퇴행성 경추질환에서 전방경유 추간판 절제술 및 골유합술의 결과분석

이상원,송근성,Lee, Sang Weon,Song, Geun Sung 대한신경외과학회 2001 Journal of Korean neurosurgical society Vol.30 No.2

Objectives : We retrospectively studied the efficacy of anterior cervical discectomy and interbody fusion without plate fixation in degenerative cervical disease. Methods : Thirty two consecutive patients with degenerative cervical disease treated by decompression and interbody fusion(Smith-Robinson technique) without anterior cervical plating were studied for postoperative complication rate as well as the clinical and radiologic outcomes and were compared the result of ours with other reported series where the anterior cervical plating was used. Results : All cases were reviewed after average period of 13 months for the purpose of this study. There were 4 postoperative complications related to grafting. A solid fusion was obtained in all cases with single-level fusion(n=21) and 81.8 % of the cases with a two-level fusion(n=11). The overall fusion rate was 93.8 % and fusion rate per level fused was 95.3%. The clinical outcome of the patients was comparable with that in the literature, with one patient having a poor result. Comparing the result of this study with others of the anterior cervical plating, clinical outcome and fusion rate were not superior in plate fixation group in single-level fusion, but increased fusion rate and decreased graft-related complication rate were noted in multilevel fusion with plate fixation. However, the clinical outcome was not superior to noninstrumented fusion group of this study. Conclusion : These results demonstrate that anterior cervical discectomy and interbody fusion(Smith-Robinson technique) without instrumentation is safe and reliable method of single-level fusion in degenerative cervical disease. Plate fixation system doesn't seem necessary in single level fusion in degenerative cervical disease.

중하부 경추손상에서 후방 경추 내고정술 및 골유합술의 분석결과

이동훈,송근성,Lee, Dong Hoon,Song, Geun Sung 대한신경외과학회 2001 Journal of Korean neurosurgical society Vol.30 No.12

Objective : In the retrospective analyzing 19 consecutive patients with subaxial cervical spine(C3~T1) injury treated by posterior cervical fixation and fusion, clinical manifestation, radiologic finding, operative technique, and postoperative results following 6 months were analyzed. Materials and Methods : Most common fracture level was C4-5, mean age 41, and male to female ratio 13 : 6. The most common cause of injury was motor vehicle accident(17 cases). In 19 cervical procedures, interspinous triple wiring was done in 14 cases, lateral mass plating in 5 cases, and additional anterior fusion in 2 cases. Results : Twelve weeks after operation, all cases were reviewed by plain cervical radiogram. In 17 cases that treated by posterior fusion only, 14 cases(81%) had kyphotic angle change less than $5^{\circ}$, 2 cases(12%) $5-20^{\circ}$, and 1 case(6%) more than $20^{\circ}$. Overall fusion rate was 88%, and there was no significant difference of bone fusion rate between autogenous bone graft and allogenous bone graft. Conclusion : In the case of severe posterior column injury or displacement, posterior approach seems superior to anterior approach, but in the case of combined anterior column injury, anterior approach is considered necessary. In this study, posterior fixation and fusion might be acceptable procedure for subaxial cervical fracture and dislocation, owing to its high fusion rate, low kyphotic angulation and low operation related complication rate.

임상 : 성상세포종의 악성도와 TGF-β1 및 Smad4 발현의 상관관계

김병주 ( Byung Joo Kim ),송근성 ( Geun Sung Song ),서영준 ( Young Jun Seo ) 대한뇌종양학회 2006 대한뇌종양학회지 Vol.5 No.1

Smads are signal transducers for the members of TGF-beta superfamily. Understanding the function of Smads in tumor cells is of paramount importance, since most tumors with defects in TGF-beta signaling still have functional components of Smads pathways that may play critical roles in determining the malignant phenotypes. Of these Smads, Smad4 is essential for TGF-beta signaling. The purpose of this study was to elucidate TGF-beta 1 and Smad4 protein expression in human astrocytomas and its pathological significance by using immunohistochemical technique. A total 54 astrocytomas among the patients who underwent operation at Pusan National University Hospital between Jan., 1996 and Dec., 2001 were included in the study. Histologically the tumors were graded as three groups according to the WHO grading system and 15 cases were in grade II(low grade astrocytoma), 19 cases in grade III(anaplastic astrocytoma) and 20 cases in grade IV(glioblastoma multiforme). As a result, TGF-￥a1 expression tended to increase with increasing grade of malignancy. Expression of Smad4 was higher in grade II astrocytoma than grade IV astrocytoma. The univariate analysis showed that there was significant difference between the malignancy and expression of TGF-￥a1 and Smad4(p<0.05). In conclusion, it is presented that reduced Smad4 expression and high TGF-￥a1 expression might be significantly associated with increased malignancy and invasiveness of astrocytoma.

전두골에 발생한 콜레스테롤 육아종 1례 - 증례보고 -

이상원,차승헌,박동준,송근성,최창화,이영우,Lee, Sang Weon,Cha, Seung Heon,Park, Dong June,Song, Geun Sung,Choi, Chang Hwa,Lee, Young Woo 대한신경외과학회 2001 Journal of Korean neurosurgical society Vol.30 No.6

Cholesterol granuloma of frontal bone is a rare disease which usually occurs at the lateral part of the supraorbital ridge. This expanding lesion grows slowly and extends into the orbit and anterior cranial fossa. The most common symptom is proptosis. This granuloma is composed of a granulomatous reaction surrounding cholesterol crystals. Surgical treatment involves aspiration of contents and stripping or curettage of the lining which is highly successful. We experienced a case of cholesterol granuloma of frontal bone with huge intracranial extension, which was cured by surgical removal. The clinical features, radiologic, and pathologic finding were discussed and the pertinent literatures were reviewed.

뇌실-복강 단락 원위도관의 심장내전위 - 증례보고 -

김병주,차승헌,박동준,송근성,최창화,이영우,Kim, Byung Joo,Cha, Seung Heon,Park, Dong June,Song, Geun Sung,Choi, Chang Hwa,Lee, Young Woo 대한신경외과학회 2000 Journal of Korean neurosurgical society Vol.29 No.2

Ventriculoperitoneal(V-P) shunt has been used as a popular method for surgical treatment of hydrocephalus. But complications such as infection, mechanical obstruction and failure of flow rate sometimes make painful stress to neurosurgeons and patients. Of particular, migration of distal V-P shunt catheter to extraperitoneal space has rarely been reported. Even rarer is intracardiac migration of distal V-P shunt catheter. Authors report a such case and discuss the possible mechanism and preventive method.

재발성 뇌실내출혈을 일으킨 경연수접합부 동정맥기형 - 증례보고 -

이상원,최창화,차승헌,박동준,송근성,이영우,Lee, Sang Weon,Choi, Chang Hwa,Cha, Seung Heon,Park, Dong June,Song, Geun Sung,Lee, Young Woo 대한신경외과학회 2001 Journal of Korean neurosurgical society Vol.30 No.6

Cervicomedullary junction arteriovenous malformation(AVM) is extremely rare. The authors present a case of a cervicomedullary junction AVM in a 31-year-old woman presenting with recurrent intraventricular hemorrhage (IVH). Magnetic resonance imaging revealed the AVM(of a size of approximately $2{\times}2.5{\times}4cm$) extending from a lower medulla to C2-3 level. Vertebral angiography demonstrated a tightly coiled vascular mass with multiple feeders (radiculomedullary arteries) and irregular-shaped aneurysm at distal part of feeder originating at right C-1 level. The patient underwent superselective embolization of upper nidus and the aneurysm. The pertinent literature is reviewed, and diagnostic and therapeutic implications are discussed.

원발병소불명의 전이성 뇌종양

전진호 ( Jin Ho Jeon ),이상원 ( Sang Weon Lee ),최병관 ( Byung Kwan Choi ),차승헌 ( Seung Heon Cha ),송근성 ( Geun Seung Song ),최창화 ( Chang Hwa Choi ) 대한뇌종양학회 2003 대한뇌종양학회지 Vol.2 No.2

Background:The prognosis of patients with brain metastasis of unknown primary tumor is controversial. The authors reviewed the results of gross total resection with radiotherapy in this group of patients. Methods:Between 1993-2000, 133 patients admitted to the study department for the treatment of metastatic brain tumor. Gross total resection was done in 33 patients with single brain lesion. Ten patients had solitary brain metastasis without a detectable primary site despite extensive systemic evaluation(Group I), and remaining 23 had previous cancer history or a detectable primary lesion(Group II). Survival analysis and comparison was done. Results:The median survival was 24.1months in group I(range, 6.5-58.5) and 19.0months in group II(range, 4.7- 40.6). The overall survival for group I was better than group II, but not significant. Adenocarcinoma was the most common histology of group I. During the follow-up the primary tumor was found in 7 patients and was located in the lung in 4 patients. Conclusion:Brain metastasis of unknown primary tumor has better prognosis than that of brain metastasis in general. Gross total resection with radiotherapy for local disease control is effective in this group of patients especially in solitary lesion.

내시경적 생검 및 제 3 뇌실 개창술과 감마나이프 방사선 수술로 치료된 시상부 교종

조원호 ( Won Ho Cho ),이상원 ( Sang Weon Lee ),이동훈 ( Dong Hoon Lee ),차승헌 ( Seung Heon Cha ),송근성 ( Geun Sung Song ),최창화 ( Chang Hwa Choi ) 대한뇌종양학회·대한신경종양학회·대한소아뇌종양학회 2005 대한뇌종양학회지 Vol.4 No.2

We present the case of a thalamic glioma with obstructive hydrocephalus. The patient was successfully treated with neuroendoscopic biopsy, third ventriculostomy and subsequent gamma knife radiosurgery. At 12 months the tumor has decreased in size and the patient has no neurologic deficits. Neuroendoscopic surgery combined with gamma knife radiosurgery may play an important role in the selected intracranial tumors with minimally invasive technique.

근골격계 질환의 한,양방협진치료 효과 연구에 대한 체계적 문헌 고찰

이승진 ( Seung Jin Lee ),신병철 ( Byung Cheul Shin ),송근성 ( Geun Sung Song ),황의형 ( Eui Hyoung Hwang ),윤영주 ( Young Ju Yun ) 한방재활의학과학회 2011 한방재활의학과학회지 Vol.21 No.4

Objectives: This study aims to systematically evaluate the effectiveness of Eastern-Western integrative medicine for musculoskeletal disorders compared with Eastern or Western Medicine. Methods: Systematic searches of 9 major Korean databases were conducted for articles published up to July 2011. Searching keyword was “Integrative Medicine”. Prospective studies dealt with musculoskeletal disorders by Eastern-Western integrative medicine were included. Quality assessment of included studies was evaluated by Cochrane risk of bias tool. Results: 470 studies in total were searched. Among them, 7 studies met our inclusion criteria(3 randomized controlled clinical trials, 2 non-randomized controlled trials and 2 uncontrolled clinical trials). Included studies dealt with lumbar pain(3), shoulder pain(2), pain after traffic injury(1), spinal compression fracture(1). Eastern-Western integrative medicine showed better or equal effect for the treatment of various musculoskeletal disorders compared with Eastern or Western medicine alone. Conclusions: There is very weak evidence for the effectiveness of Eastern-Western integrative medicine for musculoskeletal disorders compared with Eastern or Western medicine alone. Well designed randomized controlled trials with rigorous methodology are needed to evaluate the effectiveness of Eastern-Western integrative medicine objectively in the future.

흉부 전산화 단층 촬영 검사 시 발생하는 생식선 차폐 유무에따른 산란 선량 차이에 관한 연구

곽종혁(Jong Hyeok Kwak),김성진(Gyeong Rip Kim),성현철(Hyun Chul Sung),김승원(Seung Won Kim),송근성(Geun Sung Song),최민경(Min Gyeong Choi),이상원(Sang Weon Lee) 한국방사선학회 2021 한국방사선학회 논문지 Vol.15 No.2

생식선 차폐를 하지 않았을 때 전부, 양 측부, 후부, 생식선 부위의 산란선을 측정하고 Xenolite nolead Apron(0.35 mm Pb), Xenolite nolead Apron(front 0.35 mm Pb Mix back 0.25 mm Pb, Skirt overlap), Half Apron(0.5 mm Pb)로 차폐 후 각각의 산란 선량을 측정하였다. 흉부 전산화 단층촬영 검사 시 검사 부위의 산란 선량은 272 µ㏜가 측정되었고, Apron으로 차폐하지 않았을 시에 평균 전부 43 µ㏜, 좌측부 81 µ㏜, 우측부 82 µ㏜, 후부 38.8 µ㏜, Gonad 부위 16 µ㏜로 측정되었다. Xenolite nolead Apron으로 위쪽 부분만 차폐하고 측정했을 전부 11.2 µ㏜, 좌측부 43.1 µ㏜, 우측부 45.3 µ㏜, 후부 12 µ㏜, Gonad 부위 5.2 µ㏜로 측정되었다. Xenolite nolead Apron(Skirt overlap)으로 Pelvis 부위를 360˚ 감싼 후 선량을 측정하였을 때 전부 5.6 µ㏜, 좌측부 22.4 µ㏜, 우측부 15.7 µ㏜, 후부 6 µ㏜, Gonad 부위 3.2 µ㏜로 측정되었다. Xenolite nolead Apron(Skirt overlap)으로 Pelvis 부위를 360˚ 감싼 후 선량을 측정하였을 때 전부 5.6 µ㏜, 좌측부 22.4 µ㏜, 우측부 15.7 µ㏜, 후부 6 µ㏜, Gonad 위 3.2 µ㏜로 측정되었다. Half Apron으로 위쪽만 차폐하고 측정했을 때에는 전부 10.7 µ㏜, 좌측부 42.6 µ㏜, 우측부 40.6 µ㏜, 후부 11.3 µ㏜, Gonad부위 4.7 µ㏜로 측정되었다. 골반 부위를 360° 차폐하는 방법이 80% 이상 선량 감소를 보였고, 전부 차폐 시 70% 이상의 선량 감소 효과를 보였으며 모든 전산화 단층 촬영 검사에 있어 피폭선량 경감을 위한 연구와 차폐 가능한 장비를 활용하는 다양한 기법에 관한 지속적인 연구가 필요하리라 사료된다. his study is a study on the difference in dose according to the presence or absence of gonadal shielding of scattered rays generated during chest computed tomography examination, and the scattered dose of the examination site was measured by placing the RadEye G-10 device in the center of the phantom. When the gonads are not shielded, the scattering lines of the whole, both sides, posterior and gonads are measured and Xenolite nolead Apron (0.35 mm PB), Xenolite nolead Apron (front 0.35 mm PB Mix back 0.25 mm PB, Skirt overlap), Half Apron After shielding with (0.5 mm PB), each scattered dose was measured. During chest computed tomography, the scattered dose of the test site was measured at 272 µ㏜, and when not shielded with Apron, the average total was 43 µ㏜, left 81 µ㏜, right part 82 µ㏜, posterior part 38.8 µ㏜, and Gonad part 16 µ㏜. Became. Xenolite nolead Apron shielded only the upper part and measured all 11.2 µ㏜, left part 43.1 µ㏜, right part 45.3 µ㏜, posterior part 12 µ㏜ and Gonad part 5.2 µ㏜. Xenolite nolead Apron (Skirt overlap) covered the Pelvis area 360˚ and the dose was measured to be 5.6 µ㏜ in the whole, 22.4 µ㏜ in the left, 15.7 µ㏜ in the right side, 6 µ㏜ in the posterior part, and 3.2 µ㏜ in the Gonad part. Xenolite nolead Apron (Skirt overlap) covered the Pelvis area 360˚ and the dose was measured to be 5.6 µ㏜ in the whole, 22.4 µ㏜ in the left, 15.7 µ㏜ in the right side, 6 µ㏜ in the posterior part, and 3.2 µ㏜ in the Gonad part. When measuring only the upper part with Half Apron, the total measurement was 10.7 µ㏜, the left part 42.6 µ㏜, the right part 40.6 µ㏜, the posterior part 11.3 µ㏜, and the Gonad part 4.7 µ㏜. The method of 360° shielding of the pelvic area showed a dose reduction of more than 80%, and a dose reduction effect of more than 70% was shown when all shielding was performed. In all computerized tomography examinations, research to reduce the exposure dose and various shielding devices were used. It is believed that continuous research on the technique is needed.