• Journal of Korean Neurosurgical Society
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• 제64권4호
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• pp.619-630
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• 2021

Objective : The skull base reconstruction step, which prevents cerebrospinal fluid (CSF) leakage, is one of the most challenging steps in endoscopic skull base surgery (ESS). The purpose of this study was to assess the outcomes and complications of a reconstruction technique for immediate CSF leakage repair using multiple onlay grafts following ESS. Methods : A total of 230 consecutive patients who underwent skull base reconstruction using multiple onlay grafts with fibrin sealant patch (FSP), hydroxyapatite cement (HAC), and pedicled nasoseptal flap (PNF) for high-flow CSF leakage following ESS at three institutions were enrolled. We retrospectively reviewed the medical and radiological records to analyze the preoperative features and postoperative results. Results : The diagnoses included craniopharyngioma (46.8%), meningioma (34.0%), pituitary adenoma (5.3%), chordoma (1.6%), Rathke's cleft cyst (1.1%) and others (n=21, 11.2%). The trans-planum/tuberculum approach (94.3%) was the most commonly adapted surgical method, followed by the trans-sellar and transclival approaches. The third ventricle was opened in 78 patients (41.5%). Lumbar CSF drainage was not performed postoperatively in any of the patients. Postoperative CSF leakage occurred in four patients (1.7%) due to technical mistakes and were repaired with the same technique. However, postoperative meningitis occurred in 13.5% (n=31) of the patients, but no microorganisms were identified. The median latency to the diagnosis of meningitis was 8 days (range, 2-38). CSF leakage was the unique risk factor for postoperative meningitis (p<0.001). Conclusion : The use of multiple onlay grafts with FSP, HAC, and PNF is a reliable reconstruction technique that provides immediate and complete CSF leakage repair and mucosal grafting on the skull base without the need to harvest autologous tissue or perform postoperative CSF diversion. However, postoperative meningitis should be monitored carefully.

• Journal of Korean Neurosurgical Society
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• 제65권3호
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• pp.457-468
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• 2022

Objective : The clinical management paradigm of skull base chordomas is still challenging. Surgical resection plays an important role of affecting the prognosis. Endonasal endoscopic approach (EEA) has gradually become the preferred surgical approach in most cases, but traditional transcranial surgery cannot be completely replaced. This study presents a comparison of the results of the two surgical strategies and a summary of the treatment algorithms for skull base chordomas. Methods : We retrospectively analyzed the surgical outcomes and follow-up data of 48 patients with skull base chordomas diagnosed pathologically who received transnasal midline approaches (TMA) and transcranial lateral approaches (TLA) from 2010 to 2020. Results : Among the 48 patients, 36 cases were adopted TMA and 12 cases were performed with TLA. In terms of gross total resection (GTR) rate, 27.8% in TMA and 16.7% in TLA and with EEA alone it was increased to 38.9%, while 29.7% in primary surgery. In TMA, the cerebrospinal fluid (CSF) leak remains the most common complication (13 cases, 36.1%), other main complications included death, cranial nerve palsy, hypopituitarism, all the comparisons were no statistical significance. The Karnofsky Performance Scale scores in TMA were all better than those in TLA at different time, and the overall survival (OS) and recurrence free survival/progression free survival was just the reverse. Conclusion : The EEA for skull base chordomas resection has improved the GTR rate, but transcranial approach is still an alternative approach. It is necessary to select an appropriate surgical approach based on the location and the pattern of tumor growth in order to obtain the best surgical outcomes.

• 한국결정성장학회지
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• 제4권2호
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• pp.148-156
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• 1994

$YBa_2Cu_3O_X$상 부근의 3가지 조성을 skull melting 방법으로 4MHz에서 녹인 후 방향적 결정성장을 시켰다. 일반적인 무기재료 공정방법으로 처리된 분말을 skull에 넣은 후 $1200^{\circ}C$부근에서 용융시켰다. 사용한 성장속도는 4~0.25 cm/hr이었으며, 금속현미경, X-선 회절기, EDX 등을 이용해서 제조된 시편을 조사하여 사용한 분말의 조성에 따른 시편의 미세조직의 변화를 관찰하였다. $YBa_2Cu_7O_X$와 $YBa_5Cu_{11}O_X$ 시편의 대표적인 미세조직은 성장방향으로 자라난 침상형태의 $YBa_2Cu_3O_X$와 $Y_2BaCuO_5$ 상이 $CuO-BaCuO_2$의 공융 조직상 사이에 생성된 것으로 나타났다.

• 한국환경생태학회지
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• 제30권1호
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• pp.39-47
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• 2016

한반도에 서식하는 노루의 계통분류학적 위치는 아직까지 명확하게 정리되어 있지 않으며, 최근까지 내륙과 제주도 지역에 서식하는 노루 간 외부형태와 유전학적 차이가 있다고 여러 차례 보고되고 있다. 따라서 본 연구는 외부형태와 유전적으로 차이가 나타나 두 아종으로 여겨지는 내륙과 제주도 노루의 머리뼈 특성에 있어서도 차이가 있을 것으로 생각하고, 그 차이를 비교 분석하여 한국노루의 분류학적 위치를 좀 더 명확하게 규명하고자 실시하였다. 총 50개체의 성체 노루 머리뼈를 비교 분석한 결과 머리뼈최대길이, 뒤통수뼈관절융기-치조점사이길이, 머리뼈바닥길이, 머리뼈최대폭, 광대뼈사이폭, 눈확사이폭, 얼굴길이, 위어금니열길이 등에서 유의한 차이가 나타나 제주노루가 내륙노루 보다 머리뼈의 크기 및 형태가 작은 것으로 나타났다. 두개골의 형태는 노루 아종 간 차이를 결정하는 중요한 요소이며, 위도, 경도, 고도에 직접적인 영향을 받지는 않지만 이 요소들이 1차 생산자에 영향을 미쳐 먹이식물에 변화를 가져오고 노루의 먹이 선택과 연관되어 순차적으로 두개골 형태에도 영향을 미친다. 따라서 한반도에 서식하는 노루 두개골의 계량형태학적 특성을 비교 분석한 결과 내륙 노루는 아종인 C. p. tianschanicus와 비슷한 반면, 제주 노루는 시베리아노루 3아종 및 유럽노루와 확연한 차이를 나타냈다. 이상의 결과를 종합해 볼 때 제주도 지역에 서식하는 노루의 경우 제주도에만 서식하는 고유종으로 아종 수준의 분류가 가능할 것으로 생각한다.

• 한국결정성장학회지
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• 제23권3호
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• pp.124-128
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• 2013

본 연구에서는 안정화제로, 패각으로부터 정제한 CaO를 사용하여 Skull melting법으로 큐빅 지르코니아를 성장시켰다. 꼬막 패각을 HCl을 0.1~1 mol%로 1차 처리한 후 수화반응을 거쳐 최적의 처리시간과 농도를 검토하였다. HCl을 1 mol%의 농도로 처리했을 때 가장 순도가 높았으며 수화반응시 $45^{\circ}C$의 온도로 24시간 동안 반응시킬 때 완전한 $Ca(OH)_2$ 를 얻을 수 있었다. $Ca(OH)_2$를 $1200^{\circ}C$에서 5시간 처리하였을 때 CaO의 순도가 가장 높게 측정되었다. 패각으로부터 얻어진 CaO를 $ZrO_2$에 첨가하여 함량을 10~30 mol% 로 변화시켜 Skull melting법으로 단결정을 성장시켰다. Skull melting법에 사용된 고주파 발진기의 주파수는 약 3.4 MHz이며 단결정의 하강속도는 시간당 3 mm로 4 cm 길이로 성장시켰다. 실험결과 CaO의 함량이 15 mol% 일 때 결정성이 가장 우수했다.

• 한국재료학회지
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• 제19권2호
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• pp.115-118
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• 2009

The use of dolomite refractories has increased during the past several years in the manufacturing of clean steel during the stainless steelmaking process. However, at the same time, the use of dolomite refractories has led to what is known as the skull formation. In the present work, to understand the skull formation, the wetting characteristics of dolomite substrates by liquid Fe-19wt%Cr-10wt%Ni alloys in various oxygen partial pressures were initially investigated at 1753K using the sessile drop technique. For comparison, the wetting characteristics of alumina substrates were investigated with the same technique. It was found that the wetting index, (1+$cos{\theta}$), of dolomite is approximately 40% higher compared to those of alumina. In addition, the oxygen partial pressure to generate the surface oxide, which may capture the liquid metal on the refractory surface, for dolomite is much lower than that for alumina. From this study, it was concluded that the use of dolomite is much more closely associated with the skull formation compared to the use of alumina due to the stronger wettability and the surface oxide formation at a lower oxygen partial pressure of dolomite.

• 한국결정성장학회지
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• 제13권5호
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• pp.205-210
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• 2003

스컬법에 의해 alexandrite-like cubic zirconia 단결정을 성장 시켰다. 스컬용융시 R.F generator는 35 ㎾, 2 MHz 였다. 단결정들은 전이금속이온인 Pr을 1 또는 1.5 wt%와 Nd를 0.5 또는 l wt%를 함께 첨가하여 성장시켰으며, 성장 후0.25 mm의 slice와 12 mm의 round brilliant cut으로 연마하였다. 연마석은 공기중 또는 질소분위기에서 $1000^{\circ}C$에서 2시간 열처리하였으며 optical absorption spectra($\lambda$ = 400∼700 nm)를 얻었다.

• Journal of Korean Neurosurgical Society
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• 제54권3호
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• pp.246-249
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• 2013

A solitary fibrous tumor (SFT) is a rare neoplasm originated from the pleura, but they can occur in a variety of extrathoracic regions. Although many cases of primary SFT have been reported, there are extremely rare repots to date of a malignant SFT in the spine or skull. A 54-year-woman visited our hospital due to low back pain and both leg radiating pain. Several imaging studies including magnetic resonance imaging and computed tomography revealed expansive enhanced lesions in the occipital bone, T8, S1-2, and ilium, with neural tissue compression. We performed surgical resection of the tumor in each site, and postoperative radiosurgery and chemotherapy were performed. However, after six months, tumors were recurred and metastasized in multiple regions including whole spine and lung. The authors report here the first case of patient with malignant SFT of tandem lesions in the various bony structures, including skull, thoracic spine, and sacral spine, with a rapid recurrence and metastasis. Although malignant SFT is extremely rare, it should be considered in the differential diagnosis and carful follow-up is needed.

• Nuclear Medicine and Molecular Imaging
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• 제41권1호
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• pp.64-65
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• 2007

A 49-year-old woman with invasive ductal carcinoma of the right breast underwent Tc-99m MDP bone scintigraphy for an evaluation of skeletal metastases. Multiple focal hot spots in the midline and left frontoparietal skull region were observed. The plain radiographs revealed the typical findings of the calcification of the falx cerebri and dura. These findings might be mistaken for metastases of the skull in cancer patients. Therefore, a radiographic correlation is essential when multifocal hot spots in the skull are observed in cancer patients.

• Journal of Korean Neurosurgical Society
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• 제29권10호
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• pp.1372-1376
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• 2000

The authors present two cases of lytic skull metastasis from thyroid carcinoma. The first case is a 62-year-old female who was diagnosed as thyroid cancer one year ago. She complained a mass over the right parietal area but showed no neurological abnormalities. The mass didn't invade the dura, and was completely removed. Histopathological examination revealed the insular thyroid carcinoma, composed of undifferenciated cells that were responded to thyroglobulin in immunohistochemical staining. The second case is a 75-year-old female who complained a mass over the right parietal and neck area without any neurological abnormality. The mass was confined to the epidural region which was associated with osteolytic change of skull. It was also completely removed. Histopathological examination of mass revealed the follicular thyroid carcinoma.