Revision Surgery for a Failed Artificial Disc

구성욱,진동규,김근수,조용은,신동아,김긍년,구성욱 연세대학교의과대학 2021 Yonsei medical journal Vol.62 No.3

Purpose: This study aimed to present our experience with failures in C-TDR and revision surgery outcomes. Materials and Methods: We retrospectively examined patients who underwent revision surgery due to the failure of C-TDR between May 2005 to March 2019. Thirteen patients (8 males and 5 females) were included in this study. The mean age was 46.1 years (range: 22–61 years), and the average follow-up period was 19.5 months (range: 12–64 months). The outcome measures of pre- and post-operative neck and arm pain using a visual analogue scale (VAS) and functional impairment were assessed using a modified Japanese Orthopedic Association (JOA) scale and the Neck Disability Index (NDI). Results: The main complaints of patients were posterior neck pain (77%), radiculopathy (62%), and/or myelopathy (62%). The causes of failure of C-TDR were improper indications for the procedure, osteolysis and mobile implant use, inappropriate techniques, and postoperative infection. The most common surgical level was C5–6, followed by C4–5. After revision surgery, the neck and arm pain VAS (preoperative vs. postoperative: 5.46 vs. 1.31; 4.86 vs. 1.08), a modified JOA scale (14.46 vs. 16.69), and the NDI (29.77 vs. 9.31) scores were much improved. Conclusion: C-TDR is good surgical option. However, it is very important to adhere to strict surgical indications and contraindications to avoid failure of C-TDR. The results of reoperations were good regardless of the approach. Therefore, various reoperation options could be considered in patients with failed C-TDR.

A Novel Blasted and Grooved Low Profile Pedicle Screw Able to Resist High Compression Bending Loads

구성욱,김영성,최홍준,김경현,박정윤,정현용,진동규,김근수,윤영설,이윤철,조용은 대한척추신경외과학회 2012 Neurospine Vol.9 No.2

Objective: Objective: Polyaxial pedicle screws are a safe, useful adjunct to transpedicular fixation. However, the large screw head size can cause soft tissue irritation, high rod positioning, and facet joint injury. However, the mechanical resistance provided by small and low profile pedicle screws is very limited. We therefore developed a novel, low profile pedicle screw using grooving and blasting treatment that is able to resist a high compression bending load. Methods: We evaluated the compression bending force to displacement and yield loads for seven different screw head types that differed with regard to their groove intervals and whether or not they had been blasted. Results: The rank order of screw types that had the greatest compression bending force to displacement was as follows:(1) universal polyaxial, (2) low polyaxial with 0.1mm grooves and blasting, (3) low polyaxial with blasting, (4) low polyaxial with 0.15mm grooves and blasting, (5) low polyaxial with 0.05mm grooves and blasting, (6) low polyaxial with 0.05mm grooves, (7) and low polyaxial. Low polyaxial screws with 0.1mm grooves and blasting had the maximum yield load and highest compression bending force to displacement of all seven polyaxial screw head systems evaluated. Conclusion: Blasting and grooving treatment of pedicle screw heads resulted in screw heads with a high yield load and compression bending force relative to displacement because of increased friction. Low polyaxial pedicle screws with 0.1mm grooves treated by blasting have mechanical characteristics similar to those of universal polyaxial pedicle screws.

Changes in Bone Metabolism in Young Castrated Male Rats

구성욱,류성준,류달성,김종열,박정윤,김경현,진동규,김근수,조용은 연세대학교의과대학 2016 Yonsei medical journal Vol.57 No.6

Purpose: To determine the window of time during which osteoporosis affects the management of spinal surgery and the mechanismof bone metabolism changes in males with osteoporosis by examining changes in bone metabolism in young castrated male rats. Materials and Methods: A total of 30 Sprague-Dawley rats were randomly allocated into two study groups. Group 1 (control) receiveda sham surgery and Group 2 received bilateral orchiectomy to change bone mineral density (BMD). Serum osteocalcin, alkaline phosphatase (ALP), and collagen type 1 cross-linked C-telopeptide (CTX) were analyzed at postoperative date (POD) 8, 10, and 12 weeks. BMDs were measured using micro computed tomography scans. Results: Femoral and lumbar BMDs were decreased in the orchiectomy groups. BMDs in the sham and orchiectomy groups showed statistically differences at POD 8, 10, and 12 weeks for the femur (p=0.032, 0.008, 0.008) and lumbar spine (p=0.151, 0.008, 0.008, respectively). Serum osteocalcin, ALP, and CTX decreased gradually; however, N-terminal type 1 procollagen (P1NP) showed a slight increase yet no significant change. Conclusion: In young castrated male rats, a significant decrease in BMD was observed after orchiectomy due to the mixture of two detrimental factors. Young castrated male rats did not reach peak BMD. Increased bone turnover causes bone resorption to exceed bone formation. This study may contribute to the creation of a valuable model for studies of male osteoporosis and the spinal surgery field.

CO₂, Water to Hydrocarbon Conversion Using Sustainable Solar Power

구성욱,인수일 한국공업화학회 2023 한국공업화학회 연구논문 초록집 Vol.2023 No.0

The Protective Effect of Ginger Aqueous Extracts on CCl_4-induced Hepatic Damage in Mice

구성욱,이근우 한국임상수의학회 2012 한국임상수의학회지 Vol.29 No.6

The purpose of present study is to observe the hepato-protective effect of ginger aqueous extracts on carbon tetrachloride(CCl_4)-induced mouse. Ginger groups received ginger aqueous extracts (500 mg/kg) orally for 3 days and given a single dose of CCl_4 (4 mL/kg). Silymarin group was treated with silymarin (50 mg/kg) orally for 3 days and then aministration of CCl_4 (4 mL/kg). Control group was only administered CCl_4 (4 mL/kg). In the ginger groups, the AST, ALT levels were significantly (p < 0.05) decreased compared to the control groups. Histopathological evaluation,hepatic parenchyma and kidney parenchyma of ginger groups were significantly (p < 0.05) decreased compared to control group. The results obtained in this study suggest that ginger aqueous extracts are able to protect the liver CCl4-induced injury.

전두개저 종양의 두개안면절제술

구성욱,이규성,최은창 대한신경외과학회 1996 Journal of Korean neurosurgical society Vol.25 No.9

Craniofacial resection(CFR) is an ideal approaches for tumors involving the anterior skull base. This technique may be used for benign and malignant tumors arision from the paranasal sinus, nasal cavity, and orbit that extend into the anterior skull base. Recently, we have experienced 12 cases of craniofacial resection for anterior skull base tumors. Most of them were recurrent tumors, and received previous local excision, preoperative radiotherapy, or chemotherapy before craniofacial resection. Histologic types of tumors included 6 squamous cell carcinomas, one each of adenoid cystic carcinoma, rhabdomyosarcoma, osteoma, ossifying fibroma, cavernous hemangioma, and malignant schwannoma. Two patients died after surgery : one from recurrent infection and the other from rupture of the tumor invaded ICA. Four malignant tumors recurred after the CFR. Remaining 5 patients are doing well without tumor recurence. In conclusion, CFR is a commendable procedure for anterior skull base tumors providing cure for benign tumors and at least a local control for malignancies.

뇌하수체 육아종

구성욱,김선호,김태승 대한신경외과학회 1996 Journal of Korean neurosurgical society Vol.25 No.9

Granulomatous lesions of the pituitary gland are very unusual. We had only one case of pituitary granuloma among 469 pituitary gland lesion which were operated between 1980 and 1995 in our institute. In previous reports, some cases were asymptomatic and only detected incidently during post-mortem examination. The others presented the symptom of pituitary deficiency, visual field defects, and acute unilateral ophthalmoplegia. The most granulomatous inflammation of the pituitary gland may involve the intrasellar portion, but occasionally involve the hypothalamic area and combined with other systemic diseases. such as tuberculosis syphilis or sarcoidosis. Histologically, the lesion was characterized by nodular aggregates of epithelioid histiocytes, multinucleated giant cells and sheets of lymphocytes and plasma cells. In this case, the patient had positive results on VDRL. FTA-ABS, and presented the diabetes insipidus as the main symptom, speculated that this case was pituitary granuloma associated with syphilis.

Cyclophosphamide로 유발된 면역억제 마우스에서 생강의 면역 억제 효과

구성욱,임미경,이근우 한국임상수의학회 2015 한국임상수의학회지 Vol.32 No.1

The object of this study was to find out the immunomodulatory effects of Ginger Aqueous extracts, as compared with that of β-glucan well-known an immune modulator, on the cyclophosphamide (CPA) induced immunosuppress mice. To induce immunosuppress, 150 and 110 mg/kg of CPA were dissolved in saline and injected intraperitoneally at 3 or 1 day before start of test article administration, respectively. β-glucan or gingers (125, 250, 500 mg/kg) were dosed, 4 times at 12-hr intervals starting 24hrs after last CPA-treatment. Distilled water was used as a vehicle and each groups were used 10 mice. As results of twice intraperitoneal CPA treatment, decreases in the body weight and gain, weight of thymus, spleen. However these CPA-induced immunosuppress changes were inhibited by treatment of three different dosages of ginger or β-glucan as compared with CPA control. Similar favorable inhibitory activities on weight and histopathological change of spleen and thymus induced CPA treatment were detected between β-glucan and ginger 250 mg/kg treated groups.

Surgical Treatments for Lumbar Disc Disease in Adolescent Patients; Chemonucleolysis / Microsurgical Discectomy/ PLIF with Cages

구성욱,김영수,조용은,윤영설,진병호,김근수,진동규 연세대학교의과대학 2005 Yonsei medical journal Vol.46 No.1

The herniated lumbar disc (HLD) in adolescent patients is characterized by typical discogenic pain that originates from a soft herniated disc. It is frequently related to back trauma, and sometimes it is also combined with a degenerative process and a bony spur such as posterior Schmorl's node. Chemonucleolysis is an excellent minimally invasive treatment having these criteria: leg pain rather than back pain, severe limitation on the straight leg raising test (SLRT), and soft disc protrusion on computed tomography (CT). Microsurgical discectomy is useful in the cases of extruded or sequestered HLD and lateral recess stenosis due to bony spur because the nerve root is not decompressed with chymopapain. Spinal fusion, like as PLIF, should be considered in the cases of severe disc degeneration, instability, and stenosis due to posterior central bony spur. In our study, 185 adolescent patients, whose follow-up period was more than 1 year (the range was 1-4 years), underwent spinal surgery due to HLD from March, 1998 to December, 2002 at our institute. Among these cases, we performed chemonucleolysis in 65 cases, microsurgical discectomy in 94 cases, and posterior lumbar interbody fusion (PLIF) with cages in 33 cases including 7 reoperation cases. The clinical success rate was 91% for chemonucleolysis, 95% for microsurgical disectomy, and 89% for PLIF with cages, and there were no non- union cases for the PLIF patients with cages. In adolescent HLD, chemonucleolysis was the 1st choice of treatment because the soft adolescent HLD was effectively treated with chemonucleolysis, especially when the patient satisfied the chemonucleolysis indications.

Optimization of structural factors affecting photoelectrochemical performance of porous BiVO4 photoanode on electrodeposited Bi electrode

구성욱,인수일 한국공업화학회 2023 한국공업화학회 연구논문 초록집 Vol.2023 No.0