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요추부 수술후 경막외 Morphine Sulfate와 Bupivacaine의 지속적 주입에 의한 통증 조절의 효과
신문수,이병희,최훈규,노재섭,안정용,신승훈,이병희,정봉섭,Shin, Moon Soo,Lee, Byung Hee,Choi, Hun Kyu,Noh, Jae Sub,Ahn, Jung Young,Sheen, Seung Hun,Lee, Byung Hee,Chung, Bong Sub 대한신경외과학회 2000 Journal of Korean neurosurgical society Vol.29 No.5
Objective : The purpose of this non randomized prospective study was to verify the effect of pain control in small doses of epidural morphine and bupivacaine through continuous infusion for 48 hours. Patients and Methods : Thirty-five patients who underwent spine surgery including laminectomy, fusion with fixation were assigned into two groups ; pain control group(n=20) and control group(n=15). Pain score was measured on a visual analogue scale(VAS). A continuous infusor was used to give morphine and bupivacaine continuously via indwelling epidural catheter which was placed before closure of muscles in pain control group. Results : Mean scores(VAS) of pain control group were between 1.3 and 2.1 from the 30 min to the 72 hour, but the lowest mean score in the control group was about 2.6 at the 72 hour. Although a number of extra-analgesics were used in control group, differences of mean scores were statistically significant till 24 hour in pain control group. The patients in pain control group was less painful than the patients in control group from 24 hour till 72 hour, but it was statistically insignificant. There were some side effects such as nausea/vomiting, pruritus, urinary retention which existed transiently, but there was no respiratory depression. Conclusion : It was concluded that the early postoperative pain can be easily and safely controlled with continuous infusion of epidural morphine and bupivacaine in small doses.
박진영,안정용,허륭,최훈규,이병희,신문수,정봉섭,Park, Jin Young,Ahn, Jung Yong,Huh, Ryoong,Choi, Hun Kyu,Lee, Byung Hee,Shin, Moon Soo,Chung, Bong Sub 대한신경외과학회 2000 Journal of Korean neurosurgical society Vol.29 No.11
Objectives : Embolization of intracranial aneurysms by using Guglielmi detachable coils(GDC) is proving to be a safe method of protecting aneurysms from rupture. Occasionally, patients with unruptured intracranial aneurysms present with symptoms related to the aneurysm's mass effect on either the brain parenchyma or cranial nerves. In the present study, the authors conducted a retrospective review to evaluate the response to GDC embolization in a series of 6 patients presenting with cranial nerve dysfunction due to mass effect. Patients and Methods : Aneurysms were classified by size, shape, and amount of intraluminal thrombus. Patients were classified by duration of symptoms prior to GDC treatment(range<1 month to>4 years). Clinical assessment was performed within days of the GDC procedure and at later follow-up appointments(range 5-16 months, mean 9 months). Results : In the immediate post-GDC embolization period, one of the five patients had transient worsening of third nerve palsy, which later improved to better than baseline status. Two patients who presented with third nerve deficit from a internal carotid artery-posterior communicating artery junction aneurysm had complete recovery. One patient who presented with hemiparesis and dysarthria from a giant mid-basilar aneurysm showed improvement of these symptoms. One patient who presented with sixth cranial nerve deficit from a cavernous aneurysm showed no change at the 8-months follow-up examination. Conclusion : The endovascular treatment of intracranial aneurysms by using GDC is suggested as an alternative therapeutic method for improving or alleviating neurological deficits produced by mass effect.
뇌하수체졸중 환자에서 나타난 안검하수를 동반한 고립된 제 3 뇌신경 마비 -증례보고-
이현구 ( Hyun Goo Lee ),노재섭 ( Jae Sub Noh ),임종국 ( Jong Kook Rhim ),정봉섭 ( Bong Sub Chung ) 대한뇌종양학회·대한신경종양학회·대한소아뇌종양학회 2011 대한뇌종양학회지 Vol.10 No.1
Pituitary apoplexy is an acute ischemic or hemorrhagic vascular accident of a pituitary adenoma. Clinical features of pituitary apoplexy include sudden onset of headache, nausea, vomiting, visual symptoms, ptosis, altered mental status, and endocrinologic dysfunction. However, isolated third cranial nerve palsy with ptosis as the presenting sign of pituitary apoplexy is very rare. We describe one case of pituitary apoplexy presenting as sudden-onset unilateral ptosis and diplopia. So we suggest that pituitary apoplexy should be included in the differential diagnosis of patients presenting with isolated third cranial nerve palsy with ptosis and recommend that early surgical decompression should be considered for preservation of third cranial nerve.
정봉섭,이규성,도종웅,이규창 대한신경외과학회 1983 Journal of Korean neurosurgical society Vol.12 No.4
Maffuci's syndrome is characterized by defects in cartilage bone formation(dyschondroplasia) with subcutaneous multiple vascular hemangiomas, and often with enchondromas. More than 120 cases of this syndrome, which was first described by Maffucci in 1881, has been reported. But intracranial tumors are rare complication of this syndrome. In this paper we describe the 6th case in the world report of Maffucci's syndrome complicated by an intracranial tumor, which was confirmed histologically as a chondroma, and review the literature with regard to this rare complication of Maffucci's syndrome.
정봉섭,이규창 대한신경외과학회 1983 Journal of Korean neurosurgical society Vol.12 No.2
The authors analyzed 50 microsurgically treated middle cerebral artery(MCA) aneurysms among 266 intracranial aneurysms in the Department of Neurosurgery, Yonsei University Hospital from September 1975 through September 1982, in order to study the differences from those of other intracranial aneurysms, and analyze the surgical outcome versus preoperative clinical status of the patients, surgical timing, and the microsurgical techniques. The results of the analysis were summarized as follows ; 1) The middle cerebral artery aneurysms occupied 19.5% of the microsurgically treated intracranial aneurysms. 2) The brain CT scan showed subarachnoid hemorrhage in 77.5%, hemorrhage in the unilateral Sylvian cistern in 39.7%, and intracranial hematoma in 48.4%. 3) The most common location of middle cerebral artery aneurysms was the M₁-M₂junction in 84%, and MCA bifurcation aneurysms occupied 44%, and trifurcation ones 40%. 4) Clipping with reinforcement of the aneurysms were performed in 74% of total cases due to difficult complete clipping of the aneurysmal neck. And the rest were wrapped. 5) The surgical timing was around the 3rd week after the last bleeding in most cases. 6) Patients in Botterell's grade Ⅰ to Ⅲ showed no motality and good surgical outcome. Only one case of grade Ⅴ expired postoperatively, and morbidity was 10%.
정봉섭,이규호,안성기,김영환,전병찬,이화동 대한신경외과학회 1988 Journal of Korean neurosurgical society Vol.17 No.4
It has been well known that several kinds of intracranial lesions can be associated with cerebral aneurysms. Among them, each case of cerebral arteriovenous malformation, moyamoya disease and pituitary adenoma has been respectively reported as associated lesions with cerebral aneurysms. And we have added the other two cases of sylvian arachnoid cyst and nodular enhancing lesion, which might be coincidental association with cerebral aneurysms. We have reviewed literatures and discussed associated lesions with cerebral aneurysms.
유전적으로 변이된 흰쥐 섬유아세포에 의한 L-dopa 및 도파민의 실험관내 분비
정봉섭 대한신경외과학회 1993 Journal of Korean neurosurgical society Vol.22 No.4
A construct DNA containing the cDNA for rat tyrosine hydroxylase(TH) and another construct DNA containing the cDNA for bovine L-dopa decarboxylase(DDC) were made and those genes were transferred-,by calcium phosphate transfedon method into the immortalized rat fibroblasts. A both TH- & DDC- positive clone was identified by immunocytochemical staining. These cells produced L-dopa and dopamine and released them into the cell culture medium in vim. which was confirmed by high performance liquid chromatography. These results have general implications for the application of gene therapy and specific implications for Parkinson disease.
후하방 흉추간판탈출증에서 전측방 도달법으로 Carbon Cage를 이용한 골융합술
신문수,정봉섭,최훈규,김용인 대한신경외과학회 1996 Journal of Korean neurosurgical society Vol.25 No.12
The authors report a case of thoracic disc herniation at T11/12 level which was downward migrated, presenting with signs of progressive spinal cord compression. The lesion was diagnosed by MRI. The operation was done by transthoracic transpleural approach using surgical microscope and the rib was not resected due to floating ribs of T11, 12. A Carbon cage with cancellous bones were used for the graft at the partial corpectomy site. The result of operation was good.
Clinical Utility of Magnetic Resonance Angiography
Park, Se Hyuck,Chung, Bong Sub,Eoh, Whan,Lee, Kyu Ho,Lee, Kil Woo 대한신경외과학회 1992 Journal of Korean neurosurgical society Vol.21 No.5
신경계질환을 진단하고 또는 수술계획을 세우기 위하여 뇌혈관의 형태학적 혹은 혈류학적 관찰이 필요하다. 현재까지 가장 널리 이용되는 검사인 일반적인 뇌혈관조영술은 뇌혈관을 정확하게 보여주는 방법이지만 검사자체의 침윤성, 조영제에 의한 과민반응 등의 단점이 있고 경정맥계수공제혈관조영술(intravenous digital subtraction angiography)은 비교적 간단한 검사이나 역시 조영제를 사용해야 하며 영상의 질에 문제가 있었다. 최근 자기공명영상의 발달로 두경부, 체간 및 사지의 혈관들을 조영제주입없이, 삼차원 영상으로 볼 수 있는 비침윤성, 비방사선 검사인 핵자기공명혈관조영술(magnetic resonance angiograpgy)이 개발되었다. 저자들은 뇌혈관질환 및 그 외의 신경계질환 환자를 대상으로 핵자기공명혈관조영술과 일반적인 뇌혈관조영술을 시행하였다. 그 결과 근위부 뇌혈관을 관찰하는 데는 핵자기 공명혈관조영술이 큰 도움이 되었으나 원위부 혈관을 보기위해서는 일반적인 뇌혈관조영술이 더 우수하였다. 핵자기공명혈관조영술은 신경계질환, 특히 뇌혈관질환의 screening test 혹은 진단방법으로 널리 이용될 수 있고 소아 및 일반적인 뇌혈관조영술을 시행할 수 없는 경우에 동맥을 통한 혈관 조영술을 대치할 수 있는 검사법이라고 생각된다.