요추 황색인대의 미세구조 ; 내층과 외층의 차이

원유삼,이승민,최천식,주문배,어환,김종현,박윤관,서중근,Won, You Sam,Lee, Seung Min,Choi, Chun Sik,Ju, Moon Bae,Eoh, Whan,Kim, Jong Hyun,Park, Yun Kwan,Suh, Jung Keun 대한신경외과학회 2000 Journal of Korean neurosurgical society Vol.29 No.5

Objectives : In lumbar spine surgery it is observed that the ligamentum flavum(LF) is bilayered, and the inner layers can be left in situ to prevent peridural adhesion in open lumbar disc surgeries. The purposes of this study are to investigate ultrastructural differences between the inner and outer layer of lumbar LF by electron microscopic examination, and to see whether these differences are, if present, more prominent in chronic degenerative lumbar spinal disorders as compared with acute lumbar disc diseases. Methods : Biopsy specimens of LF were obtained from nine patients undergoing lumbar spine surgery, five of them for degenerative spinal stenosis and four for acute disc herniation. During the surgery the outer layers of LF were carefully dissected from the inner layer, and four pieces($1{\times}1{\times}1-mm$) of biopsy samples were made from each layer. These were examined with electron microscope for the morphologies and the contents of the elastic and the collagen fibers. Results : The outer layer of LF showed elastic fiber degeneration as evidenced and decreased fiber content, while the inner layer was relatively preserved in both cases of degenerative spinal stenosis and acute disc herniation. The ultrastructural changes of the layers were more evident in the outer layer. Conclusion : With these observations the authors believe that the LF degeneration may occur mainly in the outer layer, and that this fact may aid in making the rationale for using the inner layer as physiologic barrier to prevent peridural adhesion in open lumbar disc surgeries.

내고정을 시행한 전방경추융합술시 이식공에 따른 골융합률 ; 자가장골이식과 동종비골이식의 비교

원유삼,이승민,양재영,최천식,주문배 대한신경외과학회 1999 Journal of Korean neurosurgical society Vol.28 No.8

척수에 발생한 상피양 혈관내피종 1예 - 증례보고 -

김기태,원유삼,이승민,양재영,최천식,주문배,금주섭,Kim, Ki Tai,Won, You Sam,Lee, Seung Min,Yang, Jae Young,Choi, Chun Sik,Ju, Mun Bae,Keum, Joo Seob 대한신경외과학회 2001 Journal of Korean neurosurgical society Vol.30 No.5

Hemangioendotheliomas are vascular neoplasms characterized by histologic appearance that are intermediate between hemangiomas and angiosarcomas first described by Weiss and Enzinger in 1982. They are classified into at least 3 subgroups, including epithelioid hemangioendothelioma, spindle cell hemangioendothelioma, and malignant endovascular angioendothelioma, and have been reported principally in soft tissues of the extremities, lung, liver, and bone. The cases involving the central nervous system reported are very rare. We report an intraspinal epithelioid hemangioendothelioma occurring in a 52-year-old man. To our knowledge, it is first case of spinal hemangioendothelioma in Korea.

환추 저형성, 환추후두골 유합증, 두개저 함입증의 복합 기형 - 증례보고 -

조원중,원유삼,이승민,양재영,최천식,주문배,Cho, Won Jung,Won, Yu Sam,Lee, Seung Min,Yang, Jae Young,Choi, Chun Sik,Ju, Mun Bae 대한신경외과학회 2000 Journal of Korean neurosurgical society Vol.29 No.3

The term 'craniovertebral junction' refers to the occipital bone that surrounds the foramen magnum and the atlas and the axis vertebrae. A wide variety of congenital, developmental, and acquired anomalies exist at the craniovertebral junction. The authors present a rare case of the congenital anomaly of the craniovertebral junction consisting of atlantal hypoplasia, atlantal assimilation, and basilar invagination in a 58-year-old male. An occiput-C2 arthrodesis was performed. The clinical and imaging features are described, and the embryology and etiology of this anomaly are discussed.

Association of Initial Infarct Extent and Progressive Motor Deficits in Striatocapsular Infarction

문희수,김용범,서범천,원유삼,박광열,정필욱 대한신경과학회 2008 Journal of Clinical Neurology Vol.4 No.3

Background and Purpose: Progression of motor deficits in the acute period is frequently observed in patients with subcortical striatocapsular infarctions. Therefore, we sought to determine the factors associated with early motor progression in patients with infarcts confined to the striatocapsular region. Methods: We studied 80 consecutive patients with striatocapsular-region infarction, as defined by clinical and MRI criteria, within 24 hours after stroke onset. Motor progression was defined as an increase of >2 points in the motor items of the National Institutes of Health Stroke Scale (NIHSS) within 7 days of stroke onset. The study population was divided into patients with and without motor progression, and risk factors, clinical features, and brain MRI/magnetic resonance angiograpy (MRA) findings were compared between these groups. Results: Motor progression was observed in 40% of the 80 patients. The independent variables associated with motor progression were a history of hypertension (OR=7.8, 95% CI=1.5- 39.8, p=0.013) and an initial infarct extent of ≥15 mm (OR=9.2, 95% CI=1.8-45.7, p=0.006). However, there were no differences in the initial NIHSS score, other stroke risk factors, vascular stenosis pattern, or cardioembolic source. Conclusions: Early motor progression in patients with striatocapsular-region infarction is associated with the initial extent of the lesion. However, the stroke mechanism and vascular stenosis did not differ between the motor progression and stable groups

말초성 전정병증과 유사한 임상양상으로 내원한 소뇌 혈관종 1예

반재호,이남훈,최현진,원유삼 대한평형의학회 2008 Research in Vestibular Science Vol.7 No.1

Central vertigo of cerebellar origin may present the syndromes similar to those of peripheral vertigo such as vestibular neuronitis. The character of those vertigo syndrome depend on the location, extent, and the etiology of the lesion such as stroke, inflammation, mass. Cavernous hemangioma may be clinically silent, but can cause variable neurologic manifestations including central vertigo if it affects the vestibular system. We report a rare case of cerebellar cavernous hemangioma with the vertigo syndrome closely mimicked vestibular neuronitis. Central vertigo of cerebellar origin may present the syndromes similar to those of peripheral vertigo such as vestibular neuronitis. The character of those vertigo syndrome depend on the location, extent, and the etiology of the lesion such as stroke, inflammation, mass. Cavernous hemangioma may be clinically silent, but can cause variable neurologic manifestations including central vertigo if it affects the vestibular system. We report a rare case of cerebellar cavernous hemangioma with the vertigo syndrome closely mimicked vestibular neuronitis.

Delayed Abdominal Pseudocyst after Ventriculoperitoneal Shunt Surgery: A Case Report

Soung Bin Yim,정연구,원유삼 대한말초신경학회 2018 The Nerve Vol.4 No.2

A 59-year-old man, who had a ventriculoperitoneal shunt (VPS) operation for the treatment of hydrocephalus due to cysticercosis 26 years prior, visited our hospital with increasing abdominal distention. An abdominal computed tomography (CT) scan showed well enhanced demarcated fluid collection about 20×18 cm around the distal catheter tip. We performed exploratory laparoscopy and inserted a drainage catheter into the abdominal cyst. All cyst fluid analyses and cultures were negative. Over the course of the next eight weeks, abdominal CT demonstrated that the pseudocyst decreased. Following removal of the drainage catheter, abdominal CT showed that the pseudocyst increased again. A drainage catheter was re-inserted and Taurolin® (Taurolidine) solution irrigation was performed for 3 months. Upon the completion of this 3 months, the patient complained of abdominal distension and abdominal CT found both that the pseudocyst was increased and doubted cystic infection. Eventually, an exploratory laparotomy and cyst resection were performed. Although the occurrence of pseudocyst following VPS surgery is a rare complication, it can cause additional complications such as obstruction and infection. If a patient has gastrointestinal symptoms, pseudocyst should be considered as one of the complications of VPS surgery.

수정체유화술 및 후방인공수정체삽입술 후 유수정체안과 위수정체안의 자세에 따른 안압비교

신고운(Ko Un Shin),이재연(Jae Yeun Lee),원유삼(Yu Sam Won),김준모(Joon Mo Kim) 대한안과학회 2017 대한안과학회지 Vol.58 No.2

Purpose: In the present study, the dependence of intraocular pressure (IOP) on body position was compared between pseudophakic and phakic eyes after cataract surgery performed at least 3 months prior. Methods: IOP was measured in 214 patients over 40 years of age who received cataract surgery at least 3 months prior. The present study included 104 patients who did not have any other ocular disease which could influence visual acuity or IOP. The IOP was measured in 4 different positions, sitting, supine, right decubitus, and left decubitus by a single skilled researcher using Icare tonometer. In addition, IOP was compared between the phakic and pseudophakic eyes, specifically, the dependent eye in the decubitus position. Results: The comparison between the phakic and pseudophakic eyes in patients after cataract surgery in a single eye showed IOP was not different between the sitting and supine positions; however, in the decubitus position, IOP in the dependent eye was significantly higher than the non-dependent eye (p = 0.001). Additionally, regardless of lens status, IOP was significantly higher in the dependent eye than non-dependent eye. Conclusions: Both body position and lens status can affect IOP. After cataract surgery, regardless of lens status, IOP was higher in the dependent eye than non-dependent eye of patients in the decubitus position.