제3뇌실의 교질낭종의 1예보고

이춘장,최창락,송진언,이종무 최신의학사 1971 最新醫學 Vol.14 No.1

A case of the colloid cyst of the third ventricle is reported. This 27 year old male patient was admitted to the department of Neurosugery, Catholic Medical Center in August 1969, with the chief complaint of paroxysmal excruciating bifrontal headache for 9 months being relieved by poition change. The patient described the headache being occured since December 1968. The interval of the each attack became longer but the severity of the headache became worse. During recent 3 months the patient noticed blurred vision. On admission, general status and neurogical examination revealed wiTh in normal limit excePt PaPilledema of the both side. Pneumoventriculography through the right coronal suture revealed a mass confined to the anterior part of the third ventricle, which was obstructing Foreman Monro area. Through the anterior approach of the modified Greenwood, a cystic tumor of the third ventricle at the third ventricle at the Foramen Monro was removed without injuring the terminal vein. Histopathological diagnosis confirmed colloid cyst and postoperative course was uneventful.

실험적 중추성 폐부종으로 인한 폐 및 시상하부 병변에 대한 Phentolamine의 효과

이춘장 가톨릭대학 (가톨릭신학대학) 대학원 1982 가톨릭大學醫學部 論文集 Vol.35 No.2

소교세포종증 1예

이춘장,윤석훈,송진언 대한신경외과학회 1979 Journal of Korean neurosurgical society Vol.8 No.1

A rare case of microgliomatosis (reticulum cell sarcoma) of the brain is reported. The tumor was located in the left parietal lobe and the right cerebellar hemisphere and the vermis. V-P Shunt was performed and left parietal cranietomy was done for removal of tumor. The patient received radiation therapy and chemotherapy for brain tumor with a good result Histogenesis and therapy of the microgliomatosis are briefly discussed

실험적 중추성 폐부종으로 인한 폐 및 시상하부 병변에 대한 Phentolamine의 효과

이춘장,백민우,김달수,허춘웅,하영수,강준기,송진언 대한신경외과학회 1982 Journal of Korean neurosurgical society Vol.11 No.3

This experiment was performed to define the participation of a discrete hypothalamic neural structure in the genesis of pulmonary edema and the effect of alpha-adrenergic blockade. Fifty adult cats weighing 2.5 to 4.0㎏, were used in this study. The components of the pathophysiological systemic changes, lung weight, and histopathological changes of lung and hypothalamus were studied in groups of animals when intracranial pressure(ICP) was raised to 200㎜H₂O or 300㎜H₂O for 2 hours by intraventricular infusion with normal saline. We have also observed the effect of the alpha-adrenergic blockade(phentolamine) in the neurogenic pulmonary edema which was produced by elevated intracranial pressure. The animals were divided into 5 groups : The normal control group was comprised in 10 normal cats. Control and phentolamine treated animal groups which had an elevated ICP of up to 200㎜H₂O consisted of 10 cats each. Control and phentolamine treated animal groups which had an elevated ICP of up to 300㎜H₂O consisted of 10 cats each. The results obtained were as follows : 1) In the animal groups of elevated ICP to 200㎜H₂O or 300㎜H₂O, there were hemodynamic systemic changes which were neurogenically mediated and caused an immediate elevation in blood pressure of 30㎜Hg to 60㎜Hg. The hemodynamic data of the animals that had an elevated ICP of up to 300㎜H₂O were significantly more deviated from normal control values than the 200㎜H₂O ICP groups. The hemodynamic responses of the phentolamine treated animal with elevated ICP of up to 200 and 300㎜H₂O were less deviated from normal control values. 2) The lung weights of the animals with an elevated ICP of up to 200 and 300 ㎜H₂O were significantly heavier than the normal control value(p<0.05) and the lung weights of the animals with an elevated ICP of 300 ㎜H₂O were significantly heavier than those with an ICP of 200 ㎜H₂O(p<0.01). The lung weights of the phentolamine treated animal groups were significantly lighter than the control group but showed little increase in the lung weight when compared to the normal value. 3) By controlling the elevated ICP above 200 ㎜H₂O in the experimental animals we have confirmed gross and microscopic appearances of hemorrhagic pulmonary edema. Histopathological changes of the phentolamine treated animals were significantly less sever than in the control groups. 4)By elevating ICP above 200㎜H₂O in the experimental animals, we have confirmed discrete bilateral hemorrhagic spots of the anterior hypothalamus, preoptic region induced by increased intracranial pressure. Histopathological change of the phentolamine treated animals with the elevated ICP were significantly less severe than of the control groups. 5) This experimental model may define the specific particification of the hypothalamus in the pathophysiological pathogenesis of neurogenic pulmonary edema. These results suggest that the lungs are directly affected by the intense sympathetic discharge evoked by release phenomenon from the sympathoinhibitory influence of the hypothalamus, and pulmonary edema was effectively eliminated by alpha adrenergic blockade.

신경외과 영역에 있어서 Sulbenicillin의 임상효과

이춘장,최창락 中央醫學社 1975 中央醫學 Vol.29 No.1

腦室內 髓膜腫 2例 報告

李春章,李永根,宋鎭彦 中央醫學社 1973 中央醫學 Vol.24 No.1

The literature concerning meningioma of the parasagittal and convexity is voluminous. However, the meningiomas within ventricular system are rare. We have presented two cases of the intraventricular meningiomas which were sucessfully removed and the diagnosis was confirmed histologically. A 44-year-old male was admitted with complaints of headache and visual disturbance for one year and one month. On his admission clinical findings were mental confusion, bilateral papilledema and loss of vision except light perception. Pneumoventriculogram showed marked symmetrical dilatation of the lateral ventricles and filling defect in posterior half of the third ventricle. Through the right frontal lobe incision a solid mass occupying in posterior half of the third ventricle was removed. Histological diagnosis confirmed a fibroblastic meningioma. The other case was 10-year-old boy who was having weakness of the right extremities without headache or vomiting. Neurological findings were bilateral papilledema and weakness of the right extremities. Pneumoventriculogram outlined a spherical filling defect, 6X4X5.5 cm in size, from left lateral ventricle to right lateral ventricle and the third ventricle. Left frontal craniotomy was carried out and removed a large tumor in the trigon of the left lateral ventricle. Histological diagnosis confirmed meningothelial meningioma.

터키안배 및 주변 병소에 대한 측두와 수술 방법

최창락,이춘장,송진언 대한신경외과학회 1977 Journal of Korean neurosurgical society Vol.6 No.1

Transtemporal approach to sellar and parasellar inagnrated first by Horsley (1902). Thereafter this procedure has been cultivated by many neurosurgeons when the mass of sellar and parasellar are to extension of suprasellar, temporal or backward direction. Recently we experienced 21 temporal approach for sellar and parasellar tumors. By this procedure a clear expose of intrasellar and suprasellar portion of the tumor is guaranteed as well as their relationship to parent structures, especially the chiasm and optic nerve, vessels, hypothalamus, infundibulum, and other cranial vessels. Favorable illumination, sterescopic view, adequate magnification and depth of focal of the surgical microscope along with the microsurgical instruments provide the armamentarium in treatment of sellar and parasellar lesions.

정상척추골동맥 조영상에서의 척추기저동맥계 분포상의 측정치

허춘웅,이춘장,하영수,이정길,한대희,강준기,송진언 대한신경외과학회 1975 Journal of Korean neurosurgical society Vol.4 No.2

Angiographic diagnosis of lesions of the posterior fossa requires detailed knowledge of the normal anatomy of both arteries and veins of the brainstem and cerebellum. For this perfose we measured normal distribution of the vertebrobasilar vessels from three base lines namely clival line, Twining line and foramen magnum line. In the measurement are also included some of the methods which were published in the past. This paper is based on the results of the measurements on 18 cases of normal vertebral angiogram among 77 cases of serial vertebral angiography performed at Catholic Medical center from October 1972 to August 1975. The result obtained were as follows: 1) Distance from the most posterior portion of the pericallosal artery to the clival line is 6.55±0.68㎝. 2) Distance from the most posterior potion of the arcuate portion of the lateral posterior choroidal artery to the clival line is 5.16±0.61㎝. 3) Distance from the posterior portion of the quadrigeminal portion of the medial posterior choroidal artery to the clival line is 4.87±0.67㎝. 4) Distance from the most posterior portion of the distal segment of the medial posterior choroidal artery to the clival line is 4.47±0.49㎝. 5) Distance from the bifurcation portion of the basilar artery to the clival line is 1.22±0.26㎝. 6) Distance from the forward convexity of the basilar artery to the clival line is 0.15±0.11㎝. 7) Distance from the choroidal point to the clival line is 2.99±0.51㎝. 8) Distance from the posterior medullary portion of the PICA to the clival line is 2.58±0.45㎝ 9) Distance from the tuberculum sellae to the Torcular Herophilli (Twining line) is 10.96±0.52㎝. 10) Distance between the tuberculum sellae to the point on the Twining line crossed by a perpendicular line drawn from the choroidal point is 6.61±0.40㎝. 11) Distance from the superior portion of the anterior culminate segment of the superior cerebellar artery to the Twining line is 3.28±0.48㎝. 12) Distance from the supratonsilar portion of PICA to e Twining line is 0.97±0.42㎝. 13) Distance from the colliculocentral point to the clival line is 3.74±0.37±㎝. 14) Distance from the crural portion of the anterior pontomesencephalic vein to the clival line is 1.65±0.33㎝. 15) Distance from the crural portion of the anterior pontomesencephalic vein to the colliculocentral point is 2.51±0.35㎝. 16) Distance from the copular point to the clival line is 3.99±0.51㎝. 17) Distance from the copular point to the line drawn from the anterior margin of the foramen magnum is 1.63±0.38㎝. 18) Distance from the highest point of the lateral posterior choroidal artery to the Twining line is 4.74±0.37㎝. 19) Distance from the highest point of the medial posterior choroidal artery to the Twining line is 4.35±±0.34㎝. 20) Distance between two bisected points of the anterior culminate segment of the superior cerebellar artery by a line drawn parallel to the Twining line at 1㎝ from the top of the anterior culminate segment is 2.86±0.29㎝.

측두하감압 개두술로 치유된 재발성 샨트관 폐쇄를 동반한 Normal Volume Hydrocephalus 1예 보고

김문찬,이춘장,강준기,송진언 대한신경외과학회 1982 Journal of Korean neurosurgical society Vol.11 No.1

The authors report a case of Normal Volume Hydrocephalus with recuring ventricular catheter obstraction treated by bilateral subtemporal craniectomy. Subtemporal craniectomy provide temporary relief from increased intracranial pressure while the same time encouraging dilatation of ventricle, would protect against further catheter obstruction by prevent trapping of catheter tip between the abutting ventricular wall. The patient had been followed-up for 2 years and postoperative result was excellent.

실험적 척수손상에 대한 Steroid와 Alpha Adrenergic Blockade의 효과

하영수,이춘장,송진언,김선무 대한신경외과학회 1976 Journal of Korean neurosurgical society Vol.5 No.1

To evaluate the effect of steroid and alpha adrenergic blockade in experimental spinal cord trauma, pathological change was observed after 500 gm-cm force was impacted on the exposed cord of the 30 Mongoreal adult dogs. The progression of the pathological changes was compared in time lag with the groups of steroid administered and phenoxybenzamine treatment. In the group of the spinal cord trauma without treatment, histopathological findings were classical evolution namely from the central hemorrhage and necrosis to peripheral involvement up to amorphous necrotic pattern of entire cord at 24 hours preparation. In the steroid therapy group after the trauma, the pathological changes were confined in the gray matter around and posterior portion of the central canal in all intervals. Moreover the edematous changes and hemorrhagic necrosis were far less severe than the group without treatment. Although the pathologic change was somewhat less severe in the group which received phenoxybenzamine prior t the trauma than the group administered phenoxybenzamine afterward, these group revealed much severe edema and hemorrhagic necrosis than steroid therapy group. The pathologic change, however, in the groups which received phenoxybenzamine was less severe than the group of the spinal cord trauma without teatment.