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조현원,김한규,황용순,천태상,이화동 대한신경외과학회 1990 Journal of Korean neurosurgical society Vol.19 No.8-9
Three cases of giant pituitray adenoma are reported. Two cases were operated by transsphenoidal approach and a case by transcranial approach. Transsphenoidal approach showed satisfactory results despite of marked suprasellar extension of tumors. We report rare giant pituitary adenomas with review of relevant literatures.
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Willis 동맥환에 대한 CT Infusion Scan의 의의
조현원,김한규,황용순,이화동,조영덕 대한신경외과학회 1992 Journal of Korean neurosurgical society Vol.21 No.10
Computerized Tomography infusion scan(CTIS) with 2㎜ thickness was used for rapid and accurate delineation of circle of Willis in patients with intracranial hemorrhage. A prospective study was performed using CT scan combined with the rapid continuous intravenous infusion of contrast media in an attempt of rapidly identify cerebral aneurysm in cases of 46 patients who were presented with spontaneous intracranial hemorrhage(N=41, SAH and n=5, spontaneous ICH). In 37 patients with SAH and one with spontaneous ICH, the CT infusion scans demonstrated aneurysmal sacs which were later confirmed by angiography. With this technique, we believe this method is an easy, effective, reliable way to screen and detect whether an aneurysm in the circle of willis is the cause of spontaneous intracranial hemorrhage.
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치상골로 인한 제1-2 경추 탈구 및 경수 압박을 보이는 환자에서 경구적 감압술 및 후방융합술 1례 : Case Report
문형봉,최원규,조현원,윤성문 대한신경외과학회 1994 Journal of Korean neurosurgical society Vol.23 No.11
The authors present the one case of a 22-year-old man admitted with intermittent quadriparesis and respiratory difficulty. O n investigation, atlantoaxial instability and upper cervical cord compression due to abnormal soft tissue were weald We have PeTformed transoral decompression and biopsy, and then posterior transarticular facet screw fmtion with interspinous Wiring and fusion We could obtain immediate and long-term postoperative stability with Philadelphia collar only. The pathologic examination weald connective soft tissue hypertrophy due to chronic mechanical irritation.
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문형봉,주형근,조현원,최원규,윤성문 대한신경외과학회 1994 Journal of Korean neurosurgical society Vol.23 No.12
The authors analysed 59 cases of chronic subdural hematomas which were treated surgically at the Department of Neurosurgery, Ulsan Dong Gang Hospital from Janua~y 1989 to august 1993. AU hematomas were operated on by burr hole trephination and continuous closed-system catheter drainage as a safe, less invasive, and efficacious method Male was predominant to female with the ratio 3.9 : 1 and the peak incidence was 3-60 years ago. Most of the cases had a history of head injury(75%). The patients were graded according to the scale proposed by Marbalder et al and 87% were in Grade 1 and 2 The major clinical systoms and signs were headache(80% >, consciousness deterioration(57 % >, motor weakness(48% >, papilledema (25%).The hematoma densities shown on Brain CT Scan were iso, hypo, and hyperdense in order of frequency. Among the patients a history of chronic alcoholism were presented in 38 46, but we failed to identify any sigmfkant differences in clinical analysis between alcoholism group and non-alcoholism group. We have found that the preoperative neurological state was the most realiable prognostic factor.
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박정필,문형봉,주형근,조현원,박혁,윤성문 대한신경외과학회 1993 Journal of Korean neurosurgical society Vol.22 No.11
The authors had analysed retrospectively a series of 286 consecutive patients with head injury who were admitted to the department of neurosurgery. Dong Gang Hospital between March and July, 1992. 59 cases underwent craniotomy for evacuation ofintracranial hematoma and/or placement of subarachnoid bolt for intracranial pressure monitoring under general anesthesia. Patients with a Glasgow Coma Scale(GCS) Score of 8 or less had significantly higher serum glucose levels postoperatively than patients with GCS score of 12 to 15(p<0.05). Patients who subsequently remained in a vegetative state or died had significantly higher glucose levels postoperatively than patients who had good outcome or moderate diasbility(p<0.05). Among the more severely injured paients(GCS Score≤8), a serum glucose level greater than 200㎎/㎗ on admission is associated with a significantly worse outcome(p<0.05). The results suggest that severely head-injured patients frequently showed hyperglycemia and the elevted serum glucose level may worsen the neurological outcome in such patients.
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원발성 두개강내 융모막암 : 증례 보고 Case Report
박정필,문형봉,조재홍,조현원,박혁,윤성문 대한신경외과학회 1993 Journal of Korean neurosurgical society Vol.22 No.12
본 병원 신경외과에서는 국내에서 보고된 예가 없고, 매우 드문 질환으로 알려진 전두각의 상의하부위에 생기고 조발 청춘기 소견은 없지만 뇨, 혈장, 그리고 뇌척수액에서 그 농도의 HCG 소견을 보이는 원발성 두개강내 융모막암 1예를 경험하였기에 문헌고찰과 함께 보고한다. Primary intracranial choriocarcinoma is a extremely rare neoplasm since the case was reported by Askanasy, in 1906, there have been 35 reported, even if germinal neoplasms containing choriocarcinoma-like tissueare added. But pure choriocarcinoma was rarely reported. The purpose of this paper is to report a case of 18-year-old boy with tumor in subependymal region around left frontal horn, which was present with high level of serum beta chain of chorionic gonadotropin(B-HCG) and was verified as germine choriocarcinoma by biopay.
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주형근,최원규,김의중,문형봉,조현원,윤성문 대한신경외과학회 1996 Journal of Korean neurosurgical society Vol.25 No.4
Atlato-axial instability is a serious condition that often rsquires operation. Atlanto-axial subluxation may cause severe symptoms ; and threaten the intsrgrity of the spinal cord. leading to quadriplegia or sudden death. A techique of combining C_(1)-C_(2) posterior screw fixation with a supplemental bone wire fusion has been advocated for the management of atiantoaxial instability. It was used in 9 patients with this disorder. Patients' ages ranged from 20 years to 52 years ; fellow-up period ranged from 3 to IS months with a mean of 9 8 months All nine patients gained immediate rigid fixation of C_(1)_(2) with this technique. Of these 9 patients. instability occured due to trauma in seven. os odotoideum in one and os odontoideum with trauma in another one One patient was presented with nonunion and C_(l)_(2) instability after a Halovest application as a result of type Ⅱ odontoid fracture. All 9 patients were placed in a philadelphia collar for 12weeks and all achieved solid fusion. Posterior atlantoaxial facet screw fixation provides immediate multidirectional rigid fixation of C_(l)_(2) and is mechanically superior to wiring or clamp fixation. This technique maximizes success without the need for a supplemental rigid external orthosis.
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