스포츠 두부 손상

윤영설,진동규,김긍년,장진우,김영수 대한스포츠의학회 1999 대한스포츠의학회지 Vol.17 No.1

Head injury is the most frequent direct cause of death in sports. Furthermore, injury to the head takes an singular importance when we realise the brain is neither capable of regeneration nor, unlike many other body parts and organs, of transplantaion. Every effort must be made to protect the athlete's head as injury can lead to dementia, epilepsy, paralysis and death. There are three distinct types of stress that can be generated by an acceleration force to the head : compressive, tensile and shearing forces. The differential diagnosis with a head injury includes cerebral concussion, intracranial hemorrhage, postconcussion syndrome, second impact syndrome, malignant brain edema. 90 to 95% of all head injuries are cerebral concussions and more than 90% all cerebral concussions fall into mild categories. With a head injury the ABCs of first aid must be followed and then a neurological examination will be followed. In the case of the intracranial hematoma. definite surgical evacuation is indicated and in cases of the closed head injuries and most severe degree of concussion. observation is appropriate, with careful neurological monitoring. Over the last 20 years there has been a dramatic decrease in the most serious head injuries due to multiple factors. There are five areas that can affect a reduction in head injuries. The first two involve rules and coaching technique changes. The other three areas involve improvements in conditioning (especially of the neck), equipment, and finally medical supervision. The reduction in incidence and severity of athletic head injury gas been the results of changes and improvements instituted following constant study and research. And also, for the reduction in incidence of athletic head injury every effort or team physician, athletic trainer, physical trainer and team coaches should be necessary.

Effect of primate bone marrow stromal cells on survival and neurite outgrowth

Kim, Keung Nyun,Guest, James D.,Oh, Jin Soo,Pennant, William A.,Yoon, Do Heum,Ha, Yoon Lippincott Williams Wilkins, Inc. 2010 NEUROREPORT - Vol.21 No.13

We tested whether bone marrow stromal cells (BMSCs) could enhance the survival and neurite growth of dorsal root ganglia (DRG) through substrate effects or secreted factors. Our results showed that in DRG with BMSCs and BMSC-conditioned media cultures compared with DRG-fibroblast cultures, there was a significant increase in the number and length of, area covered by, and number of cells with definite neurites. In cytokine assays with conditioned media, vascular endothelial growth factor, granulocyte macrophage colony-stimulating factor, and IL-6 secreted by BMSCs may contribute to observed neurotrophic effects. These findings indicate that BMSCs of adult Macaca fascicularis increased neuronal survival and promoted neurite outgrowth of DRG by means of secretory factors.

Long-term surgical outcomes of cervical myelopathy with athetoid cerebral palsy.

Kim, Keung Nyun,Ahn, Poong Gee,Ryu, Mi Jung,Shin, Dong Ah,Yi, Seong,Yoon, Do Heum,Ha, Yoon Springer-Verlag 2014 European spine journal Vol.23 No.7

<P>To understand the long-term surgical outcomes and prognostic factors for the operative treatment of cervical myelopathy (CM) in patients with athetoid cerebral palsy (ACP).</P>

Total Spondylectomy for Giant Cell Tumor of Cervical Spine

황교준,Keung-Nyun Kim,Do-Heum Yoon,Woo-Ik Yang 대한신경외과학회 2003 Journal of Korean neurosurgical society Vol.34 No.3

Giant cell tumor which is arisen at vertebra is rare and this tumor of the cervical vertebra has been very rarely reported tumor which is less than 1% of all giant cell tumor. When the treatment option is considered, the curretage is often selected rather than total resection because the anatomic relationship of adjacent structures is complicated and there are major vessels and organs around the cervical vertebra. The prognosis of this tumor is decided by degree of resection so, total sponylectomy should be considered as primary surgical option. We report a case of cervical giant cell tumor in which the total spondylectomy was performed successfully and discuss the feasibility of this procedure at cervical region. Key words:Giant cell tumor;Cervical spine;Total spondylectomy.

뇌동맥류와 고혈압의 관계에 대한 임상적 연구

김긍년,주진양,이규창 대한신경외과학회 1993 Journal of Korean neurosurgical society Vol.22 No.9

To investigate relationship between intracranial aneurysm and systemic hypertension, 199 consecutive cases of intracranial aneurysm which were treated surgically were analized in regard to the incidence of hypertension and to the effect of hypertension on their outcome. The incidence of hypertension in cases with aneurysm was higher than in general population. Multiple aneurysm patients had significantly higher incidence of hypertension than single aneurysm paients did. The amount of subarachnoid clot on postictal CT scan and neurological status on admission were not statistically different between hypertensive and normotensive group. Frequency of rebleeding was significantly higher in hypertensive group than in normotensive group. The incidence of cerebral vasospasm or hydrocephalus was statistically not significant between hypertensive group and normotensive group. The clinical outcome was similar between two groups.

뇌실질내 발생한 표피양 낭종 1예 : Case Report

김긍년,최중언,윤수한,김태승 대한신경외과학회 1994 Journal of Korean neurosurgical society Vol.23 No.5

Intraparenchymal epidermoid cyst is extremely rare. The authors treated a case of intraparenchymal, temporal lobe epidermoid cyst in 21-year old male who had presented with a generalized seizure attack and headache without any neurological deficits The diagnosis was based on the characteristics of CT Scan and MR imaging. The cyst was totally removed via transtemporal approach. Postoperative course was uneventful . The authors report this rare case with a review of the literature.

Delayed Bilateral C5 Palsy following Circumferential Decompression and Fusion in Patient with Cervical Spondylotic Myelopathy

Hyeongseok Jeon,Keung Nyun Kim 대한척추신경외과학회 2015 Neurospine Vol.12 No.3

C5 palsy is a common complication after cervical decompressive surgery, which have 0 to 30% complication rate. A 61-year-old female patient with cervical spondylotic myelopathy showed bilateral C5 palsy following circumferential decompression and fusion. Unexpectedly, bilateral C5 palsy was noted in different time points on postoperative day 2 and 8, respectively. Steroid injection and physical therapy were performed, and her motor function is recovering. Surgeons should make an effort to prevent possible C5 palsy when performing cervical decompression surgery.

Total Body Replacement with an Expandable Cage after en Bloc Lumbar Spondylectomy

Shin, Dong-Ah,Kim, Keung-Nyun,Shin, Hyun-Chul,Yoon, Do-Heum The Korean Neurosurgical Society 2006 Journal of Korean neurosurgical society Vol.40 No.6

Complete vertebral tumor resection is important in order to prevent local recurrence. Among the available techniques for total spondylectomy, the total en bloc spondylectomy has been accepted as the most sophisticated one. After a total en bloc spondylectomy, anterior and posterior column reconstruction is mandatory in order to achieve stability. We experienced the usefulness of an expandable cage for anterior column reconstruction especially in this surgery. The chance of cutting the nerve root and damaging the spinal cord is minimized because the size of the expandable cage is initially small enough to be inserted into the anterior column. The technical details of total vertebral body replacement with an expandable cage after an en bloc lumbar spondylectomy are described herein.

Surgical Outcomes after Traumatic Vertebral Fractures in Patients with Ankylosing Spondylitis

An, Seong-Bae,Kim, Keung-Nyun,Chin, Dong-Kyu,Kim, Keun-Su,Cho, Yong-Eun,Kuh, Sung-Uk The Korean Neurosurgical Society 2014 Journal of Korean neurosurgical society Vol.56 No.2

Objective : Ankylosing spondylitis is an inflammatory rheumatic disease mainly affecting the axial skeleton. The rigid spine may secondarily develop osteoporosis, further increasing the risk of spinal fracture. In this study, we reviewed fractures in patients with ankylosing spondylitis that had been clinically diagnosed to better define the mechanism of injury, associated neurological deficit, predisposing factors, and management strategies. Methods : Between January 2003 and December 2013, 12 patients with 13 fractures with neurological complications were treated. Neuroimaging evaluation was obtained in all patients by using plain radiography, CT scan, and MR imaging. The ASIA Impairment Scale was used in order to evaluate the neurologic status of the patients. Management was based on the presence or absence of spinal instability. Results : A total of 9 cervical and 4 thoracolumbar fractures were identified in a review of patients in whom ankylosing spondylitis had been diagnosed. Of these, 7 fractures were associated with a hyperextension mechanism. 10 cases resulted in a fracture by minor trauma. Posttraumatic neurological deficits were demonstrated in 11 cases and neurological improvement after surgery was observed in 5 of these cases. Conclusions : Patients with ankylosing spondylitis are highly susceptible to spinal fracture and spinal cord injury even after only mild trauma. Initial CT or MR imaging of the whole spine is recommended even if the patient's symptoms are mild. The patient should also have early surgical stabilization to correct spinal deformity and avoid worsening of the patient's neurological status.

Spinal Tanycytic Ependymoma in Four Korean Patients: Case Series

Choi Jae Yon,Kim Keung Nyun,Dong Ah Shin,Yoon Ha,Do Heum Yoon,Seong Yi 대한말초신경학회 2018 The Nerve Vol.4 No.2

Tanycytic ependymoma (TE) is a rare variant of ependymoma usually arising in the intramedullary spine found usually on cervical and mid-thoracic level. Herein, we report our experience of treating rare cases of TE. Four patients were studied by retrospective analysis. A pathologist analyzed immunohistochemical results for diagnosis, and postoperative neurologic examination and magnetic resonance imaging (MRI) were followed up. In preoperative MRI study, the tumors were enhanced on T1-weighted imaging which showed well defined lesion. We thought that our patient’s tumors were schwannoma. However, spindle cell and immunohistochemical staining of the permanent section revealed strong immunoreactivity for glial fibrillary acidic protein, confirming that tumors were TE. Postoperative neurological symptoms are almost absent. The long-term clinical symptoms for TEs is the same or slightly better than that for other ependymoma subtypes. Diagnosis of TE is challenging as the morphology of the lesions resemble those found in schwannoma and astrocytomas. Differential diagnosis is extremely important for management and prognosis and differentiation of TEs from astrocytomas and schwannomas, although a correct histological diagnosis may be difficult. However, Immunohistochemical staining may be helpful in differential diagnosis.