대공부와 상위경추부 종양에 대한 수술적 치료

윤도흠,오성한,조용은,진병호,진동규,김영수,Yoon, Do Heum,Oh, Sung Han,Cho, Young Eun,Jin, Byung Ho,Jin, Dong Kyu,Kim, Young Soo 대한신경외과학회 2001 Journal of Korean neurosurgical society Vol.30 No.4

Objective : The authors reviewed 51 patients of spinal cord tumor located at the craniovertebral junction and high cervical area to determine which factors influenced resectability, complications, and postoperative outcomes. Methods : Radiological examinations, clinical data, and operation notes were evaluated, and additional follow-up information was obtained from outpatient examinations. The mean follow-up period was 3.5 years Results : The most common neurological findings were motor deficit(72.5%) and sensory change(47.1%). There was no clinical finding that is considered as pathognomic. Meningioma(18 cases, 35.3%) was the most common tumor in this region. Total removal was achieved in 45 patients. There was no surgical mortality. Immediate postoperative motor weakness were encounted in 11 cases(21.6%) which improved in long term followup except two patients. Conclusions : The location and relationship of the tumor to surrounding struncture determine its resectability. Postoperative results were related to the preoperative neurological status and pathological findings.

시험관내 배양된 제대혈 모세포에서의 신경항원 발현

하윤,윤도흠,연동수,김현옥,이진주,조용은,최중언,Ha, Yoon,Yoon, Do Heum,Yeon, Dong Su,Kim, Hyun Ok,Lee, Jin Ju,Cho, Yong Eun,Choi, Joong Uhn 대한신경외과학회 2001 Journal of Korean neurosurgical society Vol.30 No.8

Objectives : Cord blood stem cells have been widely used as donor cells for bone marrow transplantation recently. These cells can give rise to a variety of hematopoietic lineages to repopulate the blood. Recent observations reveal that some bone marrow cells and bone marrow stromal cells(MSCs) can grow to become either neurons or glial cells. It is, however, unclear whether or not there exists stems cells which can differentiate into neurons in the blood during the early stages of postnatal life. Methods : Human cord blood stem cells were prepared from human placenta after full term delivery. To induce neuronal differentiation of stem cells, ${\beta}$-mercaptoethanol was treated. To confirm the neuro-glial characteristics of differentiated stem cells, immunocytochemical stain for NeuN, neurofilament, glial fibrillary acidic protein(GFAP), microtubule associated protein2(MAP2) was performed. RT-PCR was performed for detecting nestin mRNA and MAP2 mRNA. Results : We showed in this experiment that neuro-glial markers(NeuN, neurofilament, MAP2, GFAP) were expressed and axon-like cytoplasmic processes are elaborated in the cultured human cord blood stem cells prepared from new born placenta after full term delivery. Nestin mRNA was also detected in fresh cord blood monocytes. Conclusions : These results suggest that human cord blood derived stem cells may be potential sources of neurons in early postnatal life.

척추전방전위증의 업무상질병 인정기준 개선

조준,윤도흠,박용구,Cho, Joon,Yoon, Do Heum,Park, Young Gou 대한신경외과학회 2000 Journal of Korean neurosurgical society Vol.29 No.12

Objective : World Health Organization and International Labour Organization, in June 8, 1999, requested that working conditions should be reformed ethically right and economically solid for 2.7 billion world labour force. The purpose of this study is to request compensable surgical therapeutic options and to suggest the renewal in cognizance criteria for worker's compensation, especially in spondylolisthesis. Methods : Regarding spondylolisthesis, we obtained data from Korea Labor Welfare Corporation(KLWC). Spinal disease occurrence incidences and medical fees of National Federation of Medical Insurance(NFMI) were analysed. The compensated 122 spinal instrumented cases included 117 male and 5 female patients, aged from 23 to 72 years old(mean : $45{\pm}9.85$). We compared Korean and Foreign Workers Compensation Law. Results : Numbers of herniated nucleus pulpus(78 cases), spinal fractures(34 cases) and dislocations(4 cases) were claimed after spinal interbody fusion operation and were compensated. These compensated degenerative diseases, work related illness, occurred in the course of work. A case of 52-year old spondylolisthesis patient with Disability Grade 8 was compensated by KLWC, according to its occurrence at work by accident. With exception of trauma at work by accident, current cognizance criteria were too narrow to be compensable, especially in surgical therapeutic option, for worker's spondylolisthesis. Conclusion : Considering both worker's compensation law and clinical pathologic progress, we believe that spondylolisthesis should be regarded as a compensable occupation related disease if and when aggravates rapidly in the course of work. We suggest a new cognizance standard to KLWC for labour welfare and proper worker's compensation.

상위 경추 수질내의 신경절교종

신준재,오성한,윤도흠,김태승,Shin, Jun Jae,Oh, Sung Han,Yoon, Do Heum,Kim, Tae Seung 대한신경외과학회 2001 Journal of Korean neurosurgical society Vol.30 No.2

Gangliogliomas are benign tumors, composed of neoplastic astrocytes and nerve cells. They are rare, account for 0.4-6.25% of all primary central nervous system neoplasms. Gangliogliomas affect predominantly infants or young adults. Gangliogliomas are preferentially encountered supratentorially, predominantly affecting the temporal lobe. Spinal gangliogliomas affect predominantly the cervical spinal cord. We report a case of cervical ganglioglioma which was successfully removed surgically, with a review of literature.

척수 손상 백서에서 MK801 투여가 체성감각 유발전위 및 척수 조직에 미치는 효과

노성우,김영수,윤도흠,임승철,공경엽,박성혜,이경희,Roh, Sung Woo,Kim, Young Soo,Yoon, Do Heum,Rhim, Seung Chul,Kong, Kyung Yup,Park, Sung Hye,Lee, Kyung Hee 대한신경외과학회 2000 Journal of Korean neurosurgical society Vol.29 No.9

Objectives : This study was undertaken to investigate the effect of noncompetitive NMDA receptor blocker, MK801 on motor recovery, SSEP and pathology in spinal cord injured rat. Methods : The effects of MK801 on neuronal function protection, SSEP, and pathology were measured on spinal cord injury rats which were divided into 6 groups according to dose, time of drug delivery and magnitude of injury. Spinal cord injury was made with the magnitude of 25gm-cm and 50gm-cm on 42 rats. BBB locomotor function test was performed to evaluate the motor power recovery in hindlimb for 2 weeks after injury. After motor function test was completed, SSEP was measured. Amplitude and latency of the P1, N1 peak was measured and compared between groups. Finally rats were sacrificed, and pathologic findings including measurement of area of necrotic cord were studied and compared between groups. Results : Motor recovery at 2 weeks was better in MK801 group comparing to saline control group. SSEP at 2 weeks showed no difference in N1, P1 latencies, but significantly greater amplitude in MK801 group, compared to saline control group. On light microscope, there was no specific histologic differences between experimental groups. The cystic necrotic area in coronal plane was measured and compared in each group. The necrotic area was significantly smaller in MK801 1mg/kg group(delivered after injury) than vehicle group. The necrotic area in MK801 5mg/kg group and MK801 1mg/kg group(delivered before injury) was smaller than vehicle group even though it was not statistically significant. Conclusion : From the above result, it is speculated that NMDA blocker, MK801 can improve impaired neuronal function in spinal cord injury.

불안정성 흉·요추부 골절에 대한 단 분절 척추경 나사못 고정술 및 추체 보강 성형술 - 예 비 보 고 -

김영우,오성한,윤도흠,진동규,조용은,김영수,Kim, Young Woo,Oh, Sung Han,Yoon, Do Heum,Chin, Dong Kyu,Cho, Yong Eun,Kim, Young Soo 대한신경외과학회 2001 Journal of Korean neurosurgical society Vol.30 No.11

Objectives : Since vertebroplasty has been introduced, we performed short segment pedicle screw fixation with augmented intra-operative vertebroplasty in patients with unstable thoraco-lumbar fracture. Our intentions are to demonstrate the efficacy and indication of this new technique compare to conventional methods. Material and Methods : The surgery comprised of pedicle screw fixations on one level above and below the fracture site, and the fractured level itself, if pedicle is intact, and intra-operative vertebroplasty under the fluoroscopic guide with in-situ postero-lateral bone graft. Also, in cases of bone apposition, we removed those with small impactor through a transfascetal route. During the last 2 years, we performed in seven(7) unstable thoraco-lumbar fracture patients who consisted of two different characteristics, those four(4) with primary or secondary osteoporosis and three(3) of young and very healthy. All patients were followed clinically by A.S.I.A. score and radiography. Results : Mean follow up period was 14 months. We observed well decompressed state via transfascetal route in cases of bone fragments apposition and no hardware pullout in osteoporotic cases, no poly-methyl-methacrylate (PMMA) leakage through the fracture sites into the spinal canal, and no kyphotic deformities in both cases during follow-up periods. All patients demonstrated solid bony fusion except one following osteoporotic compression fracture on other sites. Conclusions : In the management of unstable thoraco-lumbar fracture, we believe that this short segment pedicle screw fixation with augmented intra-operative vertebroplasty reduce the total length or levels of pedicle screw fixation without post-operative kyphotic deformity.

본태성 다한증 환자의 수술 후 발생하는 보상성 다한증

서의교,조용은,윤도흠,김영수,Seo, Eui Kyo,Cho, Yong Eun,Yoon, Do Heum,Kim, Young Soo 대한신경외과학회 2001 Journal of Korean neurosurgical society Vol.30 No.4

Objective : Essential hyperhidrosis is a pathological condition of excessive sweating beyond that required to cool the body, though poorly understood, originating from a dysfunction of the sympathetic nervous system. Thoracoscopic sympathectomy is the most popular treatment for upper limb hyperhidrosis, because it is a safe, effective, minimally invasive, and time-saving method. However, the common complication is the compensatory hyperhidrosis in other areas of the body, notably on the back, chest, abdomen, and buttocks. Compensatory hyperhidrosis is severe enough for some people, especially those living in a warm climate or engaging in heavy physical activities, to regret ever having had operation. The pathophysiological mechanisms underlying compensatory hyperhidrosis are incompletely understood, even though it is thought to be a truly compensatory feature related to thermoregulation of the body. Materials and Methods : we studied the clinical features of total 233 patients who were diagnosed as essential hyperhidrosis and treated with thoracoscopic sympathectomy or sympathicotomy from March 1992 to July 2000. Results : The success rate of thoracoscopic sympathetic surgery(sympathectomy or sympathicotomy) was 98.7%. The global rate of compensatory hyperhidrosis was 77% ; 84% in group T2, 3 sympathectomy, 76% in group T2 sympathectomy, 43% in group T2, 3 sympathicotomy and 59% in group T2 sympathicotomy. The rate of embarrassing or disabling compensatory sweating was significantly higher in T2 sympathectomy and in T2, 3 sympathectomy than in T2 sympathicotomy and T2, 3 sympathicotomy with significancy in statistic analysis(p<0.01). The precipitating factors of compensatory hiperhidrosis, including heat(warm weather), anxiety, stress, and exertion were noted. The compensatory hyperhidrosis was the main cause of patient dissatisfaction after thoracoscopic sympathectomy. Conclusion : The degree of compensatory hyperhidrosis is closely related to the extent of thoracic sympathectomy.

외상이 경추 후종인대 골화증 환자의 수술결과에 미치는 영향

진동규,진병호,조용은,윤도흠,김영수,Chin, Dong-Kyu,Jin, Byung-Ho,Cho, Yong-Eun,Yoon, Do-Heum,Kim, Young-Soo 대한신경외과학회 2000 Journal of Korean neurosurgical society Vol.29 No.7

Objectives : Most cases of cervical ossification of the posterior longitudinal ligament(OPLL) present with myelopathy or myeloradiculopathy, which sometimes is further complicated by minor trauma to the spinal cord. The main purpose of surgery in these patients is the alleviation symptoms but also as protection against further deterioration. The purpose of this study is to analyze the influence of trauma on the surgical outcome in patients with cervical OPLL. Methods : Over the past 13 years, we have operated on 123 patients with myelopathy associated with cevical OPLL. Among these, thirty patients had cervical cord injury associated with major or minor trauma and their clinical and radiographic data were reviewed retrosepctively. Results : As to cause of trauma, seventeen were related with traffic accident and 13 were related with minor slipping injury. The pre- and post-operative motor power were significantly weaker in the patients with trauma, but the degree of motor improvement was significantly higher(trauma group : $0.90{\pm}1.49$, non-trauma group : $0.41{\pm}0.80$). Conclusion : These results indicate that even indirect minor trauma to the cervical spine can cause irreversible changes to the spinal cord if this is associated with underlying cervical stenosis with OPLL. Although less favorable results may be anticipated in patients with trauma, operative decompression could improve motor power and protect further deterioration.

안면부와 두부에 국한된 편측성 다한증 1례

임하성 ( Ha Seong Lim ),황성원 ( Sung Won Whang ),윤도흠 ( Do Heum Yoon ),이민걸 ( Min Geol Lee ) 대한피부과학회 2001 대한피부과학회지 Vol.39 No.9

Unilateral localized hyperhidrosis over scalp and face is an extremely rare disease that usually has undetermined origin. We report a case of idiopathic unilateral localized hyperhidrosis over left scalp and face. A 55-year-old female patient with unilateral hyperhidrosis that is localized in the left side of scalp and face visited our dermatology clinic. She had increased sweating in left face and scalp, securring in summer for 3 years. She complained of the exacerbation by thermal and gustatory stimuli and exercise. The starch iodine test and digital infrared thermal imaging test revealed a marked increase in sweat gland activity on the affected areas as compared to the contralateral normal sites.

골수유래 간엽줄기세포의 조건배지가 Ntera-2 인간신경세포의 신경돌기 성장에 미치는 영향

오진수 ( Jin Soo Oh ),( Meng Lu Liu ),( Hong Lian Jin ),안성수 ( Sung Su An ),김긍년 ( Keung Nyun Kim ),윤도흠 ( Do Heum Yoon ),하윤 ( Yoon Ha ) 한국조직공학·재생의학회 2009 조직공학과 재생의학 Vol.6 No.4

Bone marrow derived mesenchymal stem cell(BMSC) based cell therapy can promote functional recovery and regeneration in central nervous system(CNS) disease models. These beneficial effects have been primarily attributed to the differentiation potential into varieties of cell lineages and the therapeutic paracrine factors secreted by BMSC after transplantation. Many secreted factors from BMSC have been identified recently in the conditioned media. However, the effects of these factors on the neuronal regeneration need further verification with relevant neuronal models. Ntera-2 neurons have been used for the therapy of several different CNS diseases in animal models. Recently some clinical trials have confirmed the safety and potential efficacy of Ntera-2 neurons for stroke therapy. In this study, the Ntera-2 neuron model was used to directly verify the effect of BMSC conditioned media(BMSCCM) on neurite outgrowth in vitro. Our study confirmed that the BMSC-CM could increase both the neurite length and branch number of Ntera-2 neurons, compared to the control group with non-conditioning media. Since the BMSC can secret many therapeutic factors into the conditioned media, our data support the theory that BMSC promote neurite outgrowth through secreting paracrine factors.