• Journal of Korean Neurosurgical Society
• /
• 제58권2호
• /
• pp.144-146
• /
• 2015

Postdural punctural headache (PDPH) following spinal anesthesia is due to intracranial hypotension caused by cerebrospinal fluid (CSF) leakage, and it is occasionally accompanied by an intracranial hematoma. To the best of our knowledge, an intracranial chronic subdural hematoma (CSDH) presenting with an intractable headache after a cervical epidural steroid injection (ESI) has not been reported. A 39-year-old woman without any history of trauma underwent a cervical ESI for a herniated nucleus pulposus at the C5-6 level. One month later, she presented with a severe headache that was not relieved by analgesic medication, which changed in character from being positional to non-positional during the preceding month. Brain magnetic resonance imaging revealed a CSDH along the left convexity. Emergency burr-hole drainage was performed and the headache abated. This report indicates that an intracranial CSDH should be considered a possible complication after ESI. In addition, the event of an intractable and changing PDPH after ESI suggests further evaluation for diagnosis of an intracranial hematoma.

• Journal of Korean Neurosurgical Society
• /
• 제37권6호
• /
• pp.456-458
• /
• 2005

We report a case of hydrocephalus in a 8-year-old boy who presented bilateral hand tremor. The hydrocephalus was caused by the aqueductal stenosis due to expanding lacunae in the mesencephalothalamic area on MR findings. The tremor was improved after CSF drainage by spinal tap and ventriculoperitoneal shunt. The authors present the possible mechanism of hydrocephalus induced tremor.

• Journal of Korean Neurosurgical Society
• /
• 제30권5호
• /
• pp.586-591
• /
• 2001

Objective : Transseptal or sublabial transsphenoidal surgery has been standard teatment for pituitary tumors for decades. However, as an alternative to this surgery endonasal endoscopic technique has been reported with encouraging results. We have started endoscopy-assisted transsphednoidal surgery from May 1998. In this paper we analyzed the methods, outcome, advantage and disadvantage of this surgical approach for the purpose of planning optimal treatment of pituitary tumors. Methods : This study consisits of 13 cases of pituitary tumors who were treated by endoscopy-assisted transsphenoidal surgery using one nostril from May 1998 to July 1999. Mean follow up period was 12.9 months. Results : There was no septal or sublabial incision and little surgical damage to nasal structure. With this technique, rapid surgical approach and short hospital day were possible, being 3-6 days in patients without CSF leakage. Using various angled endoscope, good surgical view was obtained. Initially it was difficult to use various instruments in narrow nasal cavity, but became feasible after several procedures. Among 13 cases, total removal was possible in 11 cases. One of two cases in whom tumor was incompletely removed underwent gamma-knife radiosurgery and second underwent reoperation through subfrontal approach. There were 6 cases of hormone secreting tumors and hormonal remission was achived in all of these cases. Postoperative complications were CSF leakage(6 cases), diabetes insipidus(2 cases) and panhypopituitarysm(1 case). Lumbar drainage was done in all cases of CSF leakage. Conclusion : The advantage of endoscopy-assisted transsphenoidal surgery are rapid surgical approach, low postoperative morbidity, short hospital day and good surgical view. The disadvantage of this appoach are difficulty in manupulating various instruments in narrow nostril and difficulty in distance perception but these problems can be overcome by practice and using stereoscopic endoscope.

• Journal of Korean Neurosurgical Society
• /
• 제41권2호
• /
• pp.100-104
• /
• 2007

Objective : Despite the widespread use of preoperative ventriculostomy in aneurysmal subarachnoid hemorrhage [SAH], there is no general consensus regarding the risk of bleeding associated with its use before aneurysm repair. This study was conducted to define the efficacy and rebleeding risk of ventriculostomy in aneurysmal SAH. Methods : The authors reviewed 339 consecutive patients with aneurysmal SAH who were treated at our hospital between January 1998 and December 2004. Results : Preoperative ventriculostomy was performed on 73 patients for acute hydrocephalus after aneurysmal SAH. The Hunt-Hess[H-H] grades of patients who underwent ventriculostomy were higher. Out of the 73 patients who underwent preoperative ventriculostomy, 58 [79%] demonstrated immediate clinical improvement after ventriculostomy. Of those same 73 patients 22 [30%] suffered aneurysmal rebleeding, whereas only 11 [4%] of the 266 patients who did not undergo ventriculostomy showed preoperative aneurysm rebleeding. The causes of rebleeding in the 22 patients who underwent ventriculostomy before surgery were related to the ventriculostomy procedure itself, subsequent cerebrospinal fluid [CSF] drainage, angiography and patient care procedures, such as endotracheal suction and nursing care. The mean time interval between SAH and surgery in the patients who underwent ventriculostomy was not statistically different from those who did not receive preoperative ventriculostomies [44.66 compared with 42.13 hours; p=0.73]. Conclusion : The preoperative ventriculostomy improved patients' clinical condition but increased the risk of rebleeding after aneurysmal SAH. When necessary, however, rapid change in transmural pressure during ventriculostomy must be avoided, careful management during ventricular drainage is needed, and surgery should be performed as soon as possible to prevent or reduce the incidence of rebleeding.

• 한국펄프종이공학회:학술대회논문집
• /
• 한국펄프종이공학회 2000년도 추계학술발표논문집
• /
• pp.115-115
• /
• 2000

제지 공정의 효율적인 운영을 위해 공정변수를 확인하는 작업은 매우 중요하다. 탈수 특성 평가를 위하여 SR(Shopper- RegIer)과 CSF(Canadian Standard Freeness tester) 그리고 원형 수초지기 동의 비난류 상태의 자연탈수 특성 평가 장치와 동적 조건의 감압식 탈수성 분석기 퉁이 도입되어 있으나 제지 공정에 보다 더 근접한 탈수, 보류 특성을 평가 하기 위하여 특히 wet-end 첨가제들의 효능을 보다 정확히 분석할 수 있도록 난휴 발생과 감압 탈수 둥을 유도한 탈수 특성 평가 장치 개발의 필요성이 커지고 있다Il, 2) 이미 소개된 RDA-HSF

• 정신신체의학
• /
• 제23권1호
• /
• pp.66-69
• /
• 2015

정상뇌압수두증은 보행장애, 요실금 및 치매 등의 전형적인 세 가지 증상 외에도 추체외로 증상과 다양한 신경심리 증상이 동반될 수 있다. 이 사례는 불안과 정동증상으로 치료 중 보행장애와 요실금 증상을 보였던 46세 여자 환자에서 항파킨슨 약물의 사용과 기존 정신과 치료 약물의 중단에도 불구하고 증상의 호전이 없었으나, 뇌 컴퓨터 단층 촬영상 뇌실의 확장 소견이 보였고 시험적 뇌척수액 배액에 의해서 수일 내에 증상들이 극적으로 호전되어 정상뇌압수두증을 감별해야 했던 경우이다. 뚜렷한 대뇌 실질의 위축 소견이 없으나 뇌실이 확장되어 있을 경우 추체외로 증상과 신경심리 증상이 있을 경우 정상뇌압수두증의 전형적 세 가지 증상을 보이지 않는다 하더라도 정상뇌압수두증의 가능성을 고려해서 시험적 뇌척수액 배액 등의 시술이 진단과 치료에 도움이 될 수 있음을 보여주는 사례라고 생각된다.

• 한국펄프종이공학회:학술대회논문집
• /
• 한국펄프종이공학회 2001년도 춘계학술발표논문집
• /
• pp.80-80
• /
• 2001

제지 공정의 효율적인 운영을 위한 수단으로 보류 및 탈수성의 분석은 매우 중요한 작 업 이 다. 보류 및 탈수 특성 을 평 가하기 위 하여 SR(Shopper-Riegler), CSF(Canadian S Standard Freeness tester) 그리고 원형 수초지기 등의 비난류 상태의 자연탈수 특성 평가 장치와 동적 조건의 감압식 탈수성 분석기 등이 사용되고 있다. 하지만 이것들은 제지 공정 에 보다 더 근접한 탈수 및 보류 특성을 평가하기에는 부족한 점이 있다. 특히 wet-end 첨 가제들의 효능을 보다 정확히 분석하는 것이 불가능하다. 이런 이유로 난류 발생과 감압 탈 수 둥을 유도한 탈수 특성 평가 장치 개발의 필요성이 커지고 있다. R RDA - HSF(Retention Drainage Analyzer- Handsheet Former)는 지료조성, 감압탈수 및 습지의 성형이 자동화되어 보류도와 탈수성, 종이지합 및 강도를 종합 평가 할 수 있는 새 로운 실험실용 초지기이다. 보다 현장에 가까운 초지 조건을 구현하기 위해서 지료의 농도 를 높이고 진공 탈수를 실시함에 따라 기존의 탈수성 분석기나 보류도 측정기의 단점을 보 완하게 되 었다. 본 연 구에 서 는 Canadian Standard Freeness test와 Dynamic Drainage Jar test 및 원 형 수초지기를 활용한 기존의 탈수성, 보류도 분석 결과와 RDA-HSF를 비교하여, 자연 탈수를 이용하는 기존의 탈수 및 보류 설비에 비해 현장 공정을 보다 현실적으로 재현할 수 있는 감압 탈수 초지 설비로서 RDA-HSF의 활용 가능성을 분석하였다. RDA-HSF를 활용한 실험실적 분석을 통해 현장의 상황올 유사하게 재현함에 따라 공정 운영 인자의 변화에 따른 제품의 품질 및 생산효율을 예측할 수 있게 된 바, 보다 효율적 인 공정 관리가 가능할 것으로 기대된다. 안료 입자의 경우 피인쇄체의 표면 공극을 채우고, 비히클의 경우 미세한 공극속으로 침투되어 경화됨으로써 피인쇄체가 지니고 있는 공극량을 감소시커 게 될 것이다. 그리고 피인쇄체의 각종 형태의 공극으로 침투된 잉크의 양에 반비례적으로 피인쇄체의 표변에 잉크가 잔류하게 될 것이다. 따라서 본 연구에서는 여러가지 안료를 사용하여 각각 다른 공극 특성을 지니는 도공지를 제조한 후 이들이 가지는 공극 특성과 잉크의 잔류 거동에 대해 고찰해 보고자 하였다.여 표면 유효층 일부만 오버레이시키며I 주조 및 단조가 불가능한 재료까지도 표면부에 오버레이 시킴으로 서 부품 및 설비의 제조에 있어 재료비의 절감과 제품의 수명이 획기적으로 개선될 수 있다. 그리고 최근에는 도금 빛 용사 둥과 같은 표면처리를 할 경우임의 소재 표면에 도금 및 용 사에 용이한 재료를 오버레이용접시킨 후 표면처리를 함으로써 보다 고품질의 표면층을 얻기위한 시도가 이루어지고 있다. 따라서 국내, 외의 오버레이 용접기술의 적용현황 및 대표적인 적용사례, 오버레이 용접기술 및 용접재료의 개발현황 둥을 중심으로 살펴봄으로서 아직 국내에서는 널리 알려지지 않은 본 기 술의 활용을 넓이고자 한다. within minimum time from beginning of the shutdown.및 12.36%, $101{\sim}200$일의 경우 12.78% 및 12.44%, 201일 이상의 경우 13.17% 및 11.30%로 201일 이상의 유기의 경우에만 대조구와 삭제 구간에 유의적인(p<0.05) 차이를 나타내었다.는 담수(淡水)에서 10%o의 해수(海水)로 이주된지 14일(日) 이후에 신장(腎臟)에서 수축된 것으로 나타났다. 30%o의 해수(海水)에 적응(適應)된 틸라피아의 평균 신사구체(腎絲球體)의 면적은 담수(淡水)에 적응된 개체의 면적보다 유의성있게 나타났다. 해수(海水)에 적응(適應

• Journal of Trauma and Injury
• /
• 제25권2호
• /
• pp.57-62
• /
• 2012

Gunshot wounds are rare in Korea, but they have tended to increase recently. We experienced an interesting case of penetrating gunshot injuries to the cervical spine with migration the fragments of the bullet within the dural sac of the cervical spine, so discuss the pathomechanics, treatment and complications of gunshot wounds to the spine and present a review of the literature. A 38-year-old man who had tried to commit suicide with a gun was admitted to our hospital with a penetrating injury to the anterior neck. the patient had quadriplegia. A Computed tomography (CT) scan and 3-dimensional CT of the spine showed destruction of the left lateral mass and lamina of the 5th cervical vertebra; the bullet and fragments were found at the level of the 5th cervical vertebra. The posterior approach was done. A total laminectomy and removal of the lateral mass of the 5th cervical vertebrae were performed, and bone fragments and pellets were removed from the spinal canal, but an intradurally retained pellets were not totally removed. A dural laceration was noted intraoperatively, and CSF leakage was observed, so dura repair was done watertightly with prolene 6-0. The dura repair site was covered with fibrin glue and Tachocomb$^{(R)}$. Immediately, a lumbar drain was done. Radiographs included a postoperative CT scan and X-rays. The postoperative neurological status of the patient was improved compared with the preoperative neurological status. however, the patients developed symptoms of menigitis. He received lumbar drainage(200~250 cc/day) and ventilator care. After two weeks, panperitonitis due to duodenal ulcer perforation was identified. Finally, the patient died because of sepsis.

• 펄프종이기술
• /
• 제30권2호
• /
• pp.47-54
• /
• 1998

Refining is one of the most important processes of fiber treatment that provides optical and physical properties of final paper products. The evaluation method of refining progress is usually freeness (CSF) or wetness (SR) test because of its rapidity and convenience. However, there are some deficiencies in using freeness or wetness test to evaluate pulp fibers accurately because its results are more influenced by fines contents than extent of fibers treatment. The objective of this study is to show the deficiency of wetness in evaluating the refining process. For this, beating is done by varying the beating load. Handsheets are made after beating until 25 and $32^{\circ}C$ SR, and then paper properties are measured. Refined fibers are analyzed by fiber length, fines contents, curl, kink, WRV, and zero-span tensile strength. The results show that longer beating time is required to reach the same wetness at lower beating load. There are differences in the average fiber length, distribution curve of fiber length, fines contents, curl, kink, WRV of long fiber fraction, drainage time, and zero-span tensile strength of rewetted sample at different beating load. At the low beating load in the same wetness, apparent density, breaking length, burst strength, and tear strength are higher, while opacity and air permeability are lower than those of the high beating load. Using Page s equation, which shows the relationship among tensile strength, intrinsic fiber strength, and interfiber bonding strength, interfiber bonding strength is calculated and analyzed to explain final paper properties. At $25^{\circ}C$ SR, interfiber bonding strength is only slightly higher at 2.5kgf beating load, while the intrinsic fiber strength is substantially higher. At $32^{\circ}C$ SR, intrinsic fiber strength is a little bit higher at 2.5kgf beating load, and interfiber bonding strength is remarkably higher than those of 5.6kgf beating load. These results can be used to explain the different properties of the final paper at selected beating loads.

• 펄프종이기술
• /
• 제46권3호
• /
• pp.28-36
• /
• 2014

The kind and the mixing ratio of recovered papers would affect the quality of final recycled paper. In this study, effects of the mixing ratio of various domestic recycled papers (old news print (ONP), old corrugated container (OCC) and coated paper (CP)) on variations in physical properties of paper and its productivity were investigated. When the mixing ratio of CP grade increased, the freeness (CSF) of recycled pulp was increased while paper strength and white water turbidity was decreased. Paper strength was decreased as the percentage of OCC was higher than ONP. When ONP was mixed with OCC, no adverse effect was observed except the increased drainage resistance. It is expected that these results could be utilized as fundamental data to establish regulations for the recovered paper grades according to mixing ratios of different kinds of them.