• Journal of Korean Neurosurgical Society
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• 제30권sup2호
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• pp.361-363
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• 2001

Intradural extramedullary hemangioblastoma of the spinal cord is uncommon tumor. Symptom onset is typically in the forth decade. Complete excision offers the best chance for cure. We report a case of extramedullary hemangioblastoma of the spinal cord in old age. A 76 -year old man presented with 1 month history of paraparesis. Multiple enhancing lower thoracic and lumbar spinal masses were seen on magnetic resonance imaging(MRI). Surgical exploration for symptomatic lesion revealed intradural-extramedullary mass, which had hypervascularity. The excised spinal masses were diagnosed as hemangioblastoma. Postoperative course was uneventful and symptoms improved gradually.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제28권5호
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• pp.477-482
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• 2006

The new type of orthodontic mini-implant named C-implant can be an effective alternative to conventional one-component mini-implant in the intermaxillary fixation (IMF) cases because of its particular design. The small size, two-part design, efficiency, and low cost of the C-implant make it applicable to various types of IMF cases easily such as fracture reduction and orthognathic surgery. The two part design resists highly to the fracture or deformation during implantation and removal. The long span head allows the patient to easily attach intermaxillary elastics, so that the patient can apply intermaxillary elastics for traction easily. Through this article, we tried to show the possibility of this appliance as a good adjunct for the IMF screw.

• 의료ㆍ복지 건축 : 한국의료복지건축학회 논문집
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• 제6권10호
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• pp.23-30
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• 2000

The purpose of this study is to provide the basic data that helps the supplying medical resources through understanding the present conditions of medical resources and the territory of diagnosis in Uijongbu city. To achieve this goal, the statistical data related to the medical resources of Uijongbu city were analyzed; the number of population, medical facility, beds for inpatients, medical personnels and so on. Through the analysis of statistical data, it was revealed that the present conditions of medical resources are so insufficient in Uijongbu city. The results of the study were as follows; Firstly, it should be added to the beds for inpatients. Secondly, it should be characterized by specialization of hospitals. Thirdly, it should be added to the herb medicine hospital.

• Journal of Korean Neurosurgical Society
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• 제30권6호
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• pp.800-804
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• 2001

MMD의 외과적 치료에서 소아에서는 직접 및 간접적인 혈관문합술을 병합하거나 아니면 간접적인 혈관문합술들을 병합하여 시행하는 경향이 있고, 성인에서는 혈관의 직경이나 MMD의 진행속도로 보아 STA-MCA 문합술과 같은 직접적인 수술이 많이 활용되고 있으나, 소아나 성인에서나 모두 공통적으로 보다 넓은 뇌표면에 여러 가지 수술방법을 병합하는 것이 좀더 광범위한 범위에 뇌혈류 공급을 증가 시키는데 도움이 된다고 보는 경향이다. 수술의 적응증은 혈관조영상에서의 나타난 질병의 정도보다는 acetazolamide를 이용한 PET 나 SPECT 검사로서 뇌혈류 예비량에 기준을 두고 있는 현상이 혈류 역학적으로도 합리적인 것으로 보인다. 수술후 합병증을 줄이려면 수술중에 정상탄산, 정상체온, 정상혈압을 유지 시킴과 동시에, 수술직후 통증관리도 철저히 하는 것이 매우 중요하다.

• Journal of Korean Neurosurgical Society
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• 제30권1호
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• pp.12-19
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• 2001

Objective : Albumin is a very useful drug for the improving of cerebral blood volume and the oncotic effect in cerebral ischemia or cerebral vasospasm. The purpose of this study was to examine the morphological and neurological effect of albumin therapy on reperfusion injury following transient focal cerebral ischemia. Materials and Methods : 18 Male Sprague-Dawley rats weighing 270-320g were used. The ischemia model was produced by 2-hour period of transient middle cerebral artery occlusion with a poly-L-lysin coated intraluminal suture. The agent(20% human serum albumin[HSA]) or control solution(NaCl 0.9%) was administered intravenously at a dosage of 1% of body weight immediate after reperfusion following a 2-hour period occlusion. Neurological function was evaluated by the postural reflex and the forlimb placing test during occlusion(at 60 min) and daily for 3 days thereafter. The brain was perfusion-fixed, and infarct volumes and brain edema were measured. Results : The HSA significantly improved the neurological score in treated group. The rats of albumin treatment group showed significantly reduced total infarct volume(by 34%) and brain edema(by 81%) compared with salinetreated rats. Conclusion : HSA showed a substantial effect on the transient focal cerebral ischemia and reperfusion injury model. These results may indicate its usefulness in treating reperfusion injury patients after thrombolysis treatment for the thrombo-embolic major cerebral artery occlusions.

• Journal of Korean Neurosurgical Society
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• 제30권7호
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• pp.903-906
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• 2001

Objective : The brain temperature is about $0.4-1^{\circ}C$ higher than that of the other peripheral body area. But most of these results have been obtained in normothermic condition. The objective of this study is to evaluate the temperature difference between the brain and axilla, in patients under hypothermia. Methods : Sixty-three patients(37 women and 26 men) who underwent craniotomy with implantation of the thermal diffusion flowmetry sensor were included in this study. The temperature of the cerebral cortex and axilla was measured every 2 hours, simultaneously. The patient group was divided according to axillary temperature hyperthermia( over $38^{\circ}C$), normothermia($36-38^{\circ}C$) and hypothermia(under $36^{\circ}C$). Total 1671 paired sample data were collected and analyzed. Results : The temperature difference between the cerebral cortex and the axilla was $0.45{\pm}1.04^{\circ}C$ in hyperthermic patients, $0.97{\pm}1.1^{\circ}C$ in normothermic patients and $1.04{\pm}0.81^{\circ}C$ in hypothermic patients. The temperature difference has statistical significance in each group(unpaired t-test, p<0.05). Conclusion : From our study the temperature difference between the brain and the axilla in hypothermic condition increased more than that of normothermic state. And in hyperthermic condition, the temperature difference decreased.

• Journal of Korean Neurosurgical Society
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• 제30권sup2호
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• pp.216-220
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• 2001

Objective : Cranioplasty is required to protect underlying brain, to correct major aesthetic deformities, or both. The ideal material for this purpose is autogenous bone. When this is not available, alloplastic or artificial materials may be used. In this study authors compared the infection rate according to the cranioplasty materials(the frozen autologous bone vs. bone cement), and duration of the skull defect. Materials : Between May 1994 and December 1999, 111 patients with skull defect treated with cranioplasty(82 cases of frozen autologous bone and 29 cases of artificial bone material) were included in this study. There were 77 males and 34 females with a mean age of 41.4 years(range 1-85 years). 57 patients had head trauma and 54 had non-traumatic insults. According to the duration of skull defect, there were 28 cases under 1 month, 33 cases of 1-2 months, 15 cases of 2-3 months, 20 cases of 3-6 months and 15 cases over 6 months of duration. Results : Overall infection rate was 9.9%. In cases with frozen autologous bone and artificial bone material, the infection rate was 8.5% and 13.7%, respectively. The infection rate according to the duration of skull defect was 3.6%(among 28 cases) under 1 month of age, while those were 12%(4 among 33 cases) at 1-2 months, 20%(3 among 15 cases) at 2-3 months, 5%(1 among 20 cases) at 3-6 months and 13%(2 among 15 cases) over 6 months. Accoring to the underlying disease, the infection rate in traumatic cases was 12%(7 among 57 cases) and that in non-traumatic one was 3.7%(2 among 54 cases). Conclusion : From this study, it appears that skull defect should be repaired as soon as possible, because early cranioplasty can lower the infection rate. And surgeons could save the patients' cranial bone as possible as they can because autologous bone is not only cost effective in cosmatic purpose but lower the infection rate.

• Journal of Korean Neurosurgical Society
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• 제38권2호
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• pp.121-125
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• 2005

Objective : Many recent reports have shown that the mature mammalian brain harbors multipotent stem cells, rendering the brain capable of generating new neurons and glia throughout life. Harvested stem cells from an adult rat are transplanted in order to evaluate the cell survival and differentiation. Methods : Using a percoll gradient with a high speed centrifugation method, we isolate neural stem/progenitor cells were isolated from the subventricular zone[SVZ] of a syngeneic adult Fisher 344 rats brain. For 14days expansion, the cultured cells comprised of a heterogeneous population with the majority of cells expressing nestin and/or GFAP. After expanding the SVZ cells in the presence of basic fibroblast growth factor-2, and transplanting then into the hippocampus of normal rats, the survival and differentiation of those cells were examined. For transplantation, the cultured cells were labeled with BrdU two days prior to use. In order to test their survival, the cells were transplanted into the dorsal hippocampus of normal adult Fisher 344 rats. Results : The preliminary data showed that at 7days after transplantation, BrdU+ transplanted cells were observed around the injection deposition sites. Immuno-fluorescent microscopy revealed that the cells co-expressed BrdU+ and neuronal marker ${\beta}$-tubulin III. Conclusion : The data demonstrate that the in vitro expanded SVZ cells can survive in a heterotypic environment and develop a neuronal phenotype in the neurogenic region. However more research will be needed to examine the longer survival time points and quantifying the differentiation in the transplanted cells in an injured brain environment.

• 산업기술연구
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• 제21권A호
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• pp.303-315
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• 2001

This study is a research result of investigating causes of landslides occurred at Uijongbu in Kyonggi Province, Korea. For works of this research, informations and data about landslides occurred at the site, geological and topographical informations were collected to analyze causes of landslides, and mapping landslides was performed by using results of field investigation. Data about rainfall during occurrence of landslides around Uijongbu was also used to find the effect of intense rainfall on occurrence of landslides. Based on informations obtained from field investigation and collected data, the scale and the pattern of landslides were analyzed and influencing factors on landslide such as intensity and duration of rainfall, topography, geologic condition, geotechnical engineering properties of ground, forestry were investigated statistically to find causes of landslides. On the other hands, for geotechnical engineering respects, slope stability analysis was performed for the typical sites chosen from the sites where the landslides occurred, using informations obtained from detailed topographical survey with total stations, field reconnaissance and results from laboratory tests.

• Journal of Korean Neurosurgical Society
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• 제30권3호
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• pp.295-306
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• 2001

Objectives : The management of massive brain swelling remains an unsolved problem in neurosurgical field. Despite newly developed medical and pharmacological therapy, the mortality and morbidity due to massive brain swelling remains high. According to many recent reports, surgical decompression with dura expansion is superior to medical management in patients with massive brain swelling. We performed surgical treatment on the first line of treatment, and followed medical management in case with refractory increased intracranial pressure(ICP). To show the quantitative effect of decompressive surgery on the intracranial pressure, we performed ventricular puncture and checked the ventricular ICP continuously during the decompressive surgery and postoperative period. Materials and Methods : Fifty-one patients with massive brain swelling, undergoing bilateral decompressive craniectomy with dura expansion, were studied in this study. In all patients, ventricular puncture was performed at Kocher's point on the opposite side of massive brain swelling. The ventricular pressure was monitored continuously, during the bilateral decompression procedures and postoperative period. Results : The initial ventricular ICP were varied from 13mmHg to 112mmHg. Immediately after the bilateral craniectomy, mean ventricular ICP decreased to $53.1{\pm}15.8%$ of the initial ICP(ranges from 5mmHg to 87mmHg). Dura opening decreased mean ICP by additional 36.7% and made the ventricular pressure $16.4{\pm}10.5%$ of the initial pressure (ranges from 0mmHg to 28mmHg). Postoperatively, ventricular pressure was lowered to $20.2{\pm}22.6%$(ranged from 0mmHg to 62.3mmHg) of the initial ICP. The ventricular ICP value during the first 24 hours after decompressive surgery was found to be an important prognostic factor. If ICP was over 35mmHg, the mortality was 100% instead of additional medical(barbiturate coma therapy and hypothermia) treatments. Conclusion : Bilateral decompression with dura expansion is considered an effective therapeutic modality in ICP control. To obtain favorable clinical outcome in patients with massive brain swelling, early decision making on surgical management and proper patient selection are mandatory.