• Journal of Korean Neurosurgical Society
• /
• 제37권4호
• /
• pp.275-281
• /
• 2005

Objective: The prolactinoma is the most common pituitary tumor and sometimes shows severe invasiveness to the adjacent cavernous sinus, especially in the male patient. The dopamine agonist can be used as an alternative treatment modality to surgery. But, the transsphenoidal or transcranial approach for tumor removal has been more preferred treatment option of neurosurgeons in invasive prolactinoma. Especially rapid decompression of mass effect and resolution of the neurologic deficit is demanded. The prospective study is done in order to identify the therapeutic efficacy of bromocriptine as an initial treatment option for the invasive prolactionomas. Methods: Twenty patients with invasive prolactinoma were studied. Preoperative neurological and endocrinological evaluations were done, and size and invasiveness of the tumor was estimated on MRI. Bromocriptine was administrated by increasing dose planning reaching maximum dose at 1 month of treatment, with close neurological and endocrinological monitoring. At 3months after treatment, MRI was taken and decision was made whether to continue bromocriptine or to have surgical intervention. Results: Thirteen patients showed excellent result with only bromocriptine treatment. These patients showed not only marked reduction of tumor volume and prolactin level, but also, improving clinical symptoms and other hormonal deficits. 13patients who had visual field defect and decreased visual acuity had all improved visual symptoms. But, the remaining 4patients required surgical treatment due to insufficient reduction of tumor size inspite of normalized prolactin level within 3months. Remaining 2patients had $20{\sim}30%$ of tumor size reduction, but prolactin level was not normalized. One patient required radiation therapy. Conclusion: Bromociptine can be used as initial treatment for the invasive prolactinomas with careful monitoring of the neurological and endocrinological status. It should be carefully followed up for tumor size reduction within 3 months after initiation of treatment.

• Journal of Korean Neurosurgical Society
• /
• 제38권6호
• /
• pp.413-418
• /
• 2005

Objective : Although an encephaloduroarteriosynangiosis procedure using the superficial temporal artery [STA-EDAS] is an effective indirect bypass method in children with moyamoya disease[MMD], there is still a need for an additional bypass operation that can cover the area of the posterior circulation. The goal of this study is to evaluate the efficacy of the EDAS procedure using the occipital arteries [OA-EDAS]. Methods : From August 2003 to April 2004, We performed OA-EDAS in sixteen patients with MMD who have a circulatory insufficiency in the territory of the posterior cerebral artery[PCA]. The medical records were reviewed retrospectively. The surgical outcomes, including the changes in neurological status and imaging studies, with the degree of neovascularization on the cerebral angiogram, and the hemodynamic changes on single-photon emission computed tomography[SPECT], were analyzed. Results : These 16 children consisted of 5 boys and 11 girls aged 2 to 9 years. The clinical outcome of their PCA symptoms, such as visual transient ischemic attacks[TIAs] or visual field defect, was favorable in 14 patients of 16. Nine patients of 11 who underwent follow up magnetic resonance imaging[MRI] showed favorable MRI changes. On angiogram most of the patients exhibited good or fair revascularization of the PCA territory [7 of 8]. The hemodynamic changes on SPECT in the PCA territory after surgery showed improved vascular reserve in 13 of the 16 territories. Conclusion : OA-EDAS is a safe and efficacious revascularization procedure in patients with MMD who have compromised cerebral perfusion in PCA territory, or with visual TIAs.

• Investigative Magnetic Resonance Imaging
• /
• 제3권2호
• /
• pp.173-178
• /
• 1999

목적 : 후두엽의 허혈성 경색환자에서 시각피질의 기능적 자기공명영상의 유용성을 알아보고자 하였다. 대상 및 방법 : 후대뇌동맥의 시각파절 부위에 대한 혈류공급 장애로 인하여 시각피질의 허혈 또는 경색 증후를 보이는 환자 4명을 대상으로 하였다. 모든 환자는 안과적 시야검사를 받았으며 자기공명 혈관조영술(n=4)과 디지털 감산 혈관조영술(n=2)을 시행하여 혈관이상을 확인하였다. 기능적 자기공명영상은 2D-FLASH 기법(TRITE = 90/56 msec, TA = 8.32 see, $FOV{\;}={\;}240{\times}240,{\;}matrix{\;}No.={\;}64{\times}128$, slice thickness = 8mm)을 이용하였으며 초당 8 회로 점멸하는 적색 광자극원을 이용하여 5회의 광자극기간과 5회의 휴식기간을 번갈아 8차례, 총 40회의 검사를 시행하였다. 기능적 자기공명영상 소견을 안과적 시야검사 결과, 고식적 자기 공명영상 결과, 혈관조영술 결과와 비교 분석하였다. 결과 : 기능적 자기공명영상에서는 모든 환자가 혈관조영술에서 혈관이상을 보인쪽의 시각피질의 활성화가 이루어지지 않는 소견을 보였다. 그러나 이중에 2 환자는 고식적 자기공명영상이 정상이었다. 시야결손이 3 환자에서 관찰되었는데 이중 한 환자는 고식적 자기공명영상과 확산 자기공명영상에셔 정상소견이었지만 기능적 자기공명영상에서는 시야결손이 있는 쪽의 시각피 질의 촬성화가 이루어지지 않는 소견을 보였다. 결론 : 시각피질의 기능적 자기공명영상은 안과적 시야검사, T2강조영상 또는 확산강조명영상에서 발견되지 않는 시각피질의 허혈 또는 혈류잠재능 감소 상태를 감지할 수 있는 민감한 검사 방법이라고 생각된다.효율적이고 강력한 QA 도구로 자리 잡을 수 있을 것으로 기대된다.지하였으며 폐사율은 각각 1.9%, 1.9%, 2.9%와 1.0%로써 대조군의 4.8%에 비하여 낮은 수준을 보여 질병에 대한 저항능력이 향상되었다.kg/h로 분석되었다. 6. 건조작업 중에 소요되는 전력은 9.5~19.3 Wh/kg이었으며, 연료효율 6.9~9.3kg-$H_2$O/L와 열효율 50.2~65.1%에 의한 수분증발량은 124.0~125.4 kg-$H_2$O/h 로 나타났다. 7. 건조기의 열효율을 70%를 기준으로 평가한다면, 시작기의 열효율은 조금 낮은 수준이며, 열관리 계통의 개선을 필요로 하였다. 8. 제작된 계분건조기의 시작기를 15,000수 규모의 양계농장에서 사용한다면 관행의 계분처리 방법에 비하여 약 590,700(원/월)의 비용을 절감할 수 있을 것으로 추정되었다}0.09\;ml/1.5\;hr)$. 이상(以上)의 결과(結果)는 ethanol의 혈중농도(血中濃度)가 높을수록 더 심(甚)한 혈압강하작용(血壓降下作用)을 나타내며, ethanol 로 인(因)한 이뇨작용(利尿作用)도 ethanol 량(量)이 증가(增加)함에 따라 뇨량(尿量)도 증가(增加)함을 보여 주었다.ults showed that the overall quality of Sullungtang significantly decreased as the parity increased for Hanwoo cows. The Sullungtang extracted from bones of heifer had the best sensory scores as well as nutritional quality when compared

• Pediatric Gastroenterology, Hepatology & Nutrition
• /
• 제3권2호
• /
• pp.169-174
• /
• 2000

목 적: 만성 C형 간염 환자에서 인터페론 치료후 녹내장이 발생하였다는 보고가 전세계적으로 1례 있어왔다. 최근 저자들도 15세된 만성 B형 간염 환자에게 인터페론 투여 후 녹내장이 생긴 예를 경험한 바 있어 만성 B형 간염 환자에서 인터페론 치료와 녹내장 발생과의 연관성을 알아보고자 본 연구를 전향적으로 시행하였다. 방 법: 1998년 2월부터 1999년 7월까지 인하대학교 병원에서 만성 B형 간염으로 진단 받고 인터페론 알파를 투여받은 9명의 환아(남아 4명, 여아 5명)을 대상으로 전향적으로 연구하였다. 인터페론 투여 전, 투여 3개월 후, 6개월 후 안과적 검사를 통하여 시력검사, 안압, C/D비, 시야검사를 측정 비교하였다. 결 과: 1) 대상환아들의 평균 연령은 $11.7{\pm}4.1$세, 투여기간은 6개월이었고 평균 투여량은 5백만 단위였다. 2) 각 환아들의 인터페론 투여 전 시력, 안압, C/D비를 투여 3개월 후, 6개월 후에 비교하였을 때 유의한 변화는 없었다. 3) 시야검사에서는 시야결손은 한 명도 발생하지 않았다. 결 론: 만성 B형 간염 환아에게서 인터페론 치료 후 녹내장이 발생하여, 이후 9명의 만성 B형 간염 환아를 대상으로 인터페론 치료 후 안압증가 여부 등을 전향적으로 조사하였지만 유의한 차이는 없었다. 하지만 인터페론 투여 후 녹내장 및 안과질환 발생 가능성에 대해 지속적인 관심이 필요할 것으로 보인다.

• 대한안과학회지
• /
• 제59권11호
• /
• pp.1091-1096
• /
• 2018

목적: 양안 급성 폐쇄각녹내장 후 발생한 양안 비동맥염 앞허혈시신경병증 1예를 보고하고자 한다. 증례요약: 76세 여자 환자가 하루 전 시작된 양안 통증 및 시력저하로 방문하였다. 양안 시력 0.02, 안압은 우안 52 mmHg, 좌안 50 mmHg, 양안 각막부종과 얕은 전방이 관찰되었으며, 동공은 4 mm로 고정되어 있었다. 만니톨 주사로 안압하강 시킨 후 양안 레이저홍채절개술을 시행하였다. 그러나 2일 후 시력은 우안 안전수지 10 cm, 좌안 안전수지 50 cm로 더 감소되었고 양안 시신경 유두부종이 관찰되었다. 양안 급성 폐쇄각녹내장 후 발생한 비동맥염 앞허혈시신경병증으로 진단하고 경과관찰하였다. 한 달 뒤, 시력은 우안 0.02, 좌안 0.04로 약간 호전되었고, 양안 시신경 유두부종은 사라졌다. 매우 작은 유두함몰비와 시신경 창백과 위축이 관찰되었으며, 표준자동시야검사상 우안은 완전시야결손, 좌안에 상하 수평시야결손이 관찰되었다. 결론: 급성 폐쇄각녹내장이 비동맥염 앞허혈시신경병증의 선행 위험인자가 될 수 있으며, 구심동공운동장애와 유두부종, 다른 위험인자의 동반이 있는 경우 비동맥염 앞허혈시신경병증의 동반 가능성을 고려해야 한다.

• 대한한의학회지
• /
• 제23권3호
• /
• pp.119-133
• /
• 2002

Objectives : This study was designed to investigate significant differences between the first attack and reattack groups to form fundamental data for decreasing recurrence and secondary prevention of stroke. Methods : I studied 204 patients admitted within 7 days of onset, after the diagnosis of stroke, in the Oriental Medical Hospital of Dongeui University from February to July in 2001.compared the reattack group with the first attack group for risk factors, clinical symptoms and progress, average mark and degree of improvement in Activity Index. Results : 1. Meaningful risk factors associated with the reattack group were male sex, a past history of hypertension and transient ischemic attack, and a family history of stroke. 2. The reattack group had conscious or cognitive disorder in early stage of onset, dysphagia, constipation, urinary incontinence, visual field defect in acute stage, high blood pressure and tachycardia in abnormalvital sign in acute stage, neuropsychosis, shoulder pain and rigidity, and pneumonia in complications more than the first attack group. 3. In Activity Index, the average mark of reattack group was lower than that of the first stroke group and improvement of the reattack group was delayed compared with the first attack group. Conclusions : The reattack group had more severe symptoms and clinical progress than the first attack group.

• Journal of Korean Neurosurgical Society
• /
• 제30권8호
• /
• pp.1033-1036
• /
• 2001

With improvements in diagnostic imaging techniques for the brain, pituitary tumors without neurological signs or symptoms have occasionally been found. To evaluate therapeutic strategy for incidentally found pituitary tumors ("pituitary incidentaloma"), we analyzed the result of magnetic resonance imaging findings and of ophthalmological and endocrinological studies in 3 cases with follow up. Incidentally found functioning tumors were excluded. All of 3 cases is greater than 10mm in tumor size("pituitary macroincidentaloma"). The follow-up period was 49 months, 16 months and 6 months(mean, 25.3 months) in each case. There was no evidence of tumor enlargement, endocrinological problems and visual field defect during follow-up period. Patients with pituitary incidentalomas usually follow a benign course and neurosurgical intervention is not initially required in the management even those greater than 10mm in diameter. Observation over time may be good approach to the patient with a pituitary macroincidentaloma to avoid the unnecessary risk for surgery in a patients with a stable mass.

• Journal of Korean Neurosurgical Society
• /
• 제51권3호
• /
• pp.141-143
• /
• 2012

The authors describe a case of choriocarcinoma that metastasized to the cerebral cortex, vertebral body, and intramedullary spinal cord. A 21-year-old woman presented with sudden headache, vomiting and a visual field defect. Brain computed tomography and magnetic resonance examinations revealed an intracranial hemorrhage in the left temporo-parietal lobe and two enhancing nodules in the left temporal and right frontal lobe. After several days, the size of the hemorrhage increased, and a new hemorrhage was identified in the right frontal lobe. The hematoma and enhancing mass in the left temporo-parietal lobe were surgically removed. Choriocarcinoma was diagnosed after histological examination. At 6 days after the operation, her consciousness had worsened and she was in a state of stupor. The size of the hematoma in the right frontal lobe was enlarged. We performed an emergency operation to remove the hematoma and enhancing mass. Her mental status recovered slowly. Two months thereafter, she complained of paraplegia with sensory loss below the nipples. Whole spine magnetic resonance imaging revealed a well-enhancing mass in the thoracic intramedullary spinal cord and L2 vertebral body. Despite chemotherapy and radiotherapy, the patient died 13 months after the diagnosis.

• 센서학회지
• /
• 제28권6호
• /
• pp.371-376
• /
• 2019

We have developed an acoustic resonance inspection system to inspect the welding defects in the mechanical parts fabricated using friction stir welding method. The inspection system was consisted of a DAQ board, a microphone sensor, an impact hammer, and controlled by a PC software. The system was developed to collect and analyze the sound signal generated by hitting the sample with an impact hammer to determine whether it is defective. In this study, 100% welded good samples were compared with 95%, 90%, and 85% welded samples, respectively. The variation of the completeness in welding did not affect the visual appearance in the samples. As a result of analyzing the natural frequencies of the good samples, the five natural frequency peaks were identified. In the case of the defective samples, the frequency change was observed. The welding failure detection time was fast enough to be only 0.7 seconds. Employing our welding defect inspection system to the actual industrial field will maximize the efficiency of quality inspection and thus improve the productivity.

• 대한한의학회지
• /
• 제23권4호
• /
• pp.73-90
• /
• 2002

Objectives: This study investigated significant factors that influence functional evaluation of stroke so as to be a fundamental data for estimating prognosis of stroke patients. Methods: 204 patients were studied within 7 days of admission, after the diagnosis of stroke through brain CT scan, brain MRI scan and clinical observations. They were hospitalized in the oriental medical hospital of Dongeui University from February to July in 2001. They were examined at the early stage of onset, after 2 weeks, 4 weeks and 6 weeks, and measured for average mark and the degree of improvement by using the Activity Index. Results: Ischemic stroke, past history of stroke, hypertension, diabetes mellitus, risk factor of obesity, non-professional emergency treatment and hospitalizing time after 1 day from onset, high blood pressure, tachycardia pulse and high blood sugar in abnormal vital sign in acute stage, conscious, cognitive or communication disorder, motor aphasia, dysphagia, constipation for more than 3 days, urinary incontinence, visual field defect, insomnia, and chest discomfort in early stage of onset had a negative influence on functional evaluation. Conclusions: Type of stroke, past history, risk factors, emergency treatment and hospitalizing time after onset, abnormal vital sign and intercurrent symptoms in Acute stage were relevant factors in predicting functional evaluation of stroke.