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장웅규,이상형,정영섭,김동규,정희원,김현집,최길수,한대희 대한신경외과학회 1993 Journal of Korean neurosurgical society Vol.22 No.11
The authors treated 26 cases of extramedullary tumors around foramen magnum and craniocervical junction by various surgical approaches between 1982 and February 1993. They are 12 meningiomas, 9 neurinomas, 3 chordomas, 1 teratoma and 1 capillary lymphangioma. Among them, 7 cases are located at anterior portion of foramen magnum, 6 cases at anterolateral portion, 2 cases at lateral portion, 7 cases at posterolateral portion, and 4 cases are posteriorly located. These tumors were attacked via various surgical approaches. 19 cases were treated by conventional suboccipital approach, 5 cases by far lateral suboccipital approach and 2 cases of chordoma by transoral approach which was combined with far lateral suboccipital approach. So, 19 cases of tumors were removed completely, but 7 cases were subtotally removed. There was 1 case of operative mortality and in 2 cases of meningioma there was permanent lower cranial nerve palsy. Pyogenic meningitis due to CSF leakage developed in 2 cases of chordoma which were treated by transoral approach.
The Apoptosis and Expression of p53,Bcl-2 in Graded Contusion Injury of at Spinal Cord
장웅규,최우진,김기정,정천기,김현집 대한신경외과학회 2004 Journal of Korean neurosurgical society Vol.36 No.4
Objective : This study is designed to investigate how apoptosis is presented and how the genes of p53 and bcl-2 are expressed depending on graded injury in experimental spinal cord injury. Methods : Experimental spinal cord injury was made on rats with weight drop method. Two different amounts of impact were applied on rat spinal cord. Rats were categorized into three groups (control; five rats, mild injury; five rats, severe injury; five rats). Fourty eight hours following cord injury, cord specimen was harvested from injury epicenter. TUNEL staining was done for apoptotic detection and immunohistochemical staining for p53 and bcl-2 expression. Positively stained cells were counted and mean values were compared among three groups. Results : TUNEL positive cells increased depending on injury severity(p=0.027). The p53 positive cells increased in both injury groups compared to control group(p=0.001). Bcl-2 positive cells decreased as injury amount increased(p=0.002). The p53 expression increased in proportion to TUNEL staining in correlation curve in white matter(correlation coefficient, 0.387). The bcl-2 expression was inversely proportional to TUNEL staining and steeper decrease was found in gray matter than in white matter (correlation coefficient, -0.875). Conclusion : Apoptosis increases as the injury grading elevated within 20gm-cm of impact. The p53 seems to promote apoptosis in white matter, but do not show proportional relationship with injury amount. Bcl-2 appeared to be protective to cell death due to apoptosis.
흉추강 협착증의 수술적 치료 결과와 예후인자에 관한 분석
장웅규,정상기,김동윤,정천기,김현집,Chang, Ung Kyu,Chung, Sang Kee,Kim, Dong Yoon,Chung, Chun Kee,Kim, Hyun Jib 대한신경외과학회 2001 Journal of Korean neurosurgical society Vol.30 No.6
Objective : To describe the underlying causes, surgical results, and prognostic factors in thoracic stenosis causing myelopathy, retrospective analysis for 28 cases of thoracic stenosis with surgery was performed Materials & Method : Twenty-eight patients(male, 15 ; female, 13) who underwent decompressive surgery for thoracic stenosis between 1987 and 1997 were analyzed. The mean age was 49 and the mean follow-up was 30.6 months. Statistical analysis with $SPSS^{(R)}$ was performed. Chi-square test was used for the analysis of relationship between subjects and multivariate analysis with general linear model was used to find prognostic factors. Result : Degenerative spondylosis was the most common cause, and three cases were associated with systemic diseases. Decompressive laminectomy was done in 23 cases, anterior decompression in four cases, and combined decompression in one case. Ossification of ligamentum flavum was found in 18 cases, facet hypertrophy in 13, ossification of posterior longitudinal ligament in six, and ventral spur in four. Postoperatively, 16 patients improved functionally and 4 patients worsened. The group of which initial symptom duration was less than two years showed better result(p=0.003). The group with sufficient decompression and no additional proximal stenosis had better outcome(p=0.002, p=0.001). Conclusion : Chronic myelopathy caused by thoracic stenosis can be reversible with appropriate decompression.
만성요통의 치료에 있어서 Lonazolac-Ca(Irritren^(�))과 Naproxen의 임상적 효과에 대한 비교연구
장웅규,전상룡,김현집 한국병원약사회 1997 병원약사회지 Vol.14 No.3
Chronic low back pain is a high-profile symptom in industrialized societies. To control chronic low back pain nonsteroidal anti-inflammatory drugs have been used so easily and widely. We investigated clinical effectiveness of a newly developed NSAID, Lonazolac-Ca(Irritren^(R)), and compared it to naproxen which has been used so long. We recommanded 50 chronic low back pain patients to take lrritren and Naproxen with double blind method. The patients have suffered from low back pain for more than 3 months and were not included in surgical indication. Irritren group was 27 patients and Naproxen group 23 patients. There was no significant statistical difference in age, symptom duration, and pre-medication functional status (ROM degree) between two drug groups. Total medication period was 33months(aberage 1.4 months). Back pain has much more improved in Irritren group (59%, 16 out of 27) than Naproxen group (35%, 8 out of 23), but statistically not significant. And degree of functional improvement also seemed to be larger in Irritren group than Naproxen group with Rom assessment (P=0.045). 10% of the patients showed gastrointestinal symptoms and hypersensitivity reaction but other serious side effects were not observed. So we concluded that these two drugs are useful and safe in the control of chronic low back pain.
장웅규,김동규,양희진,이현구,최길수,한대희 대한신경외과학회 1992 Journal of Korean neurosurgical society Vol.21 No.7
The authors report a case of brain abscess associated with pulmonary arteriovenous malformation(AVM). As right to left shunt in systemic circulation can precipitate brain abscess in congenital cyanotic heart disease, arteriovenous fistula in pulmonary AVM is an etiologic factor or brain abscess. Brain abscess associated with pulmonary AVM is very rare and has so far been lacking in previous report in Korea. The pertinent literatures of brain abscess associated with pulmonary AVM are also reviewed.
해면정맥동 부위 거대동맥류에 있어서 외경동맥과 중대뇌동맥간 복재정맥 우회 이식술 : 증례보고
전상룡,장웅규,정천기,한대희 대한신경외과학회 1994 Journal of Korean neurosurgical society Vol.23 No.5
The authors report a case of giant internal carotid artery aneurysm at the cavernous portion which was treated by trapping of internal carotid artery(1CA) after external carotid artery(ECA) to middle cerebral artery(MCA) bypass by long saphenous vein graft. It was impossible to clip the aneurysm because of its position and size. The patient suffered from progressive extraocular movement disturbance and decreased visual acuity. She was intolerant to balloon occlusion test. The size of the aneurysm was 3.5 X 25X 2cm. ECA to MCA bypass was done with saphenous vein graft successfdly. However, computerized tomography shows hemorrhagic infarction at left temporal lobe postoperatively. Two days later, left temporal lobectomy was done because of uncontrollable increased intracranial pressure. Internal carotid artery was trapped with pmxb mal ligation and distal clipping at the supraclinoid segment.