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The Role of Adiponectin in Secondary Inflammatory Reaction in Cerebral Ischemia
정용수,하성곤,김상대,김세훈,임동준,최종일 대한뇌혈관외과학회 2013 Journal of Cerebrovascular and Endovascular Neuros Vol.15 No.3
Objective : In this study, we investigate the role of adiponectin in the interaction between leukocytes and endothelium in the secondary inflammatory reaction of cerebral ischemia Methods : Adiponectin knock-out mice group (APN-KO) (n = 8) and wild-type mice group (WT) (n = 8) were prepared. Each group was sub-divided into 2 groups by reperfusion time. One-hour middle cerebral artery occlusion and reperfusion were induced using the intraluminal filament technique. At 6 and 12 hours after the occlusion, the mice were placed on a stereotactic frame to perform craniotomy in the left parietal area. After craniotomy, a straight pial venule was selected as a target vessel. With the fluorescence intravital microscope, the number of rolling leukocytes and leukocytes that adhered to endothelium were counted and documented at 6 and 12 hours after the reperfusion. Results : At 6 and 12 hours after the reperfusion, more rolling leukocyte and leukocyte adhesion were observed in the APN-KO mice than in the WT mice. The difference in leukocyte numbers between the APN-KO and WT mice was found to be statistically significant (p = 0.029) by Mann-Whitney U-test. Conclusion : We found that adiponectin inhibits the interaction between the endothelium and leukocytes in cerebral ischemia-reperfusion. Therefore adiponectin might prevent the secondary insult caused by the inflammation reaction.
Triple Primary Origin Tumor: A Case Report
정용수,김세훈,하성곤,김상대,임동준 대한척추신경외과학회 2013 Neurospine Vol.10 No.2
Generally, among the extradural spinal tumors, metastatic spinal tumor is much more common than primary spinal tumors. Thus, in the case of a spinal tumor patient with cancer history (such as lung cancer, breast cancer, etc.), we used to infer that the spinal lesion is the metastasis from, primary malignancy. We introduce an experience of a case of triple primary origin tumor in a 57-year-old man. When the spinal lesion was found on the abdominal computed tomography scan, he already had a history of colon cancer and liver cancer. Initially, it was thought that the lesion would probably be a metastatic tumor from the liver or colon cancers, and the operation was performed accordingly. In the pathologic final report, however, the mass was proven to plasmacytoma - the third primary lesion. The patient underwent chemotherapy after surgery. Globally, the triple primary origin tumor has been reported very rarely. With this report, we wish to emphasize the necessity of pathologic confirmation and adequate treatment even in a patient with known malignancies.
이승환,임동준,하성곤,김상대,김세훈,박정율 대한뇌혈관외과학회 2011 Journal of Cerebrovascular and Endovascular Neuros Vol.13 No.1
Ruptured vertebral artery- dissecting aneurysms (VADAs) must be treated as early as possible due to frequent rebleeding in the early stage. We have reported herein two patients with VADAs who were treated using internal trapping using detachable coils. Both patients were young females in their 40’s. They had been admitted to the emergency clinic due to severe headaches and mental deterioration. Brain computed tomography (CT) scans revealed a subarachnoid hemorrhages in the posterior fossa, and transfemoral catheter cerebral angiography revealed dissecting aneurysms at the dominant vertebral arteries. Under general anesthesia, embolization of the parent artery, including the aneurysmal portion, using Guglielmi detachable coils was performed without any procedural complications. Before the induction of general anesthesia, a balloon test occlusion was done on both patients. Both patients improved well after surgery. One patient underwent cerebral angiography at six months after surgery and showed no recurrence of the aneurysm or recanalization of the parent artery. Both patients were free of neurologic findings on follow-up at the 6- and 12- month. Based on these results, patients with ruptured VADAs, located in the dominant vertebral arteries, may be successfully treated with urgent internal trapping using an endovascular technique in selected cases.
흉요추부 외측 강외 접근법(Lateral Extracavitary Approach)의 수술해부학적 구조 - 사체해부실험 -
김상돈,서중근,하성곤,김주한,조태형,박정율,김현,Kim, Sang-Don,Suh, Jung-Keun,Ha, Sung-Kon,Kim, Joo-Han,Cho, Tae-Hyung,Park, Jung-Yul,Kim, Hyun 대한신경외과학회 2001 Journal of Korean neurosurgical society Vol.30 No.10
Objective : The lateral extracavitary approach(LECA) to the thoracolumbar spine is known as one of procedure which allows not only direct vision of pathologic lesion, but also ventral decompression, and dorsal fixation of the spine through the same incision. However, some drawbacks of LECA, including the technically- demanding, time-consuming, unfamiliar surgical anatomy and excessive blood loss, make surgeons to hesitate to use this approach. This study is to provide the surgical anatomy of LECA using cadavers, for detailed informations when LECA is considered for the surgery. Methods : We performed the 10 cadaveric studies, 7 male and 3 female, and careful dissection was carried out on right side of thoracolumbar region, except one for thoracic region. The photographs with micro-lens were taken to depict the close-up findings and for demonstrating detailed anatomy. Results : The photographs and hand-drawings demonstrated the relationships among the musculature, segmental vessels and nerve roots seen during each dissection plane. The lateral branches of dorsal rami of spinal nerve and the transverse process were confirmed to be the most important landmark of this approach. Conclusion : We concluded that detailed anatomical findings for LECA through this step-by-step dissection would be useful during operative intervention to reduce the intraoperative complications in LECA.
한진솔,임동준,김상대,하성곤,이승환,김세훈 대한뇌혈관외과학회 2016 Journal of Cerebrovascular and Endovascular Neuros Vol.18 No.3
Pure subdural hematomas caused by a ruptured intracranial aneurysm are extremely rare. We describe the case of a 42-year-old woman who presented with headache without evidence of head trauma. Magnetic resonance angiography and conventional cerebral angiography revealed a ruptured aneurysm at the right middle cerebral artery bifurcation. The patient underwent surgical treatment and had a good outcome without any neurological deficit. The mechanisms and clinical characteristics of this condition are discussed.
Late Infection from Anterior Cervical Discectomy and Fusion after Twenty Years
진성원,김세훈,최종일,하성곤,임동준 대한척추신경외과학회 2014 Neurospine Vol.11 No.1
Anterior cervical discectomy and fusion (ACDF) has been performed for degenerative and traumatic cervical diseases to improve pain and neurologic symptoms including sensory change and motor weakness. Infection, however, is a rare complication of ACDF, and late infection is even much rarer. We present a case of late Infection from ACDF C4-5 using Biocompatible Osteoconductive Polymer (BOP) after twenty years in the absence of an esophageal perforation, Zenker’s diverticulum, or recent surgery or bacteremia. Late infection from ACDF after 20 years is extremely rare in the literature. However, possibility of such a late complication should be appreciated during the follow-up period and surgical resection will be required for proper treatment.
Endovascular Treatment of Symptomatic Vertebral Artery Dissecting Aneurysms
Jin-Sol Han,임동준,하성곤,최종일,진성원,김세훈 대한뇌혈관외과학회 2016 Journal of Cerebrovascular and Endovascular Neuros Vol.18 No.3
Objective : Vertebral artery dissecting aneurysms (VADAs) are rare and many debates are present about treatment options. We review types and efficacy of our endovascular treatments and establish a safe endovascular therapeutic strategy regard to the angio-architecture of VADAs. Materials and Methods : Between July 2008 and October 2015, we treated 22 patients with symptomatic VADAs. Fifteen patients presented with subarachnoid hemorrhage from the ruptured VADAs, digital subtraction angiography and magnetic resonance image confirmed the diagnosis and endovascular treatments were followed as their angio-architecture. Results : Clinical results were good in 13 patients (86.7%), and there were no technical problems during endovascular procedures. The other 2 patients with poor prognosis showed severe neurological deficits at the initial evaluation. Among the three different endovascular treatments, there were no radiologic cure in one patient with stent insertion alone, but the patient had no significant clinical symptoms either. Conclusion : Endovascular treatments are safe and effective treatment option for managing VADAs and can be the first treatment of choice for most patients. To select proper endovascular treatment according to the angio-architecture of VADAs can reduce the risk of the treatment.