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뇌 전이를 동반한 크루켄베르크 종양 - 증 례 보 고 -
권택현,조태형,임동준,박정율,박윤관,정용구,정흥섭,서중근,Kwon, Taek-Hyun,Cho, Tai-Hyoung,Lim, Dong-Jun,Park, Jung-Yul,Park, Youn-Kwan,Chung, Yong-Gu,Chung, Hung-Seob,Suh, Jung-Keun 대한신경외과학회 2000 Journal of Korean neurosurgical society Vol.29 No.9
Krukenberg tumor has been traditionally defined as gastrointestinal malignancy metastatic to the ovary, and is known to account for 1 to 3% of ovarian neoplasms. The nature and behavior of this particularly virulent tumor still remains unclear. We have experienced a case of Krukenberg tumor with brain metastasis. A clinical description of our case is presented with a review of the literature.
SAPHO 증후근에서의 신경근병증 - 증 례 보 고 -
한석,조태형,김세훈,임동준,박정율,정용구,서중근,Han, Seok,Cho, Tai Hyoung,Kim, Se Hoon,Lim, Dong Jun,Park, Jung Yul,Chung, Yong Gu,Suh, Jung Keun 대한신경외과학회 2001 Journal of Korean neurosurgical society Vol.30 No.11
SAPHO syndrome is an acronym for an increasingly recognized syndrome of synovitis, acne, pustulosis, hyperostosis, and osteitis. Most of the previously reported case are from Japan and Europe. The authors report a case of SAPHO syndrome in Korean female who presented with extrasternal neurologic symptoms. A 60-year-old female with thoracic and right chest wall pain presented with the sternocostoclavicular hyperostosis, and recurrent aseptic osteitis. Previously, she had hystrectomy and thyroidectomy due to uterine malignancy 25 years ago. Also, she started to take medications for palm and sole pustulosis 7 days prior to admission. Through evaluation of clinical, radiological, serological studies, studies was done along with bone needle biopsy for the biological reassessment. The hyperostosis was found in the pedicles of thoracic 8, 9, 10 vertebrae and sternoclavicular joint. Radio-isotope bone scan showed an accumulation of tracer in thoracic vertebra. The bone biopsy from these site showed increased osseous turnover, thickening of trabeculae accompanied by mild acculuation of granulation tissue and round cell infiltration, compatible with mild chronic inflammation with marrow fibrosis. The patient showed good response to conservative management. The authors report a case of SAPHO syndrome with thoracic radiculopathy. It is considered that SAPHO syndrome is related to spondyloarthropathy, and appears to have benign disease process with good prognosis.
김세훈,임동준,조태형,박정율,정용구,이훈갑,이기찬,서중근,Kim, Se Hoon,Lim, Dong Jun,Cho, Tai Hyoung,Park, Jung Yul,Chung, Yong Gu,Lee, Hoon Kap,Lee, Ki Chan,Suh, Jung Keun The Korean Neurosurgical Society 2000 Journal of Korean neurosurgical society Vol.29 No.10
악성 임파종중에서 Non-Hodgkin 임파종이 척수 압박 증상을 일으키는 경우는 0.1~10.2%정도로 알려져 있으며, 이러한 척수 압박 증세가 임파종의 초기 증상으로 나타나는 경우는 특히 드문 것으로 알려져 있다. 척수 압박은 척추관내에 국한되어 있는 임파종에 의하거나 주변 임파절이나 척추로부터 전이된 경우에 발생하며, 다른 장기로의 침범 소견이 없는 원발성 척수 경막외 임파종의 경우, 조기에 외과적 감압이 이루어지고 보조요법으로 항암 치료 및 방사선 치료가 행해진다면 그 경과가 비교적 양호한 것으로 알려져 있다. 저자들은 요통을 전구 증상으로, 급성 하반신 부전마비 및 배뇨 장애 소견을 보여 본원에 내원후, 응급 감압술 및 조직병리검사 결과 B-세포성 Non-Hodgkin 임파종으로 확인된 두 명의 여자환자를 경험하였다. 수술후 두 환자의 증세는 모두 회복되었으며, 항암 치료 및 방사선 치료후 현재까지 추적 조사중이다. 이에 저자들은 초기 증상으로 경막외 척수 압박을 보인 원발성 Non-Hodgkin 임파종에 관해 문헌 고찰과 함께 보고하는 바이다. Objectives : Spinal cord compression is a rare presentation of non-Hodgkin's lymphoma(NHL), occurring in 0.1% to 10.2% of patients. Primary spinal extradural NHL, i.e. occurring in the absence of any detectable extraspinal lymphoproliferative disorder, has a potentially favourable outcome if diagnosed and treated early. The authors describe two patients with a clinical picture of acute spinal cord compression as the first presentation of NHL. Methods : The patients were 48-year-old female and 27-year-old female. Both presented with back pain followed by acute paraparesis and voiding difficulty. One patient was diabetic. Plain radiographs of the spine were not specific. Thoracic spine magnetic resonance imaging(MRI) revealed evidence of extradural soft tissue mass extending multiple vertebral segments. Results : The patients underwent emergency laminectomy for decompression and tissue diagnosis. Histological and immunohistochemical study revealed B-cell lymphoma, intermediate grade in both patients. Postoperative staging did not reveal any additional lesions other than extradural manifestation of the malignant lymphoma. Surgery with additional chemotherapy and radiotherapy allowed the clinical improvement of both patients. Conclusion : The authors report two patients with a clinical picture of acute spinal cord compression as the first presentation of NHL, and stress that primary spinal epidural NHL should be a diagnostic consideration in the patient without prior history of malignancy who presents with a prodrome of back pain followed by a rapid neurological deterioration.
당뇨 환자에서 경막외 농양과의 감별을 요한 원발성 척추 경막외 임파종 - 증례보고 -
김세훈,임동준,조태형,정용구,이훈갑,이기찬,서중근,Kim, Se Hoon,Lim, Dong Jun,Cho, Tai Hyoung,Chung, Yong Gu,Lee, Hoon Kap,Lee, Ki Chan,Suh, Jung Keun The Korean Neurosurgical Society 2001 Journal of Korean neurosurgical society Vol.30 No.3
척추 경막외 임파종은 전체 임파종의 7%정도를 차지하며, 가장 흔한 증상으로 척수 압박 증세를 유발하는 것으로 알려져 있다. 그 중에서도 원발성 척추 경막외 임파종, 즉 다른 장기의 침범 소견 없이 척추에만 국한되어 나타난 임파종은, 당뇨병 환자에서 급성 척수 압박 증상으로 나타났을 때, 척추 경막외 농양과의 감별을 요한다. 저자들은 48세의 여자 당뇨 환자에서 흉추부의 통증으로 내원 1개월 전까지 여러 차례 침술치료를 받고 난 후 통증이 악화되고 급성 하반신 부전마비와 배뇨 장애 및 감염 징후가 있어 본원에 내원하여, 병력과 제반 검사상 수술전에 척추 경막외 농양으로 진단되었던 원발성 척추 경막외 임파종 1례를 수술 치험하고 보고하는 바이다. Primary spinal epidural lymphoma(SEL), i.e. occurring in the absence of any detectable extraspinal lymphoproliferative disorder, is an unusual cause of spinal cord compression. The authors report a 48-year-old, diabetic woman presented with back pain followed by acute paraparesis and voiding difficulty. She had been treated with acupunctures on her back before admission, and complete blood count showed leukocytosis with neutrophilia and increased erythrocyte sedimentation rate(ESR). Thoracic spine magnetic resonance imaging(MRI) revealed an epidural mass extending from T5 to T8 with compression of the spinal cord. Emergency decompressive laminectomy was performed with a tentative diagnosis of spinal epidural abscess, but a B-cell lymphoma was final pathologic diagnosis. Further staging showed no other sites of lymphoma, and the spinal lesion was treated by chemotherapy and radiotherapy. The authors stress that primary SEL can mimic spinal epidural abscess(SEA) in the diabetic patient and should be a diagnostic consideration in patients with a syndrome of acute spinal cord compression manifested by a prodrome of back pain and neuroimaging consistent with an epidural compressive lesion, especially in a diabetic.
권택현,정흥섭,박윤관,조태형,임동준,박정율,정용구,이훈갑,이기찬,서중근,Kwon, Taek Hyun,Chung, Hung Seob,Park, Youn Kwan,Cho, Tai Hyoung,Lim, Dong Jun,Park, Jung Yul,Chung, Yong Gu,Lee, Hoon Kap,Lee, Ki Chan,Suh, Jung Keun 대한신경외과학회 2001 Journal of Korean neurosurgical society Vol.30 No.7
Objective : Although surgical clipping of intracranial aneurysm is the definite method of treatment, there remains a small number of patients in whom surgical clipping is not technically possible. In such difficult cases, surgeon has to consider other therapeutic alternatives. In this report, we analyze our aneurysmal cases treated by wrapping and coating method and evaluate their surgical outcome and follow-up results. Method : Among the total of 877 patients operated from 1990 to 1999 for intracranial aneurysms at our hospital, 40 cases(4.6%) were treated by wrapping and coating method. They included 24 cases of single ruptured aneurysms and 16 with unruptured ones in multiple aneurysms. Wrapping with temporalis muscle and/or muslin gauze and coating with bioadhesive agent such as fibrin glue were performed. Result : Wrapping and coating method was performed mostly to the anterior communicating artery aneurysm (35%), and mostly because of the broad-based neck of an aneurysm(43%). At the time of discharge, 30 out of 40 patients(80%) showed favourable outcome and three cases died. The patients were monitored for average of 37 months(3-75 months). Among 24 cases with single ruptured aneurysm, 4 cases(17%) had early rebleeding within 6 months from the initial hemorrhage, and such rebleeding occurred within the first postoperative month in 3 cases. However, there was no rebleeding after the 6 months. Among 16 patients whose aneurysms were unruptured ones, none of them showed bleeding episode. Conclusion : It seems likely that the wrapping and coating method would be some help to prevent the rebleeding of an intracranial aneurysm. In order to obtain more accurate results regarding the efficacy of such method, it will be necessary to perform a multi-center study for longer follow-up periods and various wrapping and coating materials.
전형적 및 악성 결과가 예상되는 수막종에서의 FGF-1과 PR 표현의 차이
조태형,박정율,채양석,박윤관,정용구,정흥섭,이훈갑,이기찬 대한신경외과학회 1996 Journal of Korean neurosurgical society Vol.25 No.8
Fibroblast growth factor(FGF) is a mitogen and a potent antigenic factor It is also known as a differentiation factor for neuroectodermal-derived cell It has been observed to be expressed in more than 90% of m-RNA of human meningiomas and gliomas. Progesterone receptor(PR) is well known surface receptor of meningioma and its number is greater than that of estrogen receptor It is one of the known prognostic factors of meningioma. Meningiomas themselves are regarded as benign tumors in general however some types show aggressive features In the present study authors examined the expression of FGF-1 and PR in meningioma tissues using immunohistochemical techniques with monoclonal antibody against human FGF-1 and PR FGF-1 was detected in 25 of 35 classic meningiomas and in 7 of 9 aggressive ones PR is expressed in 5 cases of classic and 2 cases of aggressive meningiomas. These results suggest FGF-1 may be involved in aggressive progression of meningioma There was no significant difference of aggressiveness and expression of FGFR-1 and PR between classic and aggressive meningiomas including their subtypes.
조태형,박정율,박윤관,정용구,정흥섭,이훈갑 대한신경외과학회 1995 Journal of Korean neurosurgical society Vol.24 No.9
Neuroendocrine tumors are heterogeneous and potentially aggressive, and they must be distinguished from classic carcinoid tumors as the tumors share histologic features with their counterparts that occur in the lung, such as oat cell and intermediate cell carcinomas. Histopathologically, the oat cell neuroendocrine carcinoma displays itself in sheets, cord and ribbons of small hyperchromatic, undifferentiated cells with very scanty cytoplasm. The intermediate tell is slightly larger than the oat cell and has more abundant cytoplasm. The authors report a case of a 52-year old patient with neuroendocrine carcinoma that occured at the anterior cranial fossa extending into the nasal cavity. The patient presented with recurrent meningitis and seizure. Histological examination of the nasal biopsy tumor specimen confirmed neuroendocrine carcinoma, afterwhich the patient treated with a 4300 rad radiaton therapy. Magnetic resonance imaging taken 2 year later showed an enlargement of the tumor mass at the anterior cranial fossa, and the patient was operated for removal of the intracranial tumor. The nasal cavity defect was reconstructed using rotation galeal flap technique.