뇌실질내 악성 뇌수막종 : 증례보고 Case Report

이채혁,이정교 대한신경외과학회 1999 Journal of Korean neurosurgical society Vol.28 No.6

양측성 외전신경 마비를 보인 파열성 후교통동맥 동맥류 - 증례보고 -

이채혁,고영초,Lee, Chea Heuck,Koh, Young Cho The Korean Neurosurgical Society 2000 Journal of Korean neurosurgical society Vol.29 No.3

뇌 지주막하출혈에서 흔치않은 임상양상인 양측성 외전신경마비와 두통을 주소로 내원한 46세 여자환자에서 혈관조영술을 시행하여 좌측 후교통동맥 동맥류, 전맥락동맥 동맥류, 그리고 우측 후교통동맥 동맥류등 다발성 뇌동맥류가 발견되어 수술시행 하였다. 양측성 외전신경마비 이외에 시력 및 시야장애는 보이지 않았다. 수술시 상당한 뇌압증가의 양상을 보였고, 좌측 후교통동맥 동맥류 출혈흔적과 기저조에 소량의 혈종이 있었으며, 첫번의 좌측 수술 후 2주 정도에 안구운동장애가 서서히 회복되어 정상화되었다. 저자들은 뇌동맥류 출혈에서 드물게 보는 양측성 외전신경마비 환자를 경험하였기에 문헌고찰과 함께 증례보고 한다. Arare case of bilateral abducens nerve paralyses after rupture of a left posterior communicating artery(PcomA) aneurysm with multiple unruptured aneurysms in a 46-year-old female is presented. Sudden left abducens nerve paralysis followed by progressive right abducens nerve paralysis were present without additional neuroophthalmological signs. Postoperatively, bilateral abducens nerve paralyses gradually recovered and disappeared in 2 weeks. The authors reviewed and discussed the possible mechanisms involved in this uncommon neuro-ophthalmological manifestation.

Microsurgical Clipping and Coil Removal of Previously Coiled Regrowing Cerebral Aneurysms

이채혁,최찬영 대한뇌혈관외과학회 2011 Journal of Cerebrovascular and Endovascular Neuros Vol.13 No.4

Objective : Endovascular treatment of cerebral aneurysms with detachable coils has proved to be a safe and effective. However, long term result was not satisfactory in less than 30% for regrowth or coil compaction. This paper highlighted the safety and technique of microsurgical clipping and coil removal in previously coiled aneurysms showing recurrence or remnant growth. Methods : Sixty two patients from 2007 to 2010 were treated by endovascular coiling. Among them, six patients (9.6%) showed recurrence, who had near complete obliteration initially. We retrospectively analyzed the clinical data and radiographic images of these patients (male 2, female 4, mean age 46.6) who underwent microsurgical clipping with partial (4 cases) or complete (2 cases) coil removal. Computerized tomographic angiogram (CTA) was performed soon after microsurgical clipping for the evaluation. Results : Four aneurysms were located at anterior circulation and two were at the posterior circulation. Four patients were detected by routine followed CTA or angiography and one had recurrent subarachnoid hemorrhage and another one had severe eyeball pain. Microsurgical treatment were performed about 12.9 months (range: 2~26) after coiling. Complete coil removal was done in two patients. Complete obliteration was performed in all,which were confirmed by postoperative CTA with less coil artifact. All patients attained the same neurological state presented prior to surgery (the Glasgow Outcome Scale (GOS) 4~5). Conclusion : Microsurgical clipping and coil removal following a previous endovascular coil embolization are not so common. However, these would be permanent treatment options without any morbidity in properly selected patients. These are challenging and risky procedure, but necessary to avoid postoperative coil artifact on the follow-up radiologic evaluation.

원발성 중추신경계 림프종 -33례 치료결과 보고-

이채혁,이정교,권병덕 대한신경외과학회 1999 Journal of Korean neurosurgical society Vol.28 No.4

족저압 측정시스템의 개발 및 보행 상태에 따른 족저압 신호 특성 분석

이채혁,문상찬,임태균,이순걸 제어로봇시스템학회 2011 제어로봇시스템학회 국내학술대회 논문집 Vol.2011 No.5

Many factors affect biomechanics of lower limbs during walking, including the gate state and the according pressure distribution of feet. But such relationship between the pressure distribution and the gate status has not been taken into account so in detail to analyze lower-limb kinematics and kinetics during walking. In this research, a sensor system with force sensing resistors (FSR) is developed to measure plantar pressure of feet. Several target points of plantar are decided as characteristic ones with pilot tests. The pattern matching between the pressure distribution and the lower-limb kinematics is investigated. Such the hypothetical pattern match shows good characteristical signal pattern along the gate sequence and it can be estimated the gate status with the measured signals.

자발성 뇌출혈환자의 치료와 뇌정위수술 및 보존적 치료의 비교분석

이채혁,김창진,권양,임승철,이정교,권병덕,황충진 대한신경외과학회 1992 Journal of Korean neurosurgical society Vol.21 No.3

The treatment of patients with spontaneous intracerebral hemorrhage remains a matter of debate in neurosurgery and neurology. We analyzed 203 patients with spontaneous intracerebral hematoma and compared the result of treatment between two groups : 100 patients with stereotactic hematoma evacuation and 103 patients with conservative treatment. Evaluation of outcome was performed at discharge with Glasgow come scale, motor deficit, Glasgow outcome scle. Stereotactic surgical patients with medium sized(20-50㏄) hematoma, which located in basal gaglia and thalamic area made a significantly better functional recovery than did patients with conservative treated group. Patients with relatively mild neurologic deficit preoperatively had better functional outcomes in the stereotactic surgical group. Stuporous of comatose patients had no better outcome after surgery, but showed a significantly lower mortality rate than conservative treated group. There was no significant difference in the outcome in relation to the timing of surgery, but rebleeding risk was high on early operated patients. Stereotactic surgery can minimized the brain damage and be performed under local anesthesia, so there was a trend toward better quality of survival and chance of survival in the operated group.

교육종 치험 3례 : 3 Cases

이채혁,김창진,권양,임승철,이정교,권병덕,황충진 대한신경외과학회 1992 Journal of Korean neurosurgical society Vol.21 No.7

The clinicopathologic features of 3 cases of intracerebral gliosarcoma are reported and correlations among the CT findings, angiographic findings, the surgical and histological aspects are discussed. In two cases, these tumors appear on CT scans as an isodense mass with well defined margins and homogenous contrast enhancement, attached to falx, which may mimic that of meningioma, but has a cystic or necrotic area and calcific area. Angiographic findings are different, one showed scanty tumor staining and another showed mixed dural and pial vascular supply, early cortical venous drainage, irregular tumor vessels, and a prominent vascular stain with well defined tumor vessels, and a prominent vascular stain with well defined tumor margins. These tumors were rather well demarcated, firm in surgical aspect. In other case, tumor appears on CT scan as huge intracerebral lesions, with large necrotic areas and peripheral contrast enhancement : this CT aspect, similar to that of glioblastoma, corresponds to a rather diffusely infiltrating growth of the tumor and the prevalence of a gliomatous component. The genesis and histopathology of gliosarcoma are also discussed and we needs more prolonged period of time for study on metastasis and prognosis of these cases.

두개내 설하 신경초종

이채혁,이호연,황충진 대한신경외과학회 1998 Journal of Korean neurosurgical society Vol.27 No.12

영상유도 뇌수술 장비의 임상적 적용 : Zeiss SMN System

이채혁,이호연,황충진,Lee, Chea Heuck,Lee, Ho Yeon,Whang, Choong Jin 대한신경외과학회 2000 Journal of Korean neurosurgical society Vol.29 No.1

The authors describe the experience with the interactive image-guided Zeiss SMN system, which has been applied to 20 patients with various intracranial lesions during one year. Preoperative radiologic evaluation was CT scan in 6 cases, MRI in 14 cases. In all except one case, average fiducial registration errors were less than 2mm. There was no statistical difference in registration error between CT and MR image. This system considered to be relatively stable with respect to soft and hardware. Also it was useful for the designing of the scalp incision and bone flap and assessing the extent of resection in tumors, especially in gliomas. Moreover, it was helpful to evaluate complex surgical anatomy in skull base surgery.

엘보 인식에 의한 배관로봇의 실시간 위치 추정 및 후처리 위치 측정 알고리즘

이채혁(Chae Hyeuk Lee),김광호(Gwang Ho Kim),김재준(Jae Jun Kim),김병수(Byung Soo Kim),이순걸(Soon Geul Lee) 제어로봇시스템학회 2014 제어·로봇·시스템학회 논문지 Vol.20 No.10

Robots used for pipe inspection have been studied for a long time and many mobile mechanisms have been proposed to achieve inspection tasks within pipelines. Localization is an important factor for an inpipe robot to perform successful autonomous operation. However, sensors such as GPS and beacons cannot be used because of the unique characteristics of inpipe conditions. In this paper, an inpipe localization algorithm based on elbow detection is presented. By processing the projected marker images of laser pointers and the attitude and heading data from an IMU, the odometer module of the robot determines whether the robot is within a straight pipe or an elbow and minimizes the integration error in the orientation. In addition, an off-line positioning algorithm has been performed with forward and backward estimation and Procrustes analysis. The experimental environment has consisted of several straight pipes and elbows, and a map of the pipeline has been constructed as the result.