머리에 방사선 상해를 받은 흰쥐 흑색질의 미세구조

배학근,양남길,안의태,고정식,박경호,김진국,Bae, Hack-Gun,Yang, Nam-Gil,Ahn, E-Tay,Ko, Jeong-Sik,Park, Kyung-Ho,Kim, Jin-Gook 한국현미경학회 1992 Applied microscopy Vol.22 No.2

An experimental study on the acute irradiation effects on the substantia nigra of head-irradiated rats were carried out. Rats anesthetized with sodium thiopental, were exposed only on their head areas with a single dose of 3,000 rads or 6,000 rads, respectively. Radiation was produced by Mitsubishi linear accelerator at the speed of 200 rads/min. Aminals were sacrificed on 6 hours, 2 days and 6 days following irradiations. By the perfusion fixation through the heart, rats were fixed with 1% glutaraldehyde-1% paraformaldehyde solution. Two hours later, brains were exposed and immersed in the same fixatives over night. Tissue blocks from subtantia nigra were punched out, and they were refixed in the 2% osmium tetroxide solution. Blocks were dehydrated through alcohol series, and embedded in the araldite mixture. Ultrathin sections were stained with uranyl acetate and lead citrate solutions, From the ultrastructural study, following results were made: 1. Six hours after irradiation, severe depletion of synaptic vesicles was occurred in the many axon terminals of the nigral neuropil. 2. Dramatical decrease of lysosomes and dense granules was observed. 3. Two days following irradiation, alterations of ribosomes, granular endoplasmic reticula, mitochondria, etc, were noticed. 4. Many of the malformations were seen to be repaired on the 6th day. 5. Above results were interpreted as follows. At the acute stage of heavy irradiation, neurotransmitters in the substantia nigra are released severely. But they are recovered within 6 days. It is concluded that acute head-irradiation may result severe disturbance of nigral motor control function during the first few days.

외상성 뇌실질내혈종

배학근,박영탁,도재원,이경석,윤일규,이인수 대한신경외과학회 1989 Journal of Korean neurosurgical society Vol.18 No.4

During a 36-month period, clinical outcome in 170 patients with traumatic intracerebral hematoma (TICH) was analysed. These patients represented 5.1% of 3328 consecutive patients with head injuries admitted to the Soonchunhyang University Chunan Hospital. The overall mortality was 33.5%. A significant number of patients(52.6%), who were not comatose at the time of admission(GCS>8), were dead. The factors affecting prognosis were as follows : 1) Glasgow Coma Scale(GCS) on admission(p<0.005) : 2) the presence of associated lesions(p<0.01) : 3) time delay of two hours or more from admission to operation(p<0.05) : 4) actual midline shift of 4.5㎜ or above on initial CT scan(p<0.005) : 5) obliteration of suprasellar cistern(p<0.005) : 6) the presence of delayed traumatic intracerebral hematoma(DTICH) in non-surgical patients with GCS score of 8 pr above(p<0.01). Age and location of hematoma did not affect outcome, but the patients with multiple located hematoma showed higher mortality than the others. Time delay in the treatment of TICH and DTICH contribute significantly to poor outcome. Rapidly progressive DTICH within 48 hours after trauma is high in mortality. Follow-up CT scan might as well as performed till 48 hours after injury and 8 hours after initial operation, even though neurological status did not alter for the worse.

자발성 뇌지주막하출혈 환자의 사망원인에 대한 조사

배학근,도재원,이경석,윤일규,변박장 대한신경외과학회 1996 Journal of Korean neurosurgical society Vol.25 No.5

To investigate the causes of death in patients with spontaneous subarachnoid hemorrhage. 460 consecutive patients with a subarachnoid hemorrhage were reviewed. Angiography was not performed in 78 patients due to poor clinical conditions or discharge against admission. Of all these patients, 54(69.2%) died. 28 from serious clinical condition, 21 from rebleeding, 3 from pulmonary complications. 1 from vasospasm. and 1 with unknown causes. Thirty-eight patients were angiographically negative. of which 6(15.8%) died. 3 due to rebleeding. 2 due to poor clinical condition, and 1 due to cerebral infarction caused by vasospasm. Of the 344 patients who had an aneurysmal subarachnoid hemorrhage, 74 were discharged against admission or died before the surgery. The remaining 270 patients underwent aneurysm clipping. Early surgery(within 72 hours after subarachnoid hemorrhage)was performed in 151 patients. intermediate surgery(between Day 4 and 7 post-SAH) in 74, and late surgery(Day 8 or later after SAH) in 45. Fifty-one patients(18.9%) died after aneurysm clipping. The causes were vasospasm in 17, complications related to surgery in 13, poor clinical condition in 12, preoperative rebleeding in 7, and other systemic condition in 2. A total of 59 patients suffered at least one rebleeding after the initial hemorrhage ; these patients had a mortality rate of 76.3% and the highest rate of rebleeding occurred within the first 24 hours after initial hemorrhage. Vasospasm and rebleeding were the leading causes of mortality in addition to the initial bleeding. Predictors for mortality included poor clinical grade. early surgery in patients aged 60 years or more. and association with intracerebral hematoma, intraventricular hemorrhage, or subdural hematoma.

산욕기 대뇌 혈전성정맥염으로 인한 출혈성경색증

배학근,최순관,이인수 대한신경외과학회 1983 Journal of Korean neurosurgical society Vol.12 No.3

A case of puerperal cerebral hemorrhagic infraction with venous thrombosis in a 36-year-old female is reported. Brain CT scan showed an isodensity area surrounded by ill-defind low density medially in the right frontal lobe, and the most anterior portion of superior sagittal sinus and its draining veins were prominent, but draining veins in the frontal high convexity were not filled in the venous phase of the right carotid angiogram. Osteoplastic craniotomy on the right frontal area was performed to remove the lesion which was mistakenly understood as a mass. Abnormal brain parenchyma was excised from the right frontal subcortical region. Microscopic and pathological evaluation confirmed the diagnosis of hemorrhagic infraction due to venous thrombosis.

자발성 뇌지주막하출혈 환자에서 재출혈의 임상적 의의 및 재출혈에 영향을 미쳤던 인자에 관한 조사

배학근,도재원,이경석,윤일규,변박장 대한신경외과학회 1996 Journal of Korean neurosurgical society Vol.25 No.9

To investigate the clinical significance of and risk factors for rebleeding in patients with spontaneous subarachnoid hemorrhages(SAH), the authors reviewed the consecutive cases of 527 patients admitted in the 7-year period from 1988 to 1995. Of these patients 75(14.2%) rebled. Rebleeding occurred within 24 hours in 45 patients, among whom 32 cases rebled within 12-24 hours after initial SAH, within 1-3 days in 19, within 4-7 days in 9, and after 1 week in 2. These patients had an overall mortality of 82.9% compared to 28.4% for patients without rebleeding. The patients with rebleeding within 24 hours after the initial attack 몽 무 operative rate of 34, 9% and a postoperative mortality of 53.3% compared to 26.8%, 37.5%, respectively, for patients with rebleeding after 24 hours. The significant factors affecting rebleeding were as follows ; Over 70 years in age, association with intracerebral hematoma(10-20㏄), seizure before operation, aneurysms on the vertebrobasilar system, poor neurological condition on admission, and angiography within 6 hours of initial SAH. Ultra-early operation within 24 hours following intentional delay in angiography of at least 6 hours from the initial rupture is recommended if the associated hematoma is not large enough to show mass effect.

연령에 따른 미만성뇌손상 환자의 예후에 관한 조사

배학근,이경석,윤일규,도재원,최순관,변박장,배원경 대한신경외과학회 1992 Journal of Korean neurosurgical society Vol.21 No.5

The present study compares the outcome of adult and pediatric patients with severe diffuse brain injury, and analyzes factors affection the prognosis related to age difference. Of 1912 patients admitted with head injury during the past three years, 223(11.7%) patients were identified as severe diffuse brain injury. Among the 223 patients. 100 patients were 15 years of age of less as the pediatric group. The mortality rate for pediatric and adult group was 39.0% and 48.8%, respectively. The common factors affecting poor prognosis for both groups were Glasgow Coma Scale(GCS) of 5 or less, pupillary abnormality, hypoxia (P_(a)O₂<60㎜Hg), the presence of skull fracture(basilar skull fracture in children, and basilar or vault skull fracture in adult group), diffuse brain swelling, subarachnoid hemorrhage, intraventricular hemorrhage, and thin subdural hematoma. The factors affecting prognostic difference between the adult and pediatric group with diffuse brain injury were the presence of vault skull fracture(p<0.01) and diffuse brain swelling(p<0.05). In patients associated with vault skull fracture or diffuse brain swelling, adult group had a significantly poorer outcome than child group.

거대한 소교세포종 1예

배학근,최순관,이인수,이동화 대한신경외과학회 1982 Journal of Korean neurosurgical society Vol.11 No.1

A rare case of primary reticulum cell sarcoma (microglioma) of the brain in a 30-year-old female is reported. The tumor was located in the left parietal lobe. Brain CT scan showed a slightly high attenuated area with well demarcation in the left parietal lobe, and a tumor staining was appeared in the delayed arterial phase of the left carotid angiogram. Osteoplastic craniotomy on the left parietal area was performed for removal of tumor. Then the patient received radiation therapy with a good result.

두개강내 척색종 2례

배학근,이경식,윤일규,신원한,최순관,변박장,이인수 대한신경외과학회 1987 Journal of Korean neurosurgical society Vol.16 No.4

The authors present two cases of intracranial chordoma in one aged 10 years and the other aged 36 years, who presented with gradual onset of headache, diplopia and eyeball pain. Clinical features and various diagnostic findings are described.

동시 다발성으로 발생한 자발성 뇌실질내 출혈 : 3례 보고 Three Case Reports

배학근,도재원,이경석,윤일규,변박장 대한신경외과학회 1997 Journal of Korean neurosurgical society Vol.26 No.6

요추부 경막외 수막종 1예

배학근,이인수,이동화 대한신경외과학회 1981 Journal of Korean neurosurgical society Vol.10 No.1

A 27-year-old female with low back pain and paresthesia on the left lower extremity had been treated. Lumbar myelography showed total block of the dye column at the L3 vertebral body level with a brush border. After myelography, total laminectomy on the L3 and L4 vertebrae was done. The result of operation and biopsy revealed an extradural meningioma of angioblastic type. 9 days after the surgery all neurological deficits were completely recovered.