases of brain tumor were reported, in which clinical manifestations resembled those of the meningitis, that is, clinical signs and symtoms, as well as cerebrospinal fluid pleocytosis, were consistent with the diagnosis of meningitis.

악성 신경초종 1예

최호익,주정화,이기찬,전동휘 대한신경외과학회 1977 Journal of Korean neurosurgical society Vol.6 No.2

A rare case of malignant schwannoma is reported in which the patient, a 50 year-old man, received repeated surgical operations for frequent recurrences of the tumor masses in thoracolumbar region of his back. The masses were in the paravertebral, with involvement of spine compressing the cord and of neighbouring tissues and structures. Simple X-rays demonstrated a compression of the body of L₁ vertebra along with destruction of the spinous processes of T_(12) and L₁. At operation, most of the accessible tumor tissue was removed and an adequate decompression achieved for spinal cord. Histological studies of each specimens revealed malignant schwannoma involving the spine and surrounding tissues. According to pathological finding maligant schwannoma was confirmed. Malignant peripheral nerve tumors are very rare and highly malignant. They must be treated by surgical measures either by radical local resection or amputation when necessery. Radical local excision might be applicable as the first attempt on a low grade tumor while an amputation might be a necessery procedure for recurrent tumor or for one showing a high grade of malignancy. Radical excision at the first attempt at eradication is often the only golden opportunity for permanent cure. The high rate of local recurrence after inadequate excision has been emphasized.

뇌하수체 농양 1예

최호익,주정화,이기찬,전동휘 대한신경외과학회 1977 Journal of Korean neurosurgical society Vol.6 No.1

Abscess formation within the sella turcica is a rather rare entity. The development of such an abscess may be due to a direct extension of adjacent infections, such as sphenoid sinusitis, osteomyelitis of the floor of the sella. or infections of other sinuses, or may be Transmitted through the blood stream. Several intrinsic lesions of the pituitary gland may favor the development of infections. A case of pituitary abscess is reported in which the clinical history, manifestation and laboratory data of 32 year-old Korean female showed a strong resemblance to those in pituitary adenomas. At operation a soft cystic mass was exposed and identified in the pituitary fossa of which content was yellow pus and drained. Studies of the cyst wall and content demonstrated non-specific inflammation of the pituitary gland. A brief review of abscess in the pituitary fossa is presented.

접형골 암에 의하여 유발된 비외상성 뇌척수액 비루

최호익,주정화,이기찬,전동휘,최종구 대한신경외과학회 1976 Journal of Korean neurosurgical society Vol.5 No.1

We have presented a case of spontaneous rhinorrhea which showed recurrence of supprative meningitis and destruction of the sella turcica and sphenoid sinus on the plain skull roentgenograms. By transantral and transnasal routs, the portion of sphenoid sinus could easily be approached and exposed. Surgery with microscope easily permitted an identification of the point of cerebrospinal fluid fistula and the repair of it with graft and packing of temporal muscle fascial and pieces of gelfoam. The histopathology of sphenoid bone biopsied was an infiltrating carcinoma.

뇌부종에 대한 실험적 연구 : 제1보 Part 1

전동휘,최호익,이훈갑,이기찬,주정화 대한신경외과학회 1974 Journal of Korean neurosurgical society Vol.3 No.2

The studies of the occurence and changes of experimental brain edema have been observed by calculating wet weight, volume, dry weight, per cent water content and swelling per cent in 12 normal rabbits as a control group and 24 rabbits of experimental group. The brain edema was induced by expansion of laminaria which resulted in brain compression, that was inserted into the supratentorial extradural space of rabbit. The piece of section of laminaria which is a sea weed and used for the purpose of slow expanding space-occupying mass has a characteristic mode of slow expansion in volume on contact with water. The average wet weight of cerebral hemisphere of normal rabbits was 3.30±0.19gm. The average dry weight of unilateral hemisphere of 156 from 78 rabbits was 0.69±0.04 gm, while its volume was 2.97±0.29㎖ and the percentages of water content was 78.92±1.36 per cent. The weight, volume and percentages of water content and swelling in the compressed sides of hemisphere showed higher values compared them to the opposite noncompressed hemisphere in the "laminaria-compression.' group and showed gradually increasing tendency in the values as the time elapsed.

흉추에 발생한 척색종의 치험 1례 : Case report

계종수,최호익,이기찬,주정화 대한신경외과학회 1974 Journal of Korean neurosurgical society Vol.3 No.2

Chordomas are congenital tumor which develop from remnant of the notochord. Most of them arise at the clivus Blumenbachii, at the junction of the sphenoidal and occipital bones or sacrococcygeal region. Rarely chordomas arise it the thoracic spine, which compress the spinal cord epidurally and sometimes invade the substance of the spinal cord. The authors report a case of chordoma at T-9-T 10 vertebral level in which the characteristic "physaliferous' cells were found in the slides of operative specimen. The tumor was compressing the spinal cord and extending into body and ?????? of the vertebra, which resulted the patient, 52 year-old Korean male, in paraplegia.

HERNIATED UPPER LUMBAR DISC : Case report

Chung, Yeun Tae,Choi, Ho Ik,Kay, Chong Soo,Lee, Ki Chan,Chu, Jeong Wha 대한신경외과학회 1974 Journal of Korean neurosurgical society Vol.3 No.2

요추 추간판 탈출증에 대하여 1857년 Virchow가 책을 기술한 이래 많은 연구업적과 임상보고가 있다. 요추 추간판 탈출증은 제 5 요수신경근과 제 1 천수신경근을 누르는 하부 요추부에서 많이 발생하나, 상부요추 추간판 탈출증은 드물며 이들에 대한 증상, 소견 그리고 외과적 치료에 관한 문헌들도 적다. 본 교실에서는 48세 남자 환자에서 제 1 과 제 2 요추간에서 발생한 추간판 탈출증 1예를 수술 치험하였다. 환자는 7개월 전부터 요통과 하지 방산통 감각기능 이상 그리고 양하지 운동기능부전을 가졌었으며 입원 당시에는 심한 요통과 하지 방산통 특히 전반 대퇴부로의 심한 방산통 때문에 누운 위치에서도 체위변동을 하기가 어려웠다. Saddle anesthesia(안장 감각마비)와 항문과 방광의 괄약근의 기능이상은 없었으며, 표재성 지각둔마가 제 2 요추 피부절까지 있었으며 양 하지는 이완성 부전마비이었고, 심부 건반사는 소실되었다. 단순 요추 X-선 소견에서 제 1~2, 2~3 요추간의 협소와 골 증식체의 소견을 보여 주었다. 요수 조영상에서 폐 1,2요추간에서 조영주의 완전폐쇄와 절단을 보여 주었다. 전신마취하에서 제 1,2 그리고 제 3요추에 대한 양측성 전제궁술을 시행하였다. 추간판 탈출증은 완전 전후방 탈출형이었으며 제 1,2 요추간에서 척수원추에 가까운 부위에서 마비를 압박하고 있었다. 수술후 환자는 기립보행이 가능하게 되었으며, 잠정적으로 허리에 보조기의 사용을 하였다.

척수내농양 : 1예 보고 Case report

신규만,계종수,최호익,이기찬,주정화 대한신경외과학회 1975 Journal of Korean neurosurgical society Vol.4 No.1

Intramedullary spinal cord abscess is rare condition, and that, the diagnosis of an abscess is rarely established before operative interference is indicated. A case of spinal cord abscess is reported upon 42 year-old male who was admitted to this hospital because of severe pain in the posterior lower neck and weakness in all 4 extremities. The patient have no history of infection or operation in recent past. On admission the subject was in state of quadriparesis, and the superficial sensory impairement was up to the level of T₁3 spinal dermatome. In an early course of the illness the motor weakness had started to appear in the left arm and the impairement of pain and temperature sensations in the right leg, indicating a picture of Brown-Sequard's syndrome. Radiographic examinations disclosed a localized enlargement of lower cervical canal with a widening of interpedicular distance and showed a defect and obstruction of dye column at C6 spinal level, which were suggestive of picture of intramedullary tumor. Operation the exposed spinal laminae and dura showed nothing abnormal, but the dura mater was under the great perssure. Opening the dura the spinal cord was swollen, tense and nonpulsatile with dusky red discoloration on a surface of the cord. Pus contents were obtained by needle aspiration and through a myelotomy opening the contents were evacuated completely. Culture of the pus contents produced no organisms. Pathology reported a nonspecific suppurative inflammation on the biopsy. The surgical treatment was combined with the administration of antibiotics, in full the-apeutic doses and steroid postoperatively. Two weeks after the surgery he showed significant recovery from the neurological dysfunctions in his legs.

실험적 척수압박 : 제 1 보 수분함량과 산소소비량 Part 1. Water content and oxygen consumption

김결,전동휘,최호익,이기찬,주정화 대한신경외과학회 1975 Journal of Korean neurosurgical society Vol.4 No.2

Experimental spinal cord compression was successfully produced in the rabbit by the expansion of the stalks of "laminaria", a sea weed, which was placed in the spinal epidural space at the level of fifth lumbar vertebrae. The experimental spinal cord compression and subsequent edema at the site of compression and its adjacent area were studied at interval of 6, 12 and 24 hour's compression by measuring wet weight and dry weight, and by calculating per cent water content, swelling per cent and changeapee of water content to that in control group. The oxygen consumption of cord tissues at the site of compression and its distal adjacent area of the spinal cord was investigated by using Warburg's manometric appratus suppalying 100% oxygen. In the normal rabbit, the average water content of the spinal cord was 63.38±0.9%. The percentage of water and swelling of the cord tissues in experimental group were higher than those in the control during the period of 24 hour's compression, and that at the site of compression they showed a tendency of rapid increase in value at an early stage, and the area adjacent to the compression demonstrated values increasing gradually during the process of compression. In control group, the average value of oxygen consumption of the card tissue was 0.48±0.01㎕O₂/㎎(dry weight)/30 min. The values of oxygen consumption of cord tissue at the site of compression and distal adjacent area were higher than in control group at an early stage and gradually decreased there after. It was noted that the changes of water content and oxygen consumption of spinal cord were well and influenced by the mechanical compression with "laminaria" insertion in the rabbit, resulting in spinal cord edema.

골파괴성 Dumb-bell형 뇌수막종 1예

전동휘,주정화,이기찬,노순성,최호익 대한신경외과학회 1976 Journal of Korean neurosurgical society Vol.5 No.1

A 37-year-old Korean male was admitted to the hospital in December 1976 because of a slow growing hard mass in the right frontoparietal region near the midline. The patient had noted the mass accidentally while combing his hair six years prior to admission. Since then, the mass had grown slowly but progressively. On admission, there was a hard ovoid mass, 9 by 7 cm in size, over the right frontoparietal region, projecting 3 to 4 cm above the normal level of the skull. Skull roentgenogram disclosed a large area of bone destruction and defect, 8 by 6 cm, in size at the site of the tumor, accompanying sclerosis along the margin of the bony defect. A tumor located in extracalvarial portion of the head was a well circumscribed one, 9×7×4 cm in size, with no bone tissue over the tumor. A tumor located in intracranial portion was also a well circumscribed one measuring 5×4×3 cm, compressing the brain but not infiltrating. Extracalvarial and intracranial portions of the tumor were interconnected by the pedicle which was a part of the tumor and passed through the defect of the dura mater, 3 cm in diameter, nearly in the center of the bony defect. The tumor, dumb-bell formed in extracalvarial and intracranial growths, was completely excised. Pathological diagnosis of the specimen was fibroblastic meningioma.