시상하부 신경절교종 1례 - 증례보고 -

조용운,문재곤,박인석,전병찬,김한규,장희경,Cho, Yong Woon,Moon, Jae Gon,Park, In Suk,Jeon, Byung Chan,Kim, Han Kyu,Chang, Hee Kyung 대한신경외과학회 2000 Journal of Korean neurosurgical society Vol.29 No.5

The authors report a case of ganglioglioma in unusual site, the hypothalamus. The tumor was completely removed and no recurrence was noted on the follow up. Ganglioglioma usually occurs in the temporal and frontal lobe, but is rarely found on the hypothalamus. We report this case with pertinent literatual reviews.

혈액투석을 받고있는 환자에서 자발성 뇌출혈

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.

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.

뇌수술의 비방수성 경막 봉합

조용운,문재곤,황용순,박인석,전병찬,김한규,Cho, Yong Woon,Moon, Jae Gon,Hwang, Yong Soon,Park, In Suk,Jeon, Byung Chan,Kim, Han Kyu 대한신경외과학회 2000 Journal of Korean neurosurgical society Vol.29 No.5

Objective : In neurosurgical practice, it has been generally accepted that when the dura is opened, it should be watertightly closed, and traditionally non-watertight closure has not been performed. We clinically tried non-watertight closure, analyzed the frequency of CSF leakage and evaluated the possible clinical application of non-watertight closure. Methods : After classifying our cases with supratentorial and infratentorial approach, we tried non-watertight and watertight closures and compared the results. We also analyzed the cases with or without dural graft. Results : In supratentorial approach, the rate of cerebrospinal fluid leakage noted in non-watertight closure was similar to that of watertight closure. In infratentorial approach, except microvascular decompression(MVD), the rate of cerebrospinal fluid leakage in non-watertight closure was higher than that of watertight closure. Dura graft application did not seemed to influence the cerebrospinal fluid leakage. Conclusion : Since the frequency of cerebrospinal fluid leakage was not higher in non-watertight closure than that of watertight closure, non-watertight closure can be applied in supratentorial approach. In infratentorial approach, non-watertight closure may be applied in surgery with relatively short dural incision, such as MVD. However, non-watertight closure doesn't seem to be appropriate in surgery that requires wide dural incision, such as skull base surgery.

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.

제4뇌실의 수막종 -증 례 보 고-

한정인 ( Jungin Han ),김창현 ( Chang Hyun Kim ),문재곤 ( Jae Gon Moon ),조탁근 ( Tack Geun Cho ) 대한뇌종양학회 대한신경종양학회 2014 Brain Tumor Research and Treatment Vol.2 No.1

Less than 50 cases of primary fourth ventricular meningioma are reported in literature. Most of them are hypo- to iso-signal intensity on T1-weighted images and iso- to mildly hyper-signal intensity on T2-weighted images compared with gray matter. Contrast enhancement is strong in all tumors, and the enhancement is homogeneous in 69% and heterogeneous in 31%. It could be harder to differentiate meningiomas of the fourth ventricle from ependymomas and choroid plexus papilloma. Most meningiomas in the fourth ventricle adhere to the choroid plexus. We present a new case and summarize features of magnetic resonance images.

뇌수막종의 종양주위부종에 대한 임상적 고찰

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.

제4뇌실의 수막종 - 증례보고 -

한정인 ( Jung In Han ),김창현 ( Chang Hyun Kim ),문재곤 ( Jae Gon Moon ),조탁근 ( Tack Geun Cho ) 대한뇌종양학회·대한신경종양학회·대한소아뇌종양학회 2012 대한뇌종양학회지 Vol.11 No.2

Less than 50 cases of primary fourth ventricular meningioma are reported in literature. Most of them are hypo- to iso-signal intensity on T1-weighted images and iso- to mildly hyper-signal intensity on T2-weighted images compared with gray matter. Contrast enhancement is strong in all tumors, and the enhancement is homogeneous in 69% and heterogeneous in 31%. It could be harder to differentiate meningiomas of the fourth ventricle from ependymomas and choroid plexus papilloma. Most meningiomas in the fourth ventricle adhere to the choroid plexus. We present a new case and summarize features of magnetic resonance images.

요추-복강간 션트에 관한 임상적 고찰

문재곤,오성훈,최중언,김영수,정상섭,이규창 대한신경외과학회 1989 Journal of Korean neurosurgical society Vol.18 No.1

A series of 70 lumboperitoneal shunt performed at Yonsei univesity Severance hospital was reviewed. The clinical indications for this procdures were communicating hydrocephalus, CSF fistulas, benign intracranial hypertension and bulging craniectomy site. There were several complications such as shunt migration, obstruction, infection and nonfucnctioning. Wound dehiscence, epidural hematoma and inguinal hernia were also obseved after shunting. This procedure is completely extracranial and diminished intracranial complications, thereby significantly reducing morbidity and mortality. Good results were reported due to easy insertion, short operation time and reduced complications. This report documented the efficacy of lumboperitoneal shunt and literatures were reviewed.

Steroid Psychosis : 증례 보고

문재곤,김진학,황용순,이화동 대한신경외과학회 1994 Journal of Korean neurosurgical society Vol.23 No.7

The use of steroids has long been reported many side effects. Steroid-induced mental disorder is one of many complications associated with corticosteroid therapy. Steroid psychosis is not common disease but it may be more popular due to high steroid therapy such as pulse therapy or high dose steroid therapy. Euphoria, irritability, insomnia, and hallucination are predominating symptoms. The dosage, duration'of the treatment may not be correlated with the time of the onset, duration, severity, or type of mental disturbances, but the risk of developing psychosis is increased to the high dose of steroid. It is usually reversible on dose reduction or discontinuation of the drug,