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이선일,최병욱,김수천,김형동,김수휴,심재홍 대한신경외과학회 1988 Journal of Korean neurosurgical society Vol.17 No.4
AAuthor reviewed the 31 cases of multiple intracranial aneurysms clinically from January 1981 to July 1987, at Inje College Busan Paik Hospital. The results obtained were as follows : 1) The incidence of multiple intracranial aneurysm was 7.8%. In most cases(94%), the number of aneurysm was two. 2) Approximately over 70% of patients were 6th and 7th decades, male to female ratio was 1 : 3.4. 3) The location of multiple intracranial aneurysms was in order, on the opposite side(39%), on the same side(26%), one in the midline and one on the side(29%). The location of indivisual aneurysms was in order, P-com. A (36%), MCA(25%), A-com. 4) The site of the ruptured aneurysm was determined by CT finding(55%), focal mass effect and spasm in angigraphy(29%), and others. The accurary was 97%. The possiblity of rupture at each location was A-com. A(73%), P-com. A(57%), ICA(38%), MCA(31%). 5) 12 cases among them were treated with one-stage operation and 9 cases with two-stage operation. The post-operative favorable outcome was estimated in 13 cases(54%), the surgical mortality was 13%. There was no statistical difference between two groups.
심재홍,김수천,이선일 인제대학교 1993 仁濟醫學 Vol.14 No.1
1982년 1월부터 1991년 12월까지 인제대학교 부산백병원 신경외과에서 총 809례의 뇌동맥에 대한 수술을 경험하였으며, 이 중 비교적 드물다고 알려진 원위부 전대뇌 동맥 동맥류 26례에 대한 임상적 특징 및 수술에 있어서의 문제점 등을 연구 분석하고 문헌 고찰과 함께 보고하고자 한다. Of eight-hundreds and nine patients with intracranial aneurysms who underwent operation at Inje University Pusan Paik Hospital between Jan. 1982 and Dec. 1992, twenty-six had aneurysms of distal anterior cerebral artery(DACA). Of these twenty-six patients, twenty-one had only ruptured DACA aneurysm. But, five had multiple aneurysms, and DACA aneurysms were responsible for subarachnoid hemorrhage in three. There were two incidental DACA aneurysms associated with ruptured aneurysms at other locations. All patient underwent direct surgery under the surgical microscope, if possibly within 48hrs after the last subarachnoid hemorrhage. This paper deals with clinical features, surgical techniques and problems in direct approach, and the results in our cases.
정영균,이선일,정용태,김수천,심재홍 대한신경외과학회 1993 Journal of Korean neurosurgical society Vol.22 No.7
Granulocytic sarcoma(chloroma) is an uncommon and solid tumor composed of immature cell of the mycloid series usually seen during the course of myelogenous leukemia or myeloproliferative disorders. The common sites for the occurrence of granulocytic sarcoma are soft tissue. periosteum, bone lymphoid tissue, skin, gastrointestinal tract and testic. But extradural presentation of the spine is very rare. We report two cases of extradural granulocytic sarcoma of the spine. Early recognition of the etiology of the paraplegia and the underlying systemic involvement with leukemia resulted in an excellent neurological and hematological outcome.
거대낭종을 동반한 두개강내 혈관외피세포증 : Case report
심홍보,이선일,최병욱,김수천,심재홍 대한신경외과학회 1995 Journal of Korean neurosurgical society Vol.24 No.12
Hemangiopericytomas is a rare malignent tumor of the central nervous system having an incidence of 1-3.8% of all primary intracranial meningeal tumors, and the occurrence of cystic hemangiopericytomas is even rarer. We report our recent experience of a case of cerebral Hemangiopericytoma associated with a large cyst in a 38 year-old man. The patient presented with 1-month history of headache. Computerized tomography(CT) and magnetic resonance image(MRI) showed a huge-sized, cystic tumor in the left frontal region. Histopathological report of the excised tumor confirmed cystic Hemangiopericytoma. Over the years, the issue of classifying Hemangiopericytoma as a form of meningioma has been controversial. Since Hemangiopericytoma differs from that of ordinary meningiomas because of its extremely malignant behavior and different histological and ultrastructural porperties, the author suggest that Hemangiopericytoma classified not with meningiomas. Regardless of classification, total surgical removal of this tumor is crucial due to its tendency for local recurrence despite aggressive resection.
뇌동맥류 수술 2,335례의 치험 : 2,335 Cases
심재홍,김수천,정용태,이선일,김무성,정영균,심홍보 인제대학교 백병원 2002 仁濟醫學 Vol.23 No.1S
■ Objectives The principle role of treatment for ruptured aneurysm has been to obliterate the aneurysmal sac and secure the patient's life from the hazards of rebleeding and vasospasm. The present study was conducted to evaluate the overally surgical results in 2,335 patients with intracranial aneurysms operated in our institution from January 1980 to December 31th, 2001. ■ Patients and Methods Among these, 776 cases were anterior communicating artery aneurysms, 596 internal carotid artery aneurysms, 603 middle cerebral artery aneurysms, 63 anterior cerebral artery aneurysms and 80 cases of vertebro-basilar artery aneurysms, etc. The male to female ratio was 0.7 to 1. Surgical methods were 2,111 clippings, 182 coatings and wrappings, 23 aneurysmorraphy, 19 proximal ligations. ■ Results Incidence of the rebleeding was 5.6% of the early operation group. 17% of the late operation group. Incidence of the clinical vasospasm was 18.6% angiographic vasospasm was 26.2%. The percent of the multiple aneurysms was 9.3%, dissecting aneurysm ; 5 cases(0.2%), "De Novo" aneurysm ; 4 cases(0.17%), lobectomy cases ; 7 cases (0.3%), incidental aneurysms ; 117 cases(5.0%). Overall surgical result was favorable outcome in 86% and mortality in 7%. In early surgery group, favorable outcome was 88%, mortality was 6%. The calcium-channel blocker and "Triple-H" therapy does not improve the postoperative mortality but improve the post-operative morbidity significantly. In old age group, favorable outcome was 85.5% and 8.5% mortality rate, favorable outcome 69.8%, mortality 11.3% in late operation group. In old age group, early operation can reduce vasospasm, rebleeding, medical complications, etc. In complex artery aneurysm, the use of endovascular treatment is increasing. Intraoperative angiography reduced residual aneurysm or remained aneurysm in large, giant aneurysm, and complicated aneurysm, especially in A.com. a. aneurysm. ■ Conclusions In vascular surgery, it is important how we do it for the aneurysm from surgical treatment to postoperative management. The more aneurysm operations, the more difficult.
김수천,최병욱,정용태,이선일,심재홍 인제대학교 1992 仁濟醫學 Vol.13 No.4
1985년 1월부터 1991년 12월까지 과거 7년간 인제대학교 부산백병원 신경외과에 입원하여 뇌전산화 단층촬영 및 핵자기공명 단층촬영술을 시행한 후 수술시행한 35례의 중추신경계 낭미충증에 대한 임상적 분석, 수술방법, 낭미충증의 분류 및 수술방법에 따른 수술결과 등을 분석하였다. Cysticercosis is caused by infection with the larval form of porcine tapeworm, Taenia solium. Infection and disease are increasingly recognized not only in many areas of the developing world but also in industrialized nations without endemic disease, principally because of the migration of infected persons. Neurocysticercosis is the most frequently encountered parasitic infestation of the central nervous system. The clinical course of 35 patients with neurocysticercosis who underwent surgery to control increased intracranial pressure or mass effect is analyzed. Of these, 15 were parenchymal type, 8 racemose type, 3 intraventricular type, 3 cisternal cyst, 2 subarachnoid cyst, a spinal form and 3 mixed form. The 35 patients were sumitted to a total of 40 surgical procedures, including 22 craniotomy with removal of parasitic cyst, 5 craniotomy and ventriculperiotoneal(V-P) shunt, 4 V-P shunt, 3 decompressive craniectomy and a laminectomy with removal of parasitic cyst. After surgery 30 cases(86%) showed favorable outcome and 2 cases(6%) death.