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이준국 ( Joon Kook Lee ),김창현 ( Chang Hyun Kim ),이호국 ( Ho Kook Lee ),최종훈 ( Jong Hun Choi ) 대한뇌종양학회·대한신경종양학회·대한소아뇌종양학회 2009 대한뇌종양학회지 Vol.8 No.1
Although glioblastoma multiforme(GBM) is the most common primary central nervous system(CNS) tumor, primary GBM which developed in the cerebellum has been rarely reported. We present a case of histopathologically proven cerebellar GBM in a 68-years-old woman. The clinical course was rapidly progressed like other GBMs, and suboccipital craniectomy with telovelar approach and gross total tumor removal was performed. Pathological diagnosis was a GBM. We describe about clinical presentation, radiologic differential diagnosis, and treatment with literature review.
신필재,이호국,김창현,양경헌,황도윤,Shin, Pill Jae,Lee, Ho Kook,Kim, Chang Hyun,Yang, Kyung Hun,Hwang, Do Yun 대한신경외과학회 2000 Journal of Korean neurosurgical society Vol.29 No.1
Rhinocerebral mucormycosis is a rare but acutely fatal disease caused by fungi belonging to the order Mucorales, and characterized by an aggressive necrotizing infection spreading from the nose to the paranasal sinuses, orbit, and then to the central nervous system. It most frequently develops in individuals with poorly controlled diabetes mellitus. The authors report a 65-year-old woman who developed intracerebral hemorrhage during treatment for rhinocerebral mucormycosis associated with diabetes mellitus. Despite the treatment, she became worse. The pertinent literatures were reviewed.
박재석,문재곤,김창현,이호국,황도윤,Park, Jae Suk,Moon, Jae Gon,Kim, Chang Hyun,Lee, Ho Kook,Hwang, Do Yun 대한신경외과학회 2001 Journal of Korean neurosurgical society Vol.30 No.1
Objective : The cause and clinical outcome of cerebral hemorrhage in patients on maintenance hemodialysis have been poorly studied in korea. The purpose of this paper is to clarify the clincal features and the outcome of cerebral hemorrhage in patients on maintenance hemodialysis. Method : We analyzed clincal features and the outcome of cerebral hemorrhage in 14 patients on maintenance hemodialysis. Hematomas were reviewed and evaluated for location, size, and intraventricular extension by the one of the authors without any prior informations. The axial slice of CT film that the hematoma was appeared in maximal dimension was chosen for evaluations. Result : Hypertension was found in 71.4%(10 cases) and motality rate was 78.5%(11 cases). Basal ganglia hemorrhage was found in 50%(7 cases), subcortex in 28.5%(4 cases), pons in 14.2%(2 cases). Size of hematoma in patients on maintenance hemodialysis was significantly larger than that of hypertensive cerebral hemorrhage patients(p=0.0061). The 4 cases of basal ganglia hemorrhage without intraventricular hemorrhage and subarachnoid hemorrhage were good mental state at the onset of stroke because of small mass effect relative to the size of hematoma. The duration of hemodialysis treatment prior to strokes ranged from 1 to 107 months. Strokes developed within 6 hours of the previous hemodialysis are 5 cases. Average serum albumin concentration was 3.4g/dl. The use of heparin is less responsible for the development of cerebral hemorrhage in patients on maintenance hemodialysis Conclusion : Cerebral hemorrhage in patients on maintenance hemodialysis is more severe in terms of hematoma size and clinical outcome. Therefore, the prevention and treatment of cerebral hemorrhage in patients on maintenance hemodialysis should be more aggressive.
요추전방전위증 환자들에서 후방요추체간유합술로 자가골편 또는 Cage를 사용한 두 군간의 비교
신필재,김창현,문재곤,이호국,황도윤,Shin, Pill Jae,Kim, Chang Hyun,Moon, Jae Gon,Lee, Ho Kook,Hwang, Do Yun 대한신경외과학회 2000 Journal of Korean neurosurgical society Vol.29 No.4
Objective : Posterior lumbar interbody fusion(PLIF) with transpedicular screw fixation(TPSF) have many merits in the treatment of spondylolisthesis. The aim of this study was to compare cage PLIF group(PLIF using cage and TPSF) with chip PLIF group(PLIF using autologous bone chips and TPSF) as surgical treatment of spondyloisthesis. Methods : PLIF and TPSF were performed in 44 patients with spondylolisthesis from January 1994 to December 1998. The surgical methods were divided into two groups. One group was cage PLIF(20 patients), and the other group was chip PLIF(24 patients). We analyzed the change of anterior translation, change of intervertebral space height, fusion rate, clinical outcomes, and postoperative complications in two groups. Result : There was no significant difference in reduction and maintenance of anterior translation between two groups. Intervertebral space height was increased in the two groups at immediate postoperative state. At last followup, it was decreased compared to preoperative height in chip PLIF group. In cage PLIF group, last follow-up height was decreased compared to immedate postoperative height, but it was significantly increased compared to preoperative height. Fusion rates were 70.9% and 90% in chip PLIF group and cage PLIF group, respectively. Excellent and good clinical outcomes were 79.2% in chip PLIF group and 85% in cage PLIF group, but there was no statistical significance. Complications were screw fracture(1 case), CSF leakage(1 case) in chip PLIF group and screw loosening and retropulsion of cage(1 case), CSF leakage(2 cases) in cage PLIF group. Conclusion : PLIF using cage is better than PLIF using autologous bone chips in the maintenance of intervertebral space height and fusion rate. But there is no statistical difference of the clinical outcomes between the two groups. Further studies, especially on long term follow-up, should be considered.
두피하 혈종으로부터 확장된 안구내 골막하 혈종 - 증 례 보 고 -
정병하,문재곤,김창현,이호국,황도윤,Jeong, Byung Ha,Moon, Jae Gon,Kim, Chang Hyun,Lee, Ho Kook,Hwang, Do Yun 대한신경외과학회 2000 Journal of Korean neurosurgical society Vol.29 No.9
The authors present a case of subperisoteal orbital hematoma which is extended from subgaleal hematoma. A 15-year-old-male was admitted with a complaint of multiple visual symptoms of left eye following blunt head trauma. He has suffered from Wilson's disease. Several coagulative laboratory findings were abnormal(fibrinogen and coaguation factor V, X). Computed tomography, sonography and magnetic resonance imaging established the subperiosteal orbital extension of subgaleal hematoma into the orbital cavity. Needle aspiration of orbital subperiosteal hematoma was failed but symptoms and signs of the patient were much improved spontaneously following decrease of subgaleal hematoma. The literature is reviewed and management is discussed.
뇌자기공명영상을 이용한 천막 절흔의 형태학적 분석 -임상연구-
김훈수 ( Hoon Soo Kim ),조성민 ( Sung Min Cho ),이호국 ( Ho Kook Lee ),변진수 ( Jhin Soo Pyen ),홍순기 ( Soon Ki Hong ),김헌주 ( Hun Joo Kim ) 대한뇌종양학회 2004 대한뇌종양학회지 Vol.3 No.2
Objective:This study was performed to measure anatomical basis for interpretation of the tentorial notch, oculomotor nerve and brainstem using MRI and to develop a classification system for the tentorial notch. Methods:From January 2002 to September 2002, we analized 100 patients with mild head injury who didn`t have space occupying lesion on the magnetic resonance imaging(MRI). The following measurements were done:1) anterior notch width(ANW);2) maximum notch width(MNW);3) notch length(NL);4) posterior tentorial length(PTL);5) interpedunculoclival( IC) distance;6) apicotectal(AT) distance;and 7) inter-third nerve angle. Quatile groups defined by NL were labeled long, short, and midrange, and those defined by MNW were labeled as wide, narrow, and midrange. Results:The patients were composed of 64 men and 36 women whose mean age was 29.6±15.7 year of age(range 2- 61). Mean values are presented as the means±standard deviations into following variations:1) ANW, 22.3±4.4mm; 2) MNW, 32.9±3.6mm;3) NL, 57.6±5.4mm;4) PTL, 30.4±3.0mm;5) AT distance, 25.2±4.8mm;6) IC distance, 18.0±4.9mm;7) inter-third nerve angle, 50.8±6.9°. The types of tentorial notch were wide(16%), narrow (11%), long(12%), short(12%), and typical(17%). Notches that were both wide and long were labeled large(8%), and those that were narrow and short were labeled small(12%). The category of mixed notches(12%) was assigned to tentorial notches that were either wide/short(4%) or narrow/long(8%). Conclusions:The use of MRI to identify the type of tentorial notch and regional anatomy may help neurosurgical decision making.
최정훈 ( Jeong Hoon Choi ),김창현 ( Chang Hyun Kim ),문재곤 ( Jae Gon Moon ),이호국 ( Ho Kook Lee ),이민진 ( Min Jin Lee ),최종훈 ( Jong Hun Choi ) 대한뇌종양학회 2007 대한뇌종양학회지 Vol.6 No.1
Objective:The extent of peritumoral brain edema(PTBE) in meningioma is very variable and PTBE can adversely affect the clinical course. Many influenceable factors have been investigated, but the mechanism of that is not fully understood. Recent reports have focused on the arterial blood supply pattern and immunohistopathological aspect. The authors investigated several clinical and immunohistopathological factors that may influence the development of PTBE and postoperative edema patterns in meningioma. Methods:We studied 30 cases of intracranial meningioma which were histologically proven. We focused on identifying the interaction of the location, the tumor and edema volume, the histological subtype, the preoperative edema index(EI), the biological activity indicated by the VEGF and the MIB-1 labeling index(LI), the postoperative EI. Results:There was no statistically significant correlation between the location and the PTBE. There was statistically significant correlation between the histology and the PTBE. But there was no significant correlation between the histology and the decrease in postoperative remaining PTBE. The MIB-1 LI was positively related to the PTBE formation in meningiomas. Also MIB-1 LI was related to the decrease in postoperative remaining PTBE. The VEGF was positively correlated with the PTBE formation in meningiomas but there was no statistically correlation with the decrease in postoperative remaining PTBE. Conclusion:The greater MIB-1 LI results in greater PTBE formation and more decreased in postoperative PTBE. The greater VEGF expression results in greater PTBE formation.