http://chineseinput.net/에서 pinyin(병음)방식으로 중국어를 변환할 수 있습니다.
변환된 중국어를 복사하여 사용하시면 됩니다.
Jun Mo Kim,Sukhyung Kang,Steve Sungwon Cho,Peter D. Chang,Jinseo Yang,Jin Pyeong Jeon,Hyuk Jai Choi 대한신경손상학회 2022 Korean Journal of Neurotrauma Vol.18 No.2
Objective: We present how to perform radiofrequency sensory stimulation (RFSS) and whether RFSS could be helpful in identifying symptomatic injured roots in multilevel lumbar stenosis. Methods: Consecutive patients who underwent RFSS from 2010 to 2012 were enrolled. To identify pathologic lesions, RFSS was performed for suspicious roots, as determined using lumbar magnetic resonance imaging (MRI). The RFSS procedure resembled transforaminal root block. During RFSS of the suspicious root, patients could indicate whether stimulation induced their usual pain and/or sensory changes and could indicate whether the same leg area was affected. The number of possible symptomatic roots on MRI was evaluated before and after RFSS. Based on the RFSS results, we confirmed the presence of symptomatic nerve root(s) and performed surgical decompression. Surgical results, such as numeric rating scale (NRS) scores for low back pain (LBP) and leg pain (LP), and Oswestry disability index (ODI), were evaluated. Results: Ten patients were enrolled in the study. Their mean age was 70.1±9.7 years. Clinically, NRS-LBP, NRS-LP, and ODI before surgery were 5.1%, 7.5%, and 53.2%, respectively. The mean number of suspicious roots was 2.6±0.8. After RFSS, the mean number of symptomatic roots was 1.6±1.0. On average, 1.4 lumbar segments were decompressed. The follow-up period was 35.3±12.8 months. At the last follow-up, NRS-LBP, NRS-LP, and ODI were 3.1%, 1.5%, and 35.3%, respectively. There was no recurrence or need for further surgical treatment for lumbar stenosis. Conclusion: RFSS is a potentially helpful diagnostic tool for verifying and localizing symptomatic injured root lesions, particularly in patients with multilevel spinal stenosis.
Emerging Variant Glioma: Glioblastoma with a Primitive Neuro-Ectodermal Tumor(PNET) Component
Han Bo Ram,최혁재,양진서,Kang Sukhyung,Cho Yong Jun,Choi Kyung Chan 대한말초신경학회 2015 The Nerve Vol.1 No.1
A 81-year old male with multiple mass lesion of the right fronto-temporo-parietal lobe and right frontal lobe was admitted to our hospital due to hemiparesis. Neuroimaging studies showed ring-enhancing lesions in right fronto-temporo-parietal lobe and right frontal lobe on magnetic resonance imaging (MRI). Tumor tissue evaluated to be consistent with glioblastoma radiologically was subjected to total excision. Using a morphological and immunophenotypic approach, the predominant component of the tumor was found to bear the properties of classic glioblastoma. The other component was composed of undifferentiated areas that exhibiting small cell morphology and diffuse neuronal immunophenotype. The case was diagnosed as ‘Glioblastoma with primitive neuroectodermal tumor (PNET) component’. The patient who had been performed postoperative radiotherapy, showed shrinkage of non-operative lesion and no sign of recurrence and neurological deficit during 12 months follow-up. We report a rare case of glioblastoma with a PNET component that has a relatively favorable outcome following surgery with radiotherapy and then review previous reports.
Chung Kyungmin,양진서,Cho Yongjun,Kang Sukhyung,최혁재,전진수 대한말초신경학회 2022 The Nerve Vol.8 No.2
Double fascicular nerve transfer (DFNT) involves transferring fascicles from the median and ulnar nerves to the musculocutaneous nerve to restore elbow flexion. We performed this procedure on a patient who was diagnosed with neuralgic amyotrophy (NA) 2 years previously. We aimed to investigate the short-term outcomes and feasibility of DFNT applied to non-traumatic neuropathy. A 63-year-old, right-handed man presented to us with persistent right elbow flexion weakness 24 months after receiving the diagnosis of NA. On examination, biceps strength was 0/5, and shoulder abduction strength was 3/5. Magnetic resonance neurography demonstrated muscle atrophy in the upper trunk. DFNT was considered to restore elbow flexion. The donor and recipient fascicles were then coapted (flexor digitorum superficialis to biceps brachii, flexor carpi ulnaris to brachialis). Postoperatively, paresthesia was reported in the area of ulnar innervation, and the patient complained of hand clumsiness. From postoperative day 10 onward, biceps muscle contracture was identified and on the 14th day, grade 3 elbow flexion strength was observed. We suggest that DFNT may be a safe and effective method to restore elbow flexion in patients with NA.
Junmo Kim,Jinseo Yang,Yongjun Cho,Sukhyung Kang,Hyukjai Choi,Jinpyeong Jeon 대한신경외과학회 2023 Journal of Korean neurosurgical society Vol.66 No.3
Objective : We aimed to analyze the effectiveness of external neurolysis on the common peroneal nerve (CPN) in patients with posture-induced compressive peroneal neuropathy (PICPNe). Further, we aimed to examine the utility of magnetic resonance imaging (MRI) in assessing the severity of denervation status and predicting the postoperative prognosis. Methods : We included 13 patients (eight males and five females) with foot drop who underwent CPN decompression between 2018 and 2020. We designed a grading system for assessing the postoperative functional outcome. Additionally, we performed MRI to evaluate the denervation status of the affected musculature and its effect on postoperative recovery. Results : The median time to surgery was 3 months. The median preoperative ankle dorsiflexion and eversion grades were both 3, while the average functional grade was 1. Posterior crural intermuscular septum was the most common cause of nerve compression, followed by deep tendinous fascia and anterior crural intermuscular septum. There was a significant postoperative improvement in the median postoperative ankle dorsiflexion and eversion grades and average postoperative functional (4, 5, and 2.38, respectively). Preoperative ankle eversion was significantly correlated with denervation status. Additionally, the devernation status on MRI was positively correlated with the outcome favorability. However, denervation atrophy led to a less favorable outcome. Conclusion : Among patients with intractable PICPNe despite conservative management, surgical intervention could clinically improve motor function and functional ability. Additionally, MRI examination of the affected muscle could help diagnose CPNe and assess the postoperative prognosis.
Applicability of Magnetic Resonance Imaging for Early Diagnosis of Common Peroneal Neuropathy
Choi Gwang Yoon,Yang Jinseo,Cho Yongjun,최혁재,전진수,Kang Sukhyung 대한말초신경학회 2021 The Nerve Vol.7 No.2
Objective: This study aimed to assess the clinical applicability of magnetic resonance imaging (MRI) for the early diagnosis of common peroneal neuropathy (CPNe).Methods: Over three years, the authors have treated 58 patients with CPNe. All patients had clinical or neurophysiological confirmation of CPNe. Among them, 35 (60%) patients underwent axial knee MRI with a 1.5-Tesla scanner. These 35 patients were selected for study and were classified into three groups according to the time of examination after the occurrence of dropped foot―acute, subacute, and chronic onset groups. According to muscle appearances (normal, edematous change, and atrophy), we diagnosed them with CPNe, except for those with normal morphology. We evaluated the applicability of MRI in the diagnosis of CPNe compared to that of electromyography (EMG).Results: The 18, 11, and six cases were included in the acute, subacute, and chronic onset groups, respectively. In the acute onset group, three cases had normal muscle appearance, while 15 cases had edematous changes in the affected muscles. In the subacute onset group, eight cases had edematous changes, while three cases showed muscle atrophy. In the chronic onset group, six cases had muscle atrophy. CPNe could be diagnosed using MRI in about 91% (32/35) of all the cases. Excluding the chronologically chronic stage, diagnosis rate was approximately 89%(26/29) of all the cases. However, only in 27 cases (77%) denervation potentials were presented on EMG.Conclusion: According to our results, MRI is a helpful diagnostic modality, especially in the early stage of CPNe, and may lead to proper management.
Yang, Jinseo,Cho, Yongjun,Cho, Jaeho,Choi, Hyukjai,Jeon, Jinpyeong,Kang, Sukhyung The Korean Neurosurgical Society 2018 Journal of Korean neurosurgical society Vol.61 No.4
Objective : In Asians, kneeling and squatting are the postures that are most often induce common peroneal neuropathy. However, we could not identify a compatible compression site of the common peroneal nerve (CPN) during hyper-flexion of knees. To evaluate the course of the CPN at the popliteal area related with compressive neuropathy using magnetic resonance imaging (MRI) scans of healthy Koreans. Methods : 1.5-Tesla knee MRI scans were obtained from enrolled patients and were retrospectively reviewed. The normal populations were divided into two groups according to the anatomical course of the CPN. Type I included subjects with the CPN situated superficial to the lateral gastocnemius muscle (LGCM). Type II included subjects with the CPN between the short head of biceps femoris muscle (SHBFM) and the LGCM. We calculated the thickness of the SHBFM and posterior elongation of this muscle, and the LGCM at the level of femoral condyles. In type II, the length of popliteal tunnel where the CPN passes was measured. Results : The 93 normal subjects were included in this study. The CPN passed through the "popliteal tunnel" formed between the SHBFM and the LGCM in 36 subjects (38.7% type II). The thicknesses of SHBFM and posterior portions of this muscle were statistically significantly increased in type II subjects. The LGCM thickness was comparable in both groups. In 78.8% of the "popliteal tunnel", a length of 21 mm to <40 mm was measured. Conclusion : In Korean population, the course of the CPN through the "popliteal tunnel" was about 40%, which is higher than the Western results. This anatomical characteristic may be helpful for understanding the mechanism of the CPNe by posture.
Choi Gwang Yoon,양진서,Cho Yongjun,최혁재,전진수,Kang Sukhyung 대한말초신경학회 2020 The Nerve Vol.6 No.2
Compressive radial neuropathy, a type of nerve entrapment, can cause pain, extensor weakness, and sensory change. Usually, clinicians draw a distinction between posterior intero-posterior interosseous nerve (PIN) syndrome in which weak extensor function is the main symptom, and radial tunnel syndrome (RTS), which causes pain but not motor weakness. Here, we present a case of a 55-year-old patient who experienced pain and tenderness in his right forearm, followed by extensor weakness, leading to finger and wrist drop. After undergoing surgical intervention, the patient showed improvement in both pain and motor weakness. This report indicates that clinical diagnosis should focus on clinical presentation before distinguishment as PIN syndrome or RTS. We suggest surgical intervention as an effective treatment for entrapment symptoms.