양성자 화학적 이동영상기법(¹H-CSI)을 이용한 정위적 뇌생검

장경술,손병철,김문찬,최병길,김의녕,김범수,최보영,백현만,홍용길,강준기,Chang, Kyung-Sool,Son, Byung-Chul,Kim, Moon-Chan,Choi, Byung-Gil,Kim, Euy-Neying,Kim, Bum-Soo,Choe, Bo-Young,Baik, Hyun-Man,Hong, Yong-Kil,Kang, Joon-Ki 대한신경외과학회 2000 Journal of Korean neurosurgical society Vol.29 No.12

Objective : To obtain more reliable sample in stereotactic biopsy, authors adopted proton chemical shift imaging ($^1H$-CSI)-directed biopsy. Until now, proton single voxel spectroscopy($^1H$-SVS) technique has been reported as a technique using metabolic information in stereotactic biopsy. The authors performed $^1H$-CSI with a stereotactic headframe in place and evaluated the pathologic results obtained from local metabolic information through $^1H$-CSI. Methods : $^1H$ CSI-directed stereotactic biopsy was performed in four patients. $^1H$-CSI and conventional Gd-enhancement stereotactic MRI was done simultaneously after application of the stereotatic frame. After reconstruction of metabolic maps of NAA/Cr, Cho/Cr, and Lactate/Cr ratios, the focal areas of increased Cho/Cr ratios and decreased NAA/Cr ratios were selected for target sites in the MR images Results : There was no difficulty in performing $^1H$-CSI with the stereotactic headframe in place. In pathologic examinations, the samples taken in area of increased Cho/Cr ratios and decreased NAA/Cr ratios showed the features of increased cellularity, mitoses and cellular atypism, thus facilitated the diagnosis. The pathologic samples taken from the area of increased Lactate/Cr ratios showed prominent feature of necrosis. Conclusion : $^1H$-CSI was feasible with stereotactic head frame in place. The final pathologic results obtained in our samples were concordant with the local metabolic informations from $^1H$-CSI. Authors believe that $^1H$ CSI-directed stereotactic biopsy may provide us advantages in obtaining more reliable tissue specimen in stereotactic biopsy.

연구발표논문초록 ( 공업화학 (Ⅱ) ) : r - Alumina 담체내에서 함침에 따른 Ni 촉매의 담지분포

장경술 (학),김희준 (정),박흥철 (종) ( Kung Sool Jang,Hee Joon Kim,Heung Chul Park ) 한국화학공학회 1987 춘계학술발표회 Vol.- No.-

수술 중 인도시아닌 비디오 혈관조영술에 의한 뇌동맥류의 불완전 폐쇄의 분석

이재철,장경술,장동규,한영민,박상규,윤완수,김종태,정동섭,박영섭 대한뇌혈관외과학회 2010 Journal of Cerebrovascular and Endovascular Neuros Vol.12 No.3

Objective : This study aimed to investigate factors associated with incomplete occlusion of a cerebral aneurysm detected by indocyanine green videonangiography (ICG-VA) following aneurysm clipping. Methods : We performed surgery on 135 patients with 151 intracranial aneurysms over a 1-year period. Included was an aneurysm more than 3 mm in size, the dome of which was sufficiently exposed and clipped permanently with one clip. Following ICG-VA, aneurysms were divided into a delayed-filling group and a no-filling group. Retrospective comparisons of the clip force, blade length and width, neck and dome size of the aneurysm, diameter of the parent artery, presence of atherosclerosis in the aneurysm neck, and systolic blood pressure during ICG-VA were made between the two groups. Results : Eight of 31 aneurysms in 29 patients showed delayed filling of contrast. The clip force in the delayed-filling group was lower than in the no-filling group and the atherosclerosis of the aneurysm neck differed between the two groups (P<0.05). Blade width in the delayed-filling group was also significantly lower than in the no-filling group (P<0.05). Following adjustment for atherosclerosis of the aneurysm neck, clip force and blade width in the delayed-filling group was even lower. Incomplete passage of the clip tip was observed in four aneurysms, weak clip force in three, and a slit between clip blades in one. After booster clipping or clip reposition, neither aneurysm regrowth nor recanalization was observed during 6 months of follow-up. Conclusion : Closing force, blade width, tip position, and remnant slit are important for incomplete occlusion of an aneurysm. (Kor J Cerebrovascular Surgery 12(3):206-212, 2010)

Endoscopic Versus Mini‐open Carpal Tunnel Release in Patients with Bilateral Carpal Tunnel Syndrome

장우영,장경술,장동규,정동섭,박영섭,박상규,한영민 대한척추신경외과학회 2009 Neurospine Vol.6 No.2

Objective: The purpose of this study was to determine any differences in outcome and patient satisfaction between endoscopic release (ECTR) and open carpal tunnel release (OCTR) in patients with bilateral carpal tunnel syndrome who underwent both techniques. Methods: Seven patients with confirmed bilateral idiopathic carpal tunnel syndrome were randomized to undergo endoscopic release using a single portal Agee technique to one hand and a minimal open release to the other. Subsequent assessments were made at 0, 3, and 12 months after operation using a modified Levin scale. We also analyzed subjective and objective outcomes retrospectively, including the time to return to full activity, patient preference, cosmetic satisfaction, scar tenderness, and pillar pain. The pain was assessed using a visual analogue scale from 1 to 10. Results: Based on the Levin scale, there were no significant differences between hands at any follow‐up interval. At the three‐month follow up, mean scale scores were lower in the ECTR group; however, the differences did not reach statistical significance. Cosmetically, all patients were satisfied with their scar irrespective of the technique. There were no statistical differences in terms of scar tenderness and pillar pain. Conclusion: ECTR did not show any significant advantage over short‐incision OCTR. Therefore, the operator's experience and skill in using a certain method is important, regardless of which technique is used.

양성 상완신경총 종양: 신경초종

박흥식,장경술,김종태,봉호진 대한척추신경외과학회 2009 Neurospine Vol.6 No.1

Benign peripheral nerve sheath tumors arising from the brachial plexus are rare, in general have a good prognosis. And the most common tumor arising from peripheral nerves is the schwannoma (also called neurilemoma or neurinoma). Malignant transformation is extremely rare. The tumors are composed of Schwann cells which support the peripheral nerve fibers, and are neuroectodermal in origin. We will present a case of brachial plexus schwannoma with surgical excision of anterior supraclavicular approach. Benign peripheral nerve sheath tumors arising from the brachial plexus are rare, in general have a good prognosis. And the most common tumor arising from peripheral nerves is the schwannoma (also called neurilemoma or neurinoma). Malignant transformation is extremely rare. The tumors are composed of Schwann cells which support the peripheral nerve fibers, and are neuroectodermal in origin. We will present a case of brachial plexus schwannoma with surgical excision of anterior supraclavicular approach.

γ - Alumina 담체에 담지된 니켈의 농도분포

문희,박흥철,장경술 한국화학공학회 1988 Korean Chemical Engineering Research(HWAHAK KONGHA Vol.26 No.2

NiCl₂용액으로 부터 γ-Alumina에 nickel을 함침시킨 후, 활성물질인 nickel의 농도분포를 electron probe microanalysis(EPMA)에 의하여 측정하였다. Nickel의 분포 및 담지량을 옹액의 초기 pH, 농도 및 온도와 담체의 전처리 조건을 변화시킴으로서 조절될 수 있음이 실험적으로 밝혀졌으며 Ni/γ-Alumina계의 담지메카니즘은 세공내 용액의 용해도차에 의한 침적현상으로 만족스럽게 설명될 수 있었다. After impregnating nickel from NiCl₂ solution onto γ-alumina, the concentration profile of nickel, an active material was measured by an electron probe micro-analysis(EPMA). Experimental results showed that the distribution and amounts of nickel could be controlled by changing initial pH, concentration and temperature of the solution, and pretreatment conditions of the support. The impregnation mechanism of Ni/γ-alumina system could be explained satisfactorily by the deposition due to difference in solubilities of the active material in the solution which exists in the pore.

γ- Alumina 담체에 담지된 니켈의 농도분포

문희,박흥철,장경술 한국화학공학회 1988 NICE Vol.6 No.3

Angiographic and Clinical Factors Related with Good Functional Outcome after Mechanical Thrombectomy in Acute Cerebral Artery Occlusion

Jong Hyuk Park,한영민,장경술,Wan-Soo Yoon,장동규,박상규 대한신경외과학회 2015 Journal of Korean neurosurgical society Vol.58 No.3

Objective : The aim of this study is to investigate good prognostic factors for an acute occlusion of a major cerebral artery using mechanical thrombectomy. Methods : Between January 2013 to December 2014, 37 consecutive patients with acute occlusion of a major cerebral artery treated by mechanical thrombectomy with stent retrievers were conducted. We analyzed clinical and angiographic factors retrospectively. The collateral flow and the result of recanalization were sorted by grading systems. Outcome was assessed by National Institutes of Health Stroke Scale (NIHSS) and modified Rankin Scale (mRS) at 90 days. We compared the various parameters between good and poor angiographic and clinical results. Results : Twenty seven patients demonstrated good recanalization [Thrombolysis in Cerebral Infarction (TICI) 2b or 3] after thrombectomy. At the 90-day follow up, 19 patients had good (mRS, 0–2), 14 had moderate (3–4) and four had poor outcomes (5–6). The mRS of older patients (≥75 years) were poor than younger patients. Early recanalization, high Thrombolysis in Myocardial Infarction risk score, and low baseline NIHSS were closely related to 90-day mRS, whereas high TICI was related to both mRS and the decrease in the NIHSS. Conclusion : NIHSS decreased markedly only when recanalization was successful. A good mRS was related to low initial NIHSS, good collateral, and early successful recanalization.

중앙 두개 기저부 종양에 대한 맞춤형 추체골 절제술

한영민(Young-Min Han),양승호(Seung-Ho Yang),홍용길(Yong-Kil Hong),장경술(Kyoung-Sool Chang),김종태(Jong-Tae Kim),정동섭(Dong-Sup Chung),박영섭(Young-Sup Park) 대한두개저학회 2006 대한두개저학회지 Vol.1 No.2

Different combinations of anterior and posterior petrosal approaches can be proposed for central skull base tumors. We investigated the usefulness and limitations of combining various petrosal approaches. Six operations were performed in five patients who harbor the central skull base tumor. The patients included 4 females and 1 male, and the average age was 39.3 (range, 29-53) years. Four operations were performed via combined petrosal approach preserving the labyrinth, one was via the similar approach but sacrificing the labyrinth. We used a combined petrosal and temporopolar approach in a patient with recurrent meningioma invloving the petroclival area, posterior cavernous sinus and suprasellar areas. Fontopolar approach combined in that case made a direct vision from the suprasellar to the lower brainstem area. Furthermore, it could reduce morbidity associated with an upward retraction of the temporal lobe which needed to obtain a working space to remove the tumor extending to the suprasellar area via subtemporal avenue which was afforded by a petrosal approach. The anterior petrosal approach was more useful to reach the midline and/or contralateral petroclival junction. The posterior petrosal approach can provide good control of the cranial nerves, the brainstem and the vertebrobasilar artery which are displaced posteriorly by the tumor so they are susceptible to injury via the anterior approach. Retrosigmoid approach was combined in a patient whose tumor extended below the lower cranial nerves. Gross total resection was achieved in one, subtotal resection in three and partial resection in one patient. No operative death occurred. Combining various approaches according to the extent of tumor allows better visualization of the surrounding vital structures and more room for a safe removal. It is necessary to tailor various petrosectomy in the patient with a central skull base tumor.

기초 : 악성신경교종의 세포고사체로 감작시킨 수지상세포에 의해 유도된 종양특이적 T 림프구의 HLA Type에 따른 세포독성

박익성 ( Ik Seong Park ),정동섭 ( Dong Sup Chung ),한영민 ( Young Min Han ),장경술 ( Kyung Sool Jang ),김종태 ( Jong Tae Kim ),박영섭 ( Young Sup Park ) 대한뇌종양학회 2008 대한뇌종양학회지 Vol.7 No.2

Objective:The purpose of this study is to determine whether human dendritic cells(DCs) pulsed with glioma apoptotic bodies(GABs) can induce tumor-specific T lymphocytes having cytotoxicities to allogeneic glioma cells matched or mismatched at class I human leukocyte antigen(HLA) loci. Methods:DCs were generated from peripheral blood mononuclear cells(PBMCs) of HLA-A2 positive healthy donors cultured in the presence of granulocyte macrophage-colony stimulating factor and interleukin(IL)-4. GABs from HLAA2 positive T98G glioblastoma cells following actinomycin D treatment were pulsed to DCs. CD8+ T lymphocytes isolated from PBMCs of the same donors were cultured in media containing IL-2 and were stimulated by GAB-pulsed DCs three times at weekly interval. Then cytolytic activities of these cytotoxic CD8+ T cells against HLA-A2 positive T98G and U87 glioblastoma cells, and HLA-A2 negative A172 glioblastoma cells were determined by a standard 4hr [51Cr]-release assay. Results:The average percentages of T98G , U87 and A172 cell lysis were 43.7%, 45.6% and 5.1% compared with 3.6% of controls at an effector to target cell ratio of 40:1 respectively. The cytotoxic T lymphocytes(CTLs) primed with HLAA2 positive T98G GAB-pulsed DCs had cytotoxicity to HLA-A2 positive T98G and U87 glioma cells but not to HLAA2 negative A172 cells(p<0.01). Conclusion:This study showed that tumor-specific CTLs generated by stimulations with GAB-pulsed DCs had cytotoxicity to the glioma cells in a HLA-restricted manner. This result suggests the feasibility of the use of HLA-matched allogeneic glioma cells as a source of antigens for patients not eligible for surgery in the DC-based immunotherapy.