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It is established that intracranial hemorrhage is relatively common benign intracranial diseases in adult. This is very rare in children reports are limited to a few cases or to those cited in reviews of series of intracranial hemorrhage in adult group. We wish to report three cases of large intracranial hematoma in three infants. The diagnosis was greatly facilitated by the CT scan and the treatment did by the microsurgical methods.
The locations of 9 ventricular tumors were outlined by radiological studies and their natures were determined by pathological studies following surgical intervention except for two caseses. Clinical manifestations, rediological findings and incidence of the various tumors with regards to their locations in relation to the ventricles, were analyzed. Following are the results: 1. Of the 9 cases, 4 were lateral ventricular tumors, and the rest were third ventricular tumors. Of the lateral ventricular tumors, 2 were meningiomas while the other 2 were ependymonas. Observations revealed that either meningioma or ependymona were found in both the right and left ventricles. 2. The 5 cases of third ventricular tumors were diagnosed after neuro-radiological studies. Surgical interventions were peformed on three. The type of tumors were determined by pathological studies of the surgical specimen which revealed, one colloid cyst, another meningioma and the other teratoma. 3. The predominating neurological manifestations were headache and papilledema. The lateralizing sign occurred more frequently in those with the lateral ventricular tumors. Paroxysmal headache were experienced in the cases with colloid cyst, meningioma of the third ventricle, and choroid plexus papilloma of the lateral ventricle. 4. The most prominent radiological finding was ventricular dilatation. The dilatation of the anterior choroidal artery was observed in one case of meningioma of the lateral ventricle. Secondary changes of the sella turcica due to increased intracranial pressure were seen in cases of lateral ventricular tumors and in 3 cases with the third ventricular tumor. In the colloid cyst there was an elevation on the anterior portion of the internal cerebral vein while the rest of the veins were flattened and displaced downward on the lateral view. 5. The cerebrospinal fluid protein content was significantly increased in 5 cases and electroencephalogram revealed either a focal or a generalized abnormal activity in the 6 cases. 6. In these studies we found out that Conray ventriculogram has the distinct benifit in accurately outlining tumors in the ventricles as compared to pneumoventriculogram.
Since 1969 microsurgical procedures are populary used in the neurosurgical field. Unilateral suboccipital- transmeatal approach for acoustic neurinoma was usually performed by Yasargil's group as a modification of classic suboccipital acoustic tumor operation. This report is based on two patients presenting with cerebellopontine angle tumors treated microsurgically. The main issue of this paper is microsurgical technique, especially superiority of this procedure.
The authors has reviewed the 300 patients undergoing neurosurgical operation in Tuck's position for thoracic or lumbar lesions. The superiority of this position appears to take simple position, to reduce blood loss, to maintain good ventilation, to reduce spinal epidural venous engorgement, to have good exposure of interlaminar space and to decrease risk of injury to major prevertebral vessels and organ.