요추간판 탈출증치료에서 화학적 수행용해술의 임상적 고찰

임좌혁,백승찬,고삼규,지용철,최병연,문충배,조수호 영남대학교 기초/임상의학연구소 1986 Yeungnam University Journal of Medicine Vol.3 No.1

급속하게 커진 정맥성 경막외 혈종 : 조기 뇌 CT Scan의 함정 Pitfall of Early Brain CT Scan

임좌혁 대한신경외과학회 1993 Journal of Korean neurosurgical society Vol.22 No.1

A case of a acute expanding venous extradural hematoma was treated Initial CT Scan was favorable, but delayed bleeding & its expansion was developed. The bleeding points were left transverse sinus and superior petrosal sinus. Serial neurologic examination & serial CT scan in patients with head injuries are recommended

만성요통 환자의 자기공명연상에서 관찰되는 해부학적 이상 소견의 임상적 의의

임좌혁,이종훈,노진식,문충배 대한척추신경외과학회 2004 Neurospine Vol.1 No.1

Objective: The authors have carried research on patients with chronic low back pain in order to investigate the predictive value of magnetic resonance imaging(MRI) of pathoanatomical abnormalities of the intervertebral discs, par:icularly with adjacent endplate(Modic) change, high-intensity zone(HIZ) and disc degeneration, to predict symptomatic disc derangement, with discography as the standard. Methods: The authors prospectively analyzed the discographic findings and anatomical abnormalities on lumbar spine MRI in 187 patients with chronic low back pain. MR images were evaluated for disc degeneration, high-intensity zone, and endplate abnormalities. Results of pain provocation at discography(527 discs) were rated independently of the image findings as concordant or as discordant or painless. Sensitivity, specificity, positive predictive value(PPV), negative predictive value(NPV) were calculated to assess the clinical relevance of abnormalities on MRI. Results: The prevalence of a high-intensity zone in the patients was 53.5%. Significant correlation was found between abnormal disc morphology and the HIZ(p<0.05). In morphologically abnormal discs(grade 3,4), there was a significant correlation between the HIZ and concordant pain reproduction(p<0.001). For concordant pain production, high-intensity zone(sensitivity, 41%; specificity, 78.6%; PPV, 26.4%; NPV, 87.7%), abnormal discogram(sensitivity, 94%; specificity, 77.5%; PPV, 18.5%; NPV, 95.2%), disc degeneration(sensitivity, 85.5%; specificity, 73.4%; PPV, 17.9%; NPV, 90.8%), and Modic change(sensitivity, 3.6%; specificity, 4.5%; PPV, 13.1%; NPV, 84.7%) were not helpful in identification of the symptomatic disc derangement. Conclusion: We conclude from our prospective study that the 3 pathoanatomical parameters(disc degeneration, HIZ, Modic change) observed on MRI appear not to be useful in the prediction of painful disc derangement in patients with chronic low back pain.

급성 뇌경막외 혈종내의 기포(氣泡)

임좌혁 대한신경외과학회 1991 Journal of Korean neurosurgical society Vol.20 No.6

During 3-year period, fourteen patients with air bubble in acute extradural hematomas were seen among 84 consecutively cases of extradural hematomas for a frequency of 16.7%. Extradural air were classified into 3 groups based on the location of air bubble ; frontal type(4 cases), temporal type(8 cases) & occipital type(2 cases). A skull fracture was seen in all cases & the air entrance was considered to frontobasal or laterobasal skull fractere. In patients with 4 cases of CSF leak & multiple air bubbles, delayed expansion of extradural hematoma was seen. The clinical significance of air bubble in acute extradural hematoma is disscussed.

급성 뇌경막하 혈종 수술중 반대측에 발생한 뇌경막하 혈종 : Case Report

임좌혁 대한신경외과학회 1991 Journal of Korean neurosurgical society Vol.20 No.4

A case of traumatic acute bilateral subdural hematoma with different times is expierenced. The contralateral subural hematoma was developed during the evacuation of an acute subdural hematoma. The reduction of intracranial pressure after removal of subdural hematoma was postulated to be contributing factor to formation of the contralateral subdural hematoma.

Experiences of Stereotaxic Endoscopy

임좌혁,백승찬,김오룡,지용철,최병연,조수호 대한신경외과학회 1988 Journal of Korean neurosurgical society Vol.17 No.3

Recently we experienced stereotaxic endoscopic biopsy and resection of intracranial tumors using the Brown-Robert-Wells system. Surgical exploration was undertaken under the local anesthesia : 1 germinoma in pineal region, 1 arachnoid cyst in basal cistern. The method is described, and the its potential clinical application is discussed.

개두술로 접근하기 어려운 병소에서의 BRW CT Stereotaxic System의 역활

임좌혁,지용철,최병연,문충배,조수호 대한신경외과학회 1986 Journal of Korean neurosurgical society Vol.15 No.4

With improvement of computerized tomography (CT), stereotaxic surgery has been applied for neurosurgery; aspiration of deep-seated brain lesions, radiotherapy using a small radiogenic sources, and evacuation of hematoma. And so, a prototype Brown- Roberts- Wells (BRW) CT stereotaxic system has been avaible to us. We report its utilization in evaluation and management of less accessible brain lesions. Surgical exploration was undertaken in 25 patients with various less accessible brain lesions using BRW system: 9 superficial lesions including the motor cortex and multiple lesions, 5 deep - seated lesions, 3 parasellar lesions, 8 brain stem lesions. Histologically, there are 5 gliomas, 4 metastatic cancers, 8 hematomas, 3 brain abscesses, 1 medulloblastoma, 1 malignant melanoma, 1 cryptic AVM, and 2 undiagnosed cases. There are two complications: 1 intratumoral bleeding, 1 rebleeding. The diagnostic rate is 92%. There is no mortality in this series. This BRW CT- guidance stereotaxic approach for less accessible lesions have following advantages; 1) accurate, simple and safe; 2) performed under local anesthesia; 3) less traumatic and low cost; 4) easily diagnosed; 5) relatively no limitation in lesion sites.

소뇌병소에서 BRW Stereotactic System 을 이용한 천막경유도달법 : Technical Note

임좌혁,김오룡,지용철,최병연,조수호 대한신경외과학회 1987 Journal of Korean neurosurgical society Vol.16 No.3

We previously reported the successful performances of the BRW sterotactic biopsy and aspiration of supratentorial and brain stem lesions. The BRW system has disadvantage of less accessibility to the cerebellar lesions by suboccipital approach. To overcome this disadvantage, we have tried to treat four patients having a cerebellar lesions, a case of hemangioblastoma, two cerebellar hemorrhages and acoustic neuroma, by transtentorial BRW stereotactic approach. This approach has been used successfully under the local anesthesia with satisfactory postoperative neurological results. We present a detailed technique of this approach.

지연성 외상성 뇌경막외 혈종 : Delayed Bleeding & Delayed Expansion

임좌혁 대한신경외과학회 1992 Journal of Korean neurosurgical society Vol.21 No.1

Delayed traumatic extradural hematoma is a new pathological dimension. Thirteen patients with delayed traumatic extradural hematoma were seen 70 treated cases of extradural hematomas for a freqency of 18.6%. The hematomas were insignificant or not present on the initial CT scanning. All patients had a skull fracture at the site of delayed extradural hematoma formation. Ten hematomas were surgically evacuated and three were reabsorbed spontaneously. Repeated CT scanning was performed if the patient has any new focal neurological deficits or clinical status was not improved despite of minimal extradural hematoma after head injury. Delayed extradural hematoma were classified into two gropus based on the presence of hematoma in initial CT scan : delayed bleeding type(newly formed extradual hematoma/ 4cases : 5.7%) & delayed expansion type(enlargement of initial thin hematoma/9 cases : 12.6%).

Oxytocin의 家兎 赤血球膜의 Na-K-ATPase 活性度에 미치는 影響

任佐爀,金光鎭 충남대학교 의과대학 지역사회의학연구소 1985 충남의대잡지 Vol.12 No.2

Na-K-ATPase, which is activated by Na+ and K- at physiological concentrations, have a high ability for sodium and potassium transport and material transport through the cell membrane. And the activity of this enzyme is specifically inhibited by ouabain. Oxy -locin is a neurohormone to be secreted from the posterior pituitary gland. And it is used widely in the clinical field as a agent for the onset or maintenance of labor and as a stimulant for the milk ejection. Also this hormone causes antidiuretic effect as a continous intravenous infusion. This suggested that oxytocin may have any effect on the material transport through the cell membrane. So, this study was attempted to investigate the effect of oxytocin on the activity of Na-K-ATPase in the red cell ghosts of rabbits. The red cell ghosts were purified by the method of Rosenberg and Guicotzi, and the amount of t Ic decomposed inorganic phosporus, that is the indicator of Na-K-ATPase activity, was measured by the method of Fiske and Subbarow. The results were summarized as follows l. The activity of Na-K-ATPase of the control group was 3.03±0.36 μM Pi/g protein/l0 min. 2. The activities of ATPases were showed a tendency to inhibit by the dosage of oxytocin 0.5 I.U., but it was not significant except total ATPase activity(p<0.05). 3. The activities of total ATPase and Na-K-ATPase were significantly inhibited by the dosage of oxytocin 1.0 1.U. (p<0.05 and p<0.001).